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Stability of peri-implantitis surgical reconstructive therapy—a (> 2 years) follow-up of a randomized clinical trial

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Abstract

Objectives

This follow-up study aimed to report the 24- and 30-month outcomes of a cohort previously enrolled in a randomized clinical trial on surgical reconstructive treatment of peri-implantitis.

Methods

Twenty-four patients were diagnosed with peri-implantitis and treated with surgical reconstructive therapy with or without the adjunctive use of Er:YAG laser. Within-group and between-group comparisons were tested with mixed model with repeated measures.

Results

Regarding peri-implant pocket depth (PPD) reduction (control vs. laser test group) between 6 months (− 1.85 vs. − 2.65 mm) and 30 months (− 1.84 vs. − 3.04 mm), the laser group showed statistically significant changes but not the control group. In terms of radiographic marginal bone loss (RMBL) at 6 months (− 1.1 vs. − 1.46 mm) to 24 months (− 1.96 vs. − 2.82 mm), both groups showed statistical difference compared to baseline. The six explanted implants all were featured by severe peri-implantitis and mostly with no or limited keratinized tissue (< 2 mm) at baseline and membrane exposure after surgery. Among the 15 retained cases, eight cases achieved more than 50% peri-implant bone level gain.

Conclusions

Within the limitation and follow-up time frame of this trial, the outcome of the surgical reconstructive therapy sustained or improved in most of the cases. However, 25% of the implants with severe peri-implantitis failed 2 years after the surgical reconstructive therapy. The use of Er:YAG laser favors PPD reduction in the longer term up to 30 months.

Clinical relevance

Longer-term follow-up on reconstructive therapy of peri-implantitis revealed sustained or improved stability in certain cases, but the survival of implants with severe peri-implantitis has its limitation, especially when there is limited keratinized tissue (< 2 mm or no KT).

Trial registration

Clinical Trials Registration Number: NCT03127228 and HUM00160290.

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Data Availability

The demographic information of the extracted implants were included in the supplemental table and other data is available upon request, but the results up to 6 months follow-up was published previously and the data was stated available together with the transcriptomics information [18].

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Funding

This follow-up study was supported by research grant from J. Morita (Tokyo, Japan) through the University of Michigan as well as from the Department of Periodontics and Oral Medicine Clinical Research Fund. Manuscript preparation is supported by the Taipei Medical University Research Fund (TMU110-AE1-B27) and the National Science and Technology Council, Taiwan R.O.C. (grant number: NSTC111-2314-B-038–162 to C.W.W.).

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Authors and Affiliations

  1. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA

    Chin-Wei Wang, Riccardo Di Gianfilippo, Alice Ou & Hom-Lay Wang

  2. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

    Chin-Wei Wang & Sheng-Wei Feng

  3. Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan

    Chin-Wei Wang & Sheng-Wei Feng

  4. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA

    Niko Kaciroti

Authors
  1. Chin-Wei Wang
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  2. Riccardo Di Gianfilippo
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  3. Niko Kaciroti
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  4. Alice Ou
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  5. Sheng-Wei Feng
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Contributions

CWW contributed to study conception, design, performing surgeries, data analysis, drafting of the article. RD contributed to manage study visits, data analysis, drafting of the article. AO contributed to project administration and manage study visits. NK contributed to data analysis. SWF contributed to critical review of the manuscript. HLW contributed to study conception, performing surgeries, and critical review of the article.

Corresponding author

Correspondence to Chin-Wei Wang.

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Conflict of interest

Dr. HL Wang has occasionally spoken on behalf of J. Morita and received honoraria for lectures. The other authors do not have any financial interests, either directly or indirectly, in the products or information listed in the article.

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Wang, CW., Di Gianfilippo, R., Kaciroti, N. et al. Stability of peri-implantitis surgical reconstructive therapy—a (> 2 years) follow-up of a randomized clinical trial. Clin Oral Invest 28, 30 (2024). https://doi.org/10.1007/s00784-023-05457-6

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