Stomatologiia · 2026
[Retrospective analysis of the effectiveness of complex therapy for peri-implantitis: from antibacterial sanitation to bioregenerative strategies].
СтатьяМногоцентровое исследованиеАннотация на английскомНазвание и аннотация: Оригинал на русском
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Sirak S V, Perikova M G, Bykova N I
Аннотация
OBJECTIVE: To analyze the effectiveness of complex therapy for peri-implantitis based on bioregenerative technologies over a 3-year observation period, with an assessment of the dynamics of bone tissue growth and probing depth.
MATERIAL AND METHODS: A retrospective multicenter study analyzed 86 clinical cases of peri-implantitis in 86 patients with Osstem (South Korea) TS-series SA-coated implants. All peri-implantitis cases were managed according to a uniform protocol: surgical access, mechanical and chemical removal of microbial biofilm, filling of the defect with a 1:1 mixture of allogeneic bone graft material and autologous platelet-leukocyte concentrate (APLC), application of a bioresorbable membrane, and infiltration of the APLC into the flap tissue. The assessment included peri-implant pocket depth (PID), bleeding index (PBI), implant stability quotient (ISQ), bone loss (CBCT), and recurrence rate at 6, 12, 24, and 36 months. Success was defined as a decrease in PID of at least 2 mm, the absence of progressive bone loss (less than 0.5 mm per year), an increase in ISQ of at least 3 points, and the absence of recurrent inflammation over three years. The removed dental implants and surrounding bone were subjected to histological processing and microscopic examination.
RESULTS: Successful treatment was recorded in 60 patients (69.8%). The average ISQ increase was +9.3 points (p<0.001), bone tissue gain was +0.7±0.5 mm (p<0.001). Progression of bone loss was observed in only 15.1% of patients. Relapses (new inflammation with bone loss) occurred in 12 patients (14.0%). Systemic antibiotics were used in only 4.7% of cases. Implant loss was 4.7% (4/86), all in the group of severe peri-implantitis with associated risk factors. Success correlated with hygiene (p<0.001) and smoking cessation (p=0.012). The bone tissue around the removed implants contains a large number of osteoclasts and macrophages, which corresponds to a high level of inflammation.
CONCLUSION: A comprehensive bioregenerative strategy using allogeneic osteoplastic material in the form of mineralized spongy powder and ATLC provides high clinical efficacy, bone tissue stabilization, and a significant reduction in recurrence rates compared to traditional methods. This protocol minimizes the use of systemic antibiotics and offers a promising alternative for the treatment of chronic peri-implantitis.
MATERIAL AND METHODS: A retrospective multicenter study analyzed 86 clinical cases of peri-implantitis in 86 patients with Osstem (South Korea) TS-series SA-coated implants. All peri-implantitis cases were managed according to a uniform protocol: surgical access, mechanical and chemical removal of microbial biofilm, filling of the defect with a 1:1 mixture of allogeneic bone graft material and autologous platelet-leukocyte concentrate (APLC), application of a bioresorbable membrane, and infiltration of the APLC into the flap tissue. The assessment included peri-implant pocket depth (PID), bleeding index (PBI), implant stability quotient (ISQ), bone loss (CBCT), and recurrence rate at 6, 12, 24, and 36 months. Success was defined as a decrease in PID of at least 2 mm, the absence of progressive bone loss (less than 0.5 mm per year), an increase in ISQ of at least 3 points, and the absence of recurrent inflammation over three years. The removed dental implants and surrounding bone were subjected to histological processing and microscopic examination.
RESULTS: Successful treatment was recorded in 60 patients (69.8%). The average ISQ increase was +9.3 points (p<0.001), bone tissue gain was +0.7±0.5 mm (p<0.001). Progression of bone loss was observed in only 15.1% of patients. Relapses (new inflammation with bone loss) occurred in 12 patients (14.0%). Systemic antibiotics were used in only 4.7% of cases. Implant loss was 4.7% (4/86), all in the group of severe peri-implantitis with associated risk factors. Success correlated with hygiene (p<0.001) and smoking cessation (p=0.012). The bone tissue around the removed implants contains a large number of osteoclasts and macrophages, which corresponds to a high level of inflammation.
CONCLUSION: A comprehensive bioregenerative strategy using allogeneic osteoplastic material in the form of mineralized spongy powder and ATLC provides high clinical efficacy, bone tissue stabilization, and a significant reduction in recurrence rates compared to traditional methods. This protocol minimizes the use of systemic antibiotics and offers a promising alternative for the treatment of chronic peri-implantitis.