Do systemic amoxicillin and metronidazole during the non-surgical peri-implantitis treatment phase prevent the need for future surgical treatment? A retrospective long-term cohort study.

AIM: The aim of this retrospective long-term follow-up of a 3-month RCT was to assess whether non-surgical peri-implantitis treatment with adjunctive systemic antibiotics influenced the need for additional surgical treatment. MATERIALS AND METHODS: Patients enrolled in an aftercare programme following non-surgical peri-implantitis treatment, with or without systemic amoxicillin and metronidazole, were analysed. Data had previously been collected pre-treatment (T0) and 3 months after treatment (T1) and were additionally collected during subsequent aftercare visits, until the final assessment (T2). Primary outcome was the need for additional surgical peri-implantitis therapy during the aftercare programme, analysed via Kaplan-Meier analysis and Cox regression. Secondary outcomes involved clinical parameters, assessed using parametric and non-parametric tests. RESULTS: Forty-five patients (22 AB- group, 23 AB+ group) were included. The mean follow-up time between T1 and T2 was 35.9 months (SD = 21.0). 73.9% of the AB+ group and 50.0% of the AB- group did not receive additional surgical therapy (log-rank test, p = .110). The adjusted Cox regression model did not provide a significant result for antibiotics (ß = .441, 95% CI = 0.159-1.220, p = .115). Univariable regression analysis highlighted the influence of baseline peri-implant pocket depth on the need for surgical treatment (ß = 1.446, 95% CI = 1.035-2.020, p = .031). CONCLUSIONS: Systemic amoxicillin and metronidazole administered during non-surgical peri-implantitis treatment do not seem to prevent the need for additional surgical therapy in the long term, during a structured aftercare programme.

Analysis of 8.5 mm Long Dental Implants Provided with Splinted or Solitary Implant Restorations: A 15-Year Prospective Study.

Background/Objectives: The long-term effects of implant properties, such as implant length, platform switch, and crown splinting, on peri-implant health require more investigation. Therefore, the aim was to assess the long-term peri-implant health and patient satisfaction in a patient cohort, obtained from two prospective randomized controlled trials, who received 8.5 mm long dental implants, with either splinted or solitary suprastructures and with or without a platform switch, over a period of 15 years. Methods: One hundred and twenty-two patients received either one or two 8.5 mm long dental implants (223 dental implants) with and without platform switch, restored with either a solitary (n = 89) or a splinted (n = 134) restoration in the posterior region. Clinical and radiographical parameters and patient satisfaction were prospectively recorded at 1 month, and 1, 5, and 15 years after the placement of the restoration. Patient satisfaction was recorded with a self-administered questionnaire using a 5-point scale and a visual analog scale (0-10). Results: Eighty-one patients with one hundred and fifty-four implants were assessed after a 15-year follow-up. The clinical parameters were low and comparable between the implant types (OsseoTite XP Certain, OsseoTite XP Certain Prevail, NanoTite XP Certain, NanoTite XP Certain Prevail, PalmBeach Gardens, FL, USA) over time. The implants that incorporated a platform switch showed significantly less bone loss than the implants without a platform switch (-0.37 mm, 95% CI -0.69 to -0.05 mm, p = 0.024 and ß = -0.47, 95% CI -0.80 to -0.14, p = 0.006). The implants with splinted restorations experienced more bone loss over time compared to the implants with solitary restorations (0.39 mm, 95% CI 0.15-0.63, p = 0.002). Patient satisfaction was high after 15 years. Conclusions: All the tested dental implants with 8.5 mm length provide satisfactory 15-year results with regard to the clinical and radiographical parameters as well as patient satisfaction. The platform-matched implants were associated with more bone loss compared to the platform-switched implants, and the implants with splinted crowns portrayed more bone loss than the solitary implant crowns.

The Peri-Implant Microbiome-A Possible Factor Determining the Success of Surgical Peri-Implantitis Treatment?

The objective was to assess the effect of peri-implantitis surgery on the peri-implant microbiome with a follow-up of one year. A total of 25 peri-implantitis patients in whom non-surgical treatment has failed to solve peri-implantitis underwent resective surgical treatment. Their peri-implant pockets were sampled prior to surgical treatment (T0) and one year post treatment (T12). The natural dentition was sampled to analyse similarities and differences with the peri-implantitis samples. Treatment success was recorded. The change in microbial relative abundance levels was evaluated. The microbiota was analysed by sequencing the amplified V3-V4 region of the 16S rRNA genes. Sequence data were binned to amplicon sequence variants that were assigned to bacterial genera. Group differences were analysed using principal coordinate analysis, Wilcoxon signed rank tests, and t-tests. Beta diversity analyses reported a significant separation between peri-implantitis and natural dentition samples on T0 and T12, along with significant separations between successfully and non-successfully treated patients. Eubacterium was significantly lower on T12 compared to T0 for the peri-implantitis samples. Treponema and Eubacterium abundance levels were significantly lower in patients with treatment success on T0 and T12 versus no treatment success. Therefore, lower baseline levels of Treponema and Eubacterium seem to be associated with treatment success of peri-implantitis surgery. This study might aid clinicians in determining which peri-implantitis cases might be suitable for treatment and give a prognosis with regard to treatment success.