Surgical therapy of advanced ligature-induced peri-implantitis defects: cone-beam computed tomographic and histological analysis

J Clin Periodontol. 2011 Oct;38(10):939-49. doi: 10.1111/j.1600-051X.2011.01739.x. Epub 2011 Aug 31.

Abstract

Objectives: To evaluate radiological bone level (RBL) (i.e. cone-beam computed tomography) and histological bone levels (HBL) as well as re-osseointegration [bone-to-implant contact (BIC)] after surgical resective (i.e. implantoplasty) and/or regenerative therapy of advanced ligature-induced peri-implantitis in dogs.

Material and methods: At all defect sites (n=6 dogs, n=48 implants), the intrabony component was filled with a particulate bovine-derived natural bone mineral (NBM). The supracrestal component was treated by either the application of an equine bone block (EB) or implantoplasty. In a split-mouth design, NBM and EB were soak-loaded with recombinant human bone morphogenetic protein (rhBMP)-2 or sterile saline. All sites were covered by a native collagen membrane and left to heal in a submerged position for 12 weeks.

Results: A premature wound exposure was observed at nine defect sites. Mean RBL and HBL values were lowest in the P+rhBMP-2 group, reaching statistical significance when compared with the EB group. Mean BIC values were comparable in all groups. Within-group comparisons commonly revealed a close correlation between RBL and HBL values.

Conclusions: It was concluded that (i) in all groups the investigations failed to predictably obtain complete defect resolution, (ii) the surgical procedure was associated with high exposure rates, and (iii) RBL was closely correlated with HBL.

MeSH terms

  • Alveolar Bone Loss / surgery*
  • Animals
  • Bone Morphogenetic Protein 2 / therapeutic use
  • Bone Regeneration
  • Bone Substitutes
  • Bone Transplantation
  • Cone-Beam Computed Tomography / methods*
  • Dogs
  • Ligation
  • Observer Variation
  • Osseointegration
  • Peri-Implantitis / diagnostic imaging*
  • Peri-Implantitis / pathology
  • Peri-Implantitis / surgery*
  • Plastic Surgery Procedures
  • Recombinant Proteins / therapeutic use

Substances

  • Bone Morphogenetic Protein 2
  • Bone Substitutes
  • Recombinant Proteins