Peri-implantitis
Conditions
Interventions
- 3- and 4-wall bone defects: the use of bone substitutes
- 0-, 1- and 2-wall defects: the use of systemic amoxicillin and metronidazole
Sponsors
University Medical Center Groningen
Eligibility
Inclusion criteria
Inclusion criteria: - the patient is =18 years of age; - adult patients with at least one endosseous implant in the oral cavity with clinical and radiographical evidence of peri-implantitis. Peri-implantitis is defined as probing pocket depth (PPD) of = 6mm in combination with bleeding on probing (BOP) or suppuration on probing (SOP) and radiographic bone loss of =3mm after placing the definitive suprastructure (Berglundh et al. 2018); - the implants have been in function for at least 2 years; - the patient is capable of understanding and giving informed consent.
Exclusion criteria
Exclusion criteria: Exclusion criteria prior to pre-treatment: - medical and general contra-indications for the procedure; - a history of local radiotherapy to the head and neck region; - pregnancy and lactation; - uncontrolled diabetes mellitus (HbA1c <7% or <53 mmol/mol); - use of intravenous bisphosphonates; - known allergy to chlorhexidine, amoxicillin and/or metronidazole; - long-term use of anti-inflammatory drugs - patient is incapable of performing basic oral hygiene measures as a result of physical or mental disorders; - implants with bone loss exceeding 2/3 of implant length or implants with bone loss beyond the transverse openings in hollow implants; - previous surgical treatment of the peri-implantitis lesions; - chronic bronchitis or asthma. Additional exclusion criteria after pre-treatment: - no peri-implantitis remaining: minor BoP (< 20%), PPD < 6mm, plaque < 20%; - active periodontal disease at the remaining dentition (PPD = 6mm, BOP = 20%) or insufficient oral hygiene (plaque = 20%); - use of antibiotics during the last 3 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| -Mean peri-implant bleeding on probing (BoP) | — |
Secondary
| Measure | Time frame |
|---|---|
| - Full-mouth BoP; - Mean peri-implant and full mouth suppuration on probing score (SoP); - Mean peri-implant probing and full-mouth pocket depth (PPD) - Mean radiographical bone height in millimetres - Marginal soft tissue recession (REC) - Radiographic marginal peri-implant bone level and bone defect configuration on standardized intraoral radiographs and cone-beam computed tomographies - Microbiological composition of the peri-implant and periodontal area; - Implant failure, defined as implant mobility of previously osseointegrated implants and removal of non-mobile implants because of progressive marginal bone loss or infection; - Tooth loss, defined as removal of teeth because of progressive marginal bone loss or infection; - failure of peri-implantitis treatment at 12 months after treatment: probing pocket depth (PPD) of = 6mm in combination with bleeding on probing (BOP) or suppuration on probing (SOP) and progressive radiographical peri-implant bone loss - Complication and adverse events | — |
Contacts
Public ContactJarno Hakkers
University Medical Center Groningen
Outcome results
None listed