Clinical Outcomes in the Non-Surgical Treatment of Peri-Implantitis After Removing the Suprastructure Prior to Treatment - A Retrospective Case Series.

PURPOSE: To retrospectively explore the effect of suprastructure removal prior to non-surgical treatment of peri-implantitis on clinical parameters. MATERIALS AND METHODS: The electronic patient health record (EHR) of a practice restricted to periodontology and implantology was searched to identify all subjects who had at least one implant with peri-implantitis and received non-surgical treatment after suprastructure removal. The implant was cleaned with both ultrasonic devices and metal manual instruments, and oral hygiene self-care instructions were given to the patient. The suprastructure was cleaned in the dental laboratory and temporarily replaced with a healing abutment. Clinical parameters at baseline and 3 months post-therapy were retrieved from the EHR. These included peri-implant pocket depth (PPD), bleeding on implant probing (BoIP), suppuration on probing (SUP), and recession (REC). Data at 3 months were compared to data from the baseline assessment. In addition, the photographs were evaluated with the gingival index (GI) and bone loss was estimated from the radiographs. RESULTS: Eleven patients with 15 implants were included in the study. After 3 months, a statistically significant reduction of mean PPD (from 6.1 mm to 3.3 mm) was observed (p = 0.001). The percentage of BoIP-positive sites was reduced from 94% to 28% (p = 0.001), and the percentage of SUP-positive sites was reduced from 29% to 2% (p = 0.011). REC did not show a statistically significant change (p = 0.398). The GI decreased from 0.93 to 0.40 (p = 0.005). CONCLUSION: Non-surgical treatment of peri-implantitis, including removal and laboratory cleaning of implant suprastructures combined with temporary replacement by a healing abutment, showed improvement of clinical peri-implant health parameters.