ABSTRACT
This study assessed the effectiveness and predictability of a readily available protocol to treat peri-implantitis utilizing mechanical debridement, chemical antiseptic surface detoxification, and osseous grafting. Nine patients (7 women, 2 men; mean age: 56.5 years) with 15 implants with peri-implantitis were included. Pocket probing depth (PPD), bleeding on probing (BOP), and standardized digital periapical radiographic measurements were taken. Surgical flaps were elevated, and the implant threads were cleaned with a plastic curette. Chemical decontamination was performed by scrubbing solutions of 0.25% sodium hypochlorite (NaClO) and 1.5% hydrogen peroxide (H2O2) around the exposed implant using cotton pellets. Bony defects were filled with a 50/50 mixture of bovine hydroxyapatite and nanocrystalline calcium sulfate (CaSO4). A porcine collagen membrane was placed over the grafted bony defect. Follow-up appointments were scheduled 1 week, 2 weeks, 3 months, 6 months, 9 months, and 1 year posttreatment. Clinical and radiographic parameters were assessed and compared. At baseline, PPD ranged from 5 to 7.5 mm (mean: 6 ± 0.7 mm). At 12 months, PPD ranged from 1.5 to 4.2 mm (mean: 2.5 ± 0.8 mm). The mean PPD reduction of 3.6 mm (59.2%) was statistically significant (P < .001). The number of bleeding sites around each test implant decreased significantly from 4 to 0.4 sites between baseline and 12 months (P < .001). Mean radiographic bone loss decreased from 4.8 ± 1.3 mm to 2.7 ± 1.2 mm (P < .001). The proposed method of mechanical decontamination, chemical detoxification, and bone regeneration is clinically effective and reproducible. Clinical peri-implant parameters and radiographic bone levels were improved and maintained their stability for 1 year using this peri-implantitis treatment protocol.
Subject(s)
Dental Implants , Peri-Implantitis , Male , Swine , Humans , Female , Animals , Cattle , Middle Aged , Peri-Implantitis/diagnostic imaging , Peri-Implantitis/surgery , Hydrogen Peroxide/therapeutic use , Decontamination , Treatment OutcomeABSTRACT
O presente trabalho tem como objetivo descrever um caso clínico de utilização de enxertos ósseos homólogos na Odontologia, para reconstrução parcial de uma maxila. A diminuição da morbidade dos enxertos, quando comparados com a necessidade de um segundo sítio cirúrgico intrabucal ou extrabucal para utilização de osso autógeno, levou à escolha dessa alternativa para reconstrução óssea do paciente e se mostrou capaz de receber implantes e reabilitação protética com segurança. Métodos: foi utilizada uma porção de osso homólogo (crista ilíaca) oriundo do banco de ossos da Universidade Federal do Paraná. Parte do enxerto foi triturada e utilizada para preencher o seio maxilar, e parte foi colocada em aposição na região anterior. Resultados: a realização, após oito meses, de um exame tomográfico da região enxertada mostrou disponibilidade óssea suficiente para receber oito implantes com carga imediata. Conclusão: o resultado do enxerto com osso homólogo conseguido no caso clínico permitiu que fossem colocados oito implantes nas áreas que receberam enxertos e mostrou-se capaz de receber forças mastigatórias, estáveis e assintomáticos, com carga imediata e durante 15 meses de acompanhamento...
This study aims to report the completion of a clinical case using homologous bone graft for partial reconstruction of a maxilla. The grafts decreased morbidity, when compared to the need for a second intra- or extra oral surgical site to use autogenous bone, made us choose this alternative bone reconstruction procedure. The patient proved to have received implants and prosthetic rehabilitation safely. Methods: A portion of homologous bone (iliac crest) derived from the bone bank of Universidade Federal do Paraná (UFPR) was used. Part of the graft was ground and used to fill the maxillary sinus; additionally, it was placed in opposition to the anterior region. Results: A CT scan of the grafted area was obtained eight months after surgery and showed enough bone availability to receive eight immediately loaded implants. Conclusion: The results of homologous bone graft achieved in the clinical case reported herein allowed eight implants to be placed in areas that received grafts and proved capable of receiving masticatory forces, stable and asymptomatic, with immediate loading and during 15 months of follow-up...
