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Nonsurgical Treatment of Peri-implantitis Without Eliminating Granulation Tissue

A 3-Year Study

Crespi, Roberto, MD, MS*; Marconcini, Simone, DDS, PhD, MS; Crespi, Giovanni, MD; Giammarinaro, Enrica, DDS§; Menchini Fabris, Giovanni Battista, DDS; Barone, Antonio, DDS, PhD, MS; Covani, Ugo, MD#

doi: 10.1097/ID.0000000000000832
Basic and Clinical Research
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Objectives: The purpose of this study was to evaluate a nonsurgical approach toward peri-implantitis by means of mechanical debridement and local detoxification leaving granulation tissue into the peri-implant pockets.

Materials and Methods: An analysis was performed on the outcomes of 2 nonsurgical protocols: mechanical debridement plus chemical detoxification with 0.2% chlorhexidine and chlortetracycline hydrochloride (test), and mechanical debridement alone (control). Measures were collected at baseline, 3, 24, and 36 months after treatment.

Results: Seventy-five implants with peri-implantitis were included. At a 36-month evaluation, mean pocket probing depth was 3.15 ± 0.32 mm for the test group and 5.97 ± 0.90 mm for the control group, the difference being significant. An improvement of marginal bone level was recorded for the test group, whether the control group showed a further marginal bone loss. Treatment success was 100% in the test group and 31.4% in the control group.

Conclusion: Nonsurgical implant debridement alone seemed not efficient in the treatment of peri-implantitis. Further longitudinal studies are required to evaluate the efficacy of mechanical debridement with chemical detoxification and removal of granulation tissues against mechanical debridement with chemical detoxification alone.

*Professor, Department of Dentistry, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy.

Researcher, Department of Surgical, Medical, Molecular and Critical Area Pathology, University-Hospital at Pisa, University of Pisa, Pisa, Italy; Responsible for Research at the Tuscan Dental Institute, Foundation for Dental Clinic, Research and Continuing Education, Versilia General Hospital, Lido di Camaiore, Lucca, Italy.

Researcher, Department of Dentistry, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy.

§Researcher, Department of Surgical, Medical, Molecular and Critical Area Pathology, University-Hospital at Pisa, University of Pisa, Pisa, Italy; Researcher at the Tuscan Dental Institute, Foundation for Dental Clinic, Research and Continuing Education, Versilia General Hospital, Lido di Camaiore, Lucca, Italy.

Researcher at the Tuscan Dental Institute, Foundation for Dental Clinic, Research and Continuing Education, Versilia General Hospital, Lido di Camaiore, Lucca, Italy.

Full Professor, Unit of Oral Surgery and Implantology, Department of Surgery, School of Dental Medicine, University Hospital at Geneva, Geneva, Switzerland.

#Full Professor, Department of Surgical, Medical, Molecular and Critical Area Pathology, University-Hospital at Pisa, University of Pisa, Italy; Director of the Tuscan Dental Institute, Foundation for Dental Clinic, Research and Continuing Education, Versilia General Hospital, Lido di Camaiore, Lucca, Italy.

Reprint requests and correspondence to: Simone Marconcini, DDS, PhD, MSc, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via G. Rosini 7, Pisa 56124, Italy, Phone: +39 (050) 575882, Fax: +39 (050) 575882, E-mail: simosurg@gmail.com

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