Surgical Treatments for Peri-Implantitis

This trial aims to compare two types of surgeries for peri-implantitis, a condition involving inflammation around dental implants. One group will undergo resective surgery with implantoplasty (implant polishing), while the other will receive resective surgery with mechanical debridement (thorough cleaning without polishing). The researchers aim to assess how these treatments affect inflammation and healing. The trial seeks participants who have had dental implants for over a year, exhibit inflammation with bleeding, and have experienced bone loss around their implants. As an unphased trial, participants can contribute to valuable research that may enhance future dental treatments.

The trial does not specify if you need to stop taking your current medications. However, if you are using systemic corticosteroids, immunosuppressants, or antibiotics, you may not be eligible to participate.

Research has shown that both treatments in this study—resective surgery with implantoplasty and resective surgery with mechanical cleaning—are safe.

For resective surgery with implantoplasty, studies have found that dental implants remain durable over time. One study reported survival rates between 97.9% and 100% over several years, indicating that the treatment is generally safe and well-tolerated, with few long-term issues.

Resective surgery with mechanical cleaning has also undergone safety evaluation. Research indicates it effectively treats inflammation around dental implants, known as peri-implantitis, suggesting it is a safe choice for many patients.

Researchers are excited about these treatments for peri-implantitis because they offer innovative approaches to managing this challenging condition. Resective surgery with implantoplasty stands out by polishing titanium implant surfaces to reduce roughness and remove bacterial biofilm, potentially improving outcomes by minimizing the chances of future bacterial colonization. On the other hand, resective surgery with mechanical debridement uses submucosal air-polishing with a special powder, which could enhance cleaning effectiveness without the need for more invasive bone removal. These techniques aim to optimize healing and prevent further implant complications, offering promising alternatives to the standard of care, which often involves more conventional cleaning and decontamination methods.

This trial will compare two surgical treatments for peri-implantitis. Research has shown that both types of surgery can reduce inflammation and improve the area around dental implants affected by peri-implantitis. One treatment arm involves resective surgery with implantoplasty, which smooths the implant surface. This method has success rates between 66% and 79.5% in improving implant health, significantly reducing the space between the gum and implant, as well as bleeding and inflammation. The other treatment arm involves resective surgery with mechanical debridement, which cleans the implant surface without smoothing it. This method also effectively reduces signs of peri-implantitis, and studies suggest that with ongoing care, long-term improvement is possible in about 60% of cases. Both treatments are promising, but the best choice depends on the patient's specific needs and conditions.³⁶⁷⁸⁹