Peri-Implant Reconstruction With Autogenous Bone and Electrolytic Therapy: A Randomized Controlled Clinical Trial.

OBJECTIVES

To evaluate the efficacy of peri-implant reconstructive therapy using autogenous tuberosity bone grafts, with or without adjunctive electrolytic therapy, as part of surgical treatment for peri-implantitis.

METHODS

This randomized controlled clinical trial included 31 patients diagnosed with peri-implantitis. Participants were assigned to either a control group receiving mechanical debridement and bone grafting or a test group undergoing additional electrolytic cleaning (EC). Clinical parameters assessed included probing pocket depth (PPD) at mesial, buccal, distal, and lingual sites, gingival index (GI), and bleeding on probing (BOP), with measurements taken at baseline and at 12 months post-treatment. Radiographic assessments were conducted at baseline and at the 1-year follow-up to evaluate bone defect fill at mesial and distal sites. Intraoperative bone fill was also assessed at mesial, buccal, distal, and lingual sites on the day of surgery and 6 months post-surgery.

RESULTS

Both groups exhibited statistically significant PPD reductions at all sites and improvements in GI and BOP compared to baseline. No statistically significant differences between groups were found for these clinical parameters. Radiographically, the test group demonstrated significantly greater mean bone defect fill at the mesial site compared to the control group, with gains of 4.6 mm (±1.10 mm) versus 2.5 mm (±1.77 mm), respectively (p = 0.002). Intraoperatively, the distal site showed a mean gain of 4.7 mm (±1.41 mm) in the test group and 3.8 mm (±1.72 mm) in the control group after 6 months; however, this difference was not statistically significant (p = 0.069). Suppuration resolved completely in both groups after 1 year (p < 0.001), with no significant differences between groups.

CONCLUSIONS

Peri-implant reconstructive therapy using autogenous bone grafts led to statistically significant clinical and radiographic improvements in both groups. The addition of electrolytic cleaning did not result in significant differences. The absence of histological data, which could not be obtained in this human trial, remains a limitation for confirming re-osseointegration.