Clinical and radiographic outcomes of a combined resective and regenerative approach in the treatment of peri-implantitis: a prospective case series

Aim To assess the clinical and radiographic outcomes applying a combined resective and regenerative approach in the treatment of peri‐implantitis. Materials and methods Subjects with implants diagnosed with peri‐implantitis (i.e., pocket probing depth (PPD) ≥5 mm with concomitant bleeding on probing (BoP) and ≥2 mm of marginal bone loss or exposure of ≥1 implant thread) were treated by means of a combined approach including the application of a deproteinized bovine bone mineral and a collagen membrane in the intrabony and implantoplasty in the suprabony component of the peri‐implant lesion, respectively. The soft tissues were apically repositioned allowing for a non‐submerged healing. Clinical and radiographic parameters were evaluated at baseline and 12 months after treatment. Results Eleven subjects with 11 implants were treated and completed the 12‐month follow‐up. No implant was lost yielding a 100% survival rate. At baseline, the mean PPD and mean clinical attachment level (CAL) were 8.1 ± 1.8 mm and 9.7 ± 2.5 mm, respectively. After 1 year, a mean PPD of 4.0 ± 1.3 mm and a mean CAL of 6.7 ± 2.5 mm were assessed. The differences between the baseline and the follow‐up examinations were statistically significant (P = 0.001). The mucosal recession increased from 1.7 ± 1.5 at baseline to 3.0 ± 1.8 mm at the 12‐month follow‐up (P = 0.003). The mean% of sites with BoP+ around the selected implants decreased from 19.7 ± 40.1 at baseline to 6.1 ± 24.0 after 12 months (P = 0.032). The radiographic marginal bone level decreased from 8.0 ± 3.7 mm at baseline to 5.2 ± 2.2 mm at the 12‐month follow‐up (P = 0.000001). The radiographic fill of the intrabony component of the defect amounted to 93.3 ± 13.0%. Conclusion Within the limits of this study, a combined regenerative and resective approach for the treatment of peri‐implant defects yielded positive outcomes in terms of PPD reduction and radiographic defect fill after 12 months.