Surgical Management of Peri-implantitis
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PERI-IMPLANTITIS (I DARBY, SECTION EDITOR)
Surgical Management of Peri-implantitis Ausra Ramanauskaite 1 & Karina Obreja 1 & Frank Schwarz 1
# The Author(s) 2020
Abstract Purpose of Review To provide an overview of current surgical peri-implantitis treatment options. Recent Findings Surgical procedures for peri-implantitis treatment include two main approaches: non-augmentative and augmentative therapy. Open flap debridement (OFD) and resective treatment are non-augmentative techniques that are indicated in the presence of horizontal bone loss in aesthetically nondemanding areas. Implantoplasty performed adjunctively at supracrestally and buccally exposed rough implant surfaces has been shown to efficiently attenuate soft tissue inflammation compared to control sites. However, this was followed by more pronounced soft tissue recession. Adjunctive augmentative measures are recommended at peri-implantitis sites exhibiting intrabony defects with a minimum depth of 3 mm and in the presence of keratinized mucosa. In more advanced cases with combined defect configurations, a combination of augmentative therapy and implantoplasty at exposed rough implant surfaces beyond the bony envelope is feasible. Summary For the time being, no particular surgical protocol or material can be considered as superior in terms of long-term periimplant tissue stability. Keywords Peri-implantitis . Treatment . Surgical therapy
Introduction Peri-implantitis is a plaque-associated pathological condition occurring around dental implants that results in a breakdown of the supporting tissues [1•, 2••]. Clinically, peri-implantitisaffected sites exhibit bleeding on probing (BOP) and/or suppuration (Supp), increased probing depths (PDs), and/or recession of the peri-implant mucosal margin in addition to radiographic bone loss compared to previous examination [1•]. Untreated disease progresses in nonlinear accelerating pattern and finally leads to a loss of the implant [3••, 4]. As the number of patients undergoing restorative therapy through dental implants increases, peri-implantitis is considered to be a major and growing problem in dentistry [4]. The primary goal of peri-implantitis treatment has been established as a resolution of the inflammation and a prevention This article is part of the Topical Collection on Peri-implantitis * Ausra Ramanauskaite [email protected] 1
Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
of further bone loss [5]. To achieve these treatment endpoints, it is currently accepted that surgical approaches that allow adequate access to the contaminated implant surface are required [6–8]. Indeed, numerous peri-implantitis surgical treatment protocols have been proposed, which basically can be categorized into two main modalities: non-augmentative and augmentative. The aim of this narrative review is to provide an overview of various peri-implantitis surgical treatment strategies with regard to their indications, performance, and efficacy.
Non-augmentati
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