Abstract
Background: To evaluate the 10-year implant survival outcome of surgical management of peri-implantitis with crater-like bone defect by combination of deproteinised bovine bone mineral with 10% collagen (DBBMC), enamel matrix derivative (EMD) and Doxycycline powder (BED).
Description of the procedure: The original population consisted of 30 patients with peri-implantitis (BoP/suppuration, probing depth > 4 mm), minimum radiographic bone loss of 20%, at least 2 years in function (Mercado et al., Clin Oral Implant Res, 2018; 29:583-591). Following surgical access and debridement, the implant surfaces were decontaminated with 24% EDTA for 2 min, the bone defects were filled with BED cocktail. The defects were covered with connective tissue grafts where necessary. All the patients were enrolled in an individualised supportive periodontal and implant therapy (SPIT) program.
Outcomes: Twenty-nine patients reached the 10-year review period (96.6% survival rate). During SPIT, 12 implants needed further antibiotic therapy, and one implant had to be removed. PD was reduced from 8.90 ± 1.9 to 3.06 ± 0.98 mm and the percentage bone loss reduced from 57 ± 16.5 to 13 ± 2.5 after 10 years. There were no statistically significant differences in the clinical parameters measured at the 5th and 10th year. 60% of the implants were considered successful (Successful Treatment Outcome Criterion: PD < 5 mm, no further bone loss > 10%, no BoP/suppuration, no recession > 0.5 mm for anterior implants) after 10 years.
Conclusions: The surgical management of peri-implantitis using the BED cocktail followed by personalised SPIT, resulted in high survival rate of peri-implantitis affected implants. The benefits of this protocol incorporating EMD and xenograft should be tested in multi-centre randomised clinical trials.
Poster presentation.