EC Dental Science

Review Article Volume 22 Issue 1 - 2023

A Regenerative Approach for Management of Peri-Implantitis

Mohamed Hany Ahmad Fouad1*, Abrar Abdrabalameer Almarzouq2, Ahmed Mosa Alharbi2, Ali Madhah Alshehri2, Areej Ali Alhaddad2, Afrah Ahmed Alkhars2, Mohammed Hashem Aboalrahi2, Bader Kazem Bader Aleid2, Abdulrahman Moedh Alqhtani2, Arafa Ali Al Mahroos2, Fatimah Hassan Almubarak2, Wael Abdullah Alshehri2, Abdulaziz Mohammad Namsha2, Amal Kamal Jumaymi3 and Wael Ahmed Khumayes3

1Cairo University, Egypt
2Ministry of Health, Saudi Arabia
3Armed Forces Hospital, Saudi Arabia

*Corresponding Author: Mohamed Hany Ahmad Fouad, Professor of Restorative Dentistry, Registered in Saudi Commission for Health Specialties as Consultant, Saudi Arabia. Email:, Number: 05JD0323.
Received: December 05, 2022; Published: December 09, 2022

Introduction: Peri-implantitis is an inflammatory process at a specific site and infectious disease that causes inflammation in soft tissues as well as bone loss around an osseointegrated implant. The etiology of peri-implantitis depends on the status and condition of the tissue surrounding the implant, the type of implant design, external morphology, degree of roughness, and excessive mechanical load. The most common microorganisms associated with implant failure are Gram-negative anaerobes (mobile forms) and spirochetes, except the etiology, which is a result of mechanical overload. Diagnosis is made on the basis of bleeding and probing depth of peri-implant pockets, suppuration, changes of color in the gingiva of surrounding tissues, and X-ray of the implant region to assess gradual loss of bone height around the implant tooth. Treatment varies according to the case, whether it is peri-implantitis or peri-implant mucositis. The first and most important step in the management of peri-implantitis is to control the infection by surface decontamination, the detoxification of the surface of the implant, followed by regeneration of the alveolar bone. Resective and regenerative techniques are the two surgical techniques available to clinicians to treat peri-implant diseases. Although the variety of investigations present currently that aim to identify the etiology for peri-implantitis, the best approach to treat implant infection is yet not completely clear and has no universally recognized protocol for treatment. A new regenerative approach seems to be promising in managing implant infection.

Aim of the Study: The aim of the present review is to understand the recent regenerative approach for the management of peri-implantitis.

Methodology: The review is a comprehensive research of PUBMED, Crossref since the year 1998 to 2021.

Conclusion: In reconstructive peri-implant therapy, regenerative surgical techniques have shown good efficacy in the management of peri-implant infection and related parameters. Despite ongoing research, there is yet not enough evidence to select a specific grafting material or membrane that would have long-term benefits. No particular surface decontamination treatment can be considered better that can influence the clinical outcomes of regenerative treatment of peri-implantitis. Peri-implant bone defect morphology is an important factor that influences the final outcomes. Regenerative therapies for the treatment of peri-implantitis are confined to specific and selected clinical scenarios.

Keywords: Peri-Implantitis; Bone Defect; Regenerative Therapy

  1. Mombelli A and Lang NP. “The diagnosis and treatment of peri‐implantitis”. Periodontology 20001 (1998): 63-76.
  2. Georgiev T. “Method of treatment of periimplantitis”. Journal of IMAB-Annual Proceeding (Scientific Papers) 2 (2009).
  3. Smile D and Soltan M. “The bone-grafting decision tree: a systematic methodology for achieving new bone”. Implant Dentistry2 (2006): 122-128.
  4. van der Reijden W., et al. “Microbiota around root-formed endosseous implants. A review of the literature”. International Journal of Oral and Maxillofacial Implants 6 (2002): 829-838.
  5. Prathapachandran J and Suresh N. “Management of peri-implantitis”. Dental Research Journal5 (2012): 516-521.
  6. Berglundh T., et al. “Peri‐implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions”. Journal of Periodontology 89 (2018): S313-S318.
  7. Renvert S., et al. “Peri‐implant health, peri‐implant mucositis, and peri‐implantitis: Case definitions and diagnostic considerations”. Journal of Clinical PeriodontologyS20 (2018): S278-S285.
  8. Mordini L., et al. “Peri-Implantitis Regenerative Therapy: A Review”. Biology8 (2021): 773.
  9. Almohandes A., et al. “Re‐osseointegration following reconstructive surgical therapy of experimental peri‐implantitis. A pre‐clinical in vivo study”. Clinical Oral Implants Research5 (2019): 447-456.
  10. Renvert S., et al. “Re‐osseointegration on previously contaminated surfaces: a systematic review”. Clinical Oral Implants Research4 (2009): 216-227.
  11. Schwarz F., et al. “Comparison of naturally occurring and ligature‐induced peri‐implantitis bone defects in humans and dogs”. Clinical Oral Implants Research2 (2007): 161-170.
  12. Aghazadeh A., et al. “Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis”. International Journal of Implant Dentistry1 (2020): 33.
  13. Schwarz F., et al. “Surgical therapy of advanced ligature‐induced peri‐implantitis defects: cone‐beam computed tomographic and histological analysis”. Journal of Clinical Periodontology10 (2011): 939-949.
  14. Koo KT., et al. “Implant surface decontamination by surgical treatment of periimplantitis: A literature review”. Implant Dentistry2 (2019): 173-176.
  15. Roccuzzo M., et al. “Surgical therapy of peri‐implantitis lesions by means of a bovine‐derived xenograft: Comparative results of a prospective study on two different implant surfaces”. Journal of Clinical Periodontology8 (2011): 738-745.
  16. Nart J., et al. “Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri-implantitis: a 1-year follow-up case series”. Clinical Oral Investigations6 (2018): 2199-2207.
  17. Suárez‐López del Amo F., et al. “Dental implants‐associated release of titanium particles: A systematic review”. Clinical Oral Implants Research11 (2018): 1085-1100.
  18. Schou, S., et al. “Anorganic porous bovine‐derived bone mineral (Bio‐Oss®) and ePTFE membrane in the treatment of peri‐implantitis in cynomolgus monkeys”. Clinical Oral Implants Research5 (2003): 535-547.
  19. Jepsen K., et al. “Reconstruction of peri-implant osseous defects: a multicenter randomized trial”. Journal of Dental Research1 (2016): 58-66.

Mohamed Hany Ahmad Fouad., et al. “A Regenerative Approach for Management of Peri-Implantitis”.”. EC Dental Science 22.1 (2023): 46-54.