Dental News - Novel surgical procedure may help combat peri-implantitis

Dental Tribune International

Thu. 13. July 2017

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SEOUL, South Korea: The most common cause of peri-implantitis is the formation of a biofilm on the implant surface. Thus, effectively decontaminating the affected surface is essential for avoiding implant failure. Researchers in South Korea have now tested a novel surgical procedure and shown promising results in combating this inflammation.

In two case studies of male patients over the age of 50 who exhibited severe peri-implantitis, the clinicians used the R-Brush (Neobiotech), a round brush with titanium alloy bristles, to clean the affected implant surfaces. In addition, a regenerative approach incorporating bone grafting materials was used to rebuild the bone surrounding the implant.

The titanium brush proved to be highly effective at removing biofilm from the implant surface, the researchers noted. In addition to eliminating the contaminated original rough surface, the brush created a new rough implant surface. This newly created surface made the regenerative process more successful and predictable, the follow-up assessment at three, six and 12 months after treatment indicated.

During the two-year follow-up, the bone level was maintained. Periapical radiographs showed that the alveolar bone height was stable, and no bone resorption was observed mesially or distally.

The results are in line with those of previous studies that have shown that re-osseointegration can occur on surfaces previously contaminated by dental plaque and surrounded by a bone defect. Although there is no similar protocol in the treatment of severe peri-implantitis yet, the two cases in which the R-Brush was used suggest that open debridement may result in re-osseointegration and that this integration may be more pronounced on a rougher implant surface, the researchers wrote.

In addition to its promising results, the procedure has one significant advantage compared with conservative therapies for removing debris, which include the use of metallic curettes with an adjunct of local or systematic antibiotics, as well as laser and ultrasonic devices: it has a very short chair time. In one of the cases, it took about 4 minutes to treat the eight exposed threads with the R-Brush, the researchers noted in their paper.

However, owing to the small number of cases considered, the efficacy of the described method needs further investigation in clinical trials, the researchers concluded.

The study, titled “Treatment of severe peri-implantitis using a round titanium brush for implant surface decontamination: A case report with clinical reentry”, was published in the June issue of the Journal of Oral Implantology.

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