| 1. |
- Ichioka, Yuki, et al.
(författare)
-
Factors influencing outcomes of surgical therapy of peri-implantitis: A secondary analysis of 1-year results from a randomized clinical study
- 2023
-
Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979. ; 50:10, s. 1282-1304
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify predictors of treatment outcomes following surgical therapy of peri-implantitis.Materials and Methods: We performed a secondary analysis of data from a randomized controlled trial (RCT) comparing access flap with or without bone replacement graft. Outcomes at 12 months were probing pocket depth (PPD), bleeding on probing (BOP), soft-tissue recession (REC) and marginal bone level (MBL) change. Multilevel regression analyses were used to identify predictors. We also built an explanatory model for residual signs of inflammation.Results: Baseline PPD was the most relevant predictor, showing positive associations with final PPD, REC and MBL gain, and negative association with probability of pocket closure. Smokers presented higher residual PPD. Absence of keratinized mucosa at baseline increased the probability of BOP but was otherwise not indicative of outcomes. Plaque at 6 weeks was detrimental in terms of residual PPD and BOP. Treatment allocation had an effect on REC. Final BOP was explained by residual PPD & GE;6 mm and plaque at more than two sites.Conclusions: Baseline PPD was the most relevant predictor of the outcomes of surgical therapy of peri-implantitis. Pocket closure should be a primary goal of treatment. Bone replacement grafts may be indicated in aesthetically demanding cases to reduce soft-tissue recession. The importance of smoking cessation and patient-performed plaque control is also underlined.
|
|
| 2. |
- Regidor, E., et al.
(författare)
-
The adjunctive effect of a resorbable membrane to a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri-implantitis: A randomized clinical trial
- 2023
-
Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 50:6, s. 765-783
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the potential adjunctive effect of a resorbable collagen membrane covering a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri-implantitis. Materials and Methods: Forty-three patients (43 implants) diagnosed with peri-implantitis associated with intra-bony defects were treated with a surgical recon-structive approach that included a xenogeneic bone substitute material. Additionally, resorbable collagen membranes were placed over the grafting material at sites ran-domly allocated to the test group; conversely, no membranes were placed in the con-trol group. Clinical outcomes, namely probing pocket depth (PPD), bleeding and suppuration on probing (BoP and SoP), marginal mucosal level (REC) and keratinized mucosa width (KMW), were recorded at baseline and 6 and 12 months after surgery. Radiographic marginal bone levels (MBLs) and patient-reported outcomes (PROs) were assessed at baseline and 12 months. A composite outcome (success) was evalu-ated at 12 months, which included the absence of BoP/SoP, PPD <= 5 mm and reduction of buccal marginal mucosal level (buccal REC) of <= 1 mm.Results: At 12 months, no implants were lost and treatment success was observed at 36.8% and 45.0% of implants in the test and control groups, respectively (p = .61). Similarly, there were no significant differences between groups in terms of changes of PPD, BoP/SoP, KMW, MBL or buccal REC. Post-surgical complications were observed in the test group only (e.g., soft tissue dehiscence, exposure of particulate bone graft and/or resorbable membrane). Longer surgical times (similar to 10 min; p < .05) and higher levels of self-reported pain at 2 weeks (p < .01) were observed in the test group.Conclusions: This study failed to demonstrate the presence of added clinical or radio-graphic benefits of the use of a resorbable membrane to cover a bone substitute material within the reconstructive surgical therapy of peri-implantitis associated with intra-bony defects.
|
|
