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Reconstructive Therapy of Peri-Implantitis Following Non-Surgical Treatment: A Randomized Controlled Trial

Clin Implant Dent Relat Res. 2025 Apr;27(2):e70024. doi: 10.1111/cid.70024.

ABSTRACT

AIM: To evaluate the clinical and radiographic outcomes of non-surgical treatment followed by either reconstructive therapy or supportive care with no further surgical measures for the treatment of peri-implantitis intra-bony defects.

MATERIALS AND METHODS: This randomized clinical trial included patients diagnosed with peri-implantitis exhibiting intrabony defects (≥ 3 mm). All 36 patients received a standardized peri-implant non-surgical therapy. Patients who did not demonstrate disease resolution based on clinical and radiographic re-evaluation were randomized into two groups. The test group received reconstructive therapy [reconstructive group (RG)] while the control group received no additional treatment except supportive care every 3 months [non-reconstructive group (NRG)]. The primary outcome was the mean radiographic bone change at 12 months; the difference between groups was assessed using Mann-Whitney two-sample tests. Clinical and radiographic parameters were recorded at the initial examination and at 3, 6, and 12 months. Also, patient-reported outcomes were assessed.

RESULTS: Overall, 34 patients (implants = 34) completed the study. Both therapies resulted in significant clinical and radiographic changes after 12 months. Disease resolution was achieved in 8 (44.4%) NRG patients and 7 (43.8%) RG patients (p ≥ 0.05) with no significant differences between groups. The groups displayed no significant differences in clinical variables, but radiographic bone fill was ~3× greater in the RG group at 12 months [1.21 (SD 0.92) mm versus 0.36 (SD 0.59) mm], demonstrating statistical significance between the tested groups.

CONCLUSIONS: The tested therapeutic modalities demonstrated equal disease resolution. Nevertheless, the marginal bone level gain was significantly greater for sites subjected to reconstructive surgical therapy (NCT05168891-This clinical trial was not registered prior to participant recruitment and randomization).

PMID:40183214 | DOI:10.1111/cid.70024