Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report
Identifieur interne : 000A60 ( Pmc/Checkpoint ); précédent : 000A59; suivant : 000A61Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report
Auteurs : Fabrizio Bassi [Italie] ; Pier Paolo Poli [Italie] ; Davide Rancitelli [Italie] ; Fabrizio Signorino [Italie] ; Carlo Maiorana [Italie]Source :
- Case Reports in Dentistry [ 2090-6447 ] ; 2015.
Abstract
The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.
Url:
DOI: 10.1155/2015/574676
PubMed: 26064700
PubMed Central: 4443933
Affiliations:
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Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Poli, Pier Paolo" sort="Poli, Pier Paolo" uniqKey="Poli P" first="Pier Paolo" last="Poli">Pier Paolo Poli</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Rancitelli, Davide" sort="Rancitelli, Davide" uniqKey="Rancitelli D" first="Davide" last="Rancitelli">Davide Rancitelli</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Signorino, Fabrizio" sort="Signorino, Fabrizio" uniqKey="Signorino F" first="Fabrizio" last="Signorino">Fabrizio Signorino</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Maiorana, Carlo" sort="Maiorana, Carlo" uniqKey="Maiorana C" first="Carlo" last="Maiorana">Carlo Maiorana</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author></analytic><series><title level="j">Case Reports in Dentistry</title><idno type="ISSN">2090-6447</idno><idno type="eISSN">2090-6455</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lindhe, J" uniqKey="Lindhe J">J. Lindhe</name></author><author><name sortKey="Meyle, J" uniqKey="Meyle J">J. Meyle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lang, N P" uniqKey="Lang N">N. P. Lang</name></author><author><name sortKey="Berglundh, T" uniqKey="Berglundh T">T. Berglundh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Boever, A L" uniqKey="De Boever A">A. L. de Boever</name></author><author><name sortKey="De Boever, J A" uniqKey="De Boever J">J. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Dent</journal-id><journal-id journal-id-type="iso-abbrev">Case Rep Dent</journal-id><journal-id journal-id-type="publisher-id">CRID</journal-id><journal-title-group><journal-title>Case Reports in Dentistry</journal-title></journal-title-group><issn pub-type="ppub">2090-6447</issn><issn pub-type="epub">2090-6455</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26064700</article-id><article-id pub-id-type="pmc">4443933</article-id><article-id pub-id-type="doi">10.1155/2015/574676</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-6368-5882</contrib-id><name><surname>Bassi</surname><given-names>Fabrizio</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-3739-1490</contrib-id><name><surname>Poli</surname><given-names>Pier Paolo</given-names></name><xref ref-type="aff" rid="I1"></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-4017-4227</contrib-id><name><surname>Rancitelli</surname><given-names>Davide</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-5232-0909</contrib-id><name><surname>Signorino</surname><given-names>Fabrizio</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-8748-9483</contrib-id><name><surname>Maiorana</surname><given-names>Carlo</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib></contrib-group><aff id="I1">Department of Dental Implants, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, University of Milan, Via della Commenda 10, 20122 Milan, Italy</aff><author-notes><corresp id="cor1">*Pier Paolo Poli: <email>pierpaolo.poli@unimi.it</email></corresp><fn fn-type="other"><p>Academic Editor: Jamil A. Shibli</p></fn></author-notes><pub-date pub-type="ppub"><year>2015</year></pub-date><pub-date pub-type="epub"><day>12</day><month>5</month><year>2015</year></pub-date><volume>2015</volume><elocation-id>574676</elocation-id><history><date date-type="received"><day>25</day><month>2</month><year>2015</year></date><date date-type="accepted"><day>27</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>Copyright © 2015 Fabrizio Bassi et al.</copyright-statement><copyright-year>2015</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Clinical situation of the peri-implantitis affected implant, before treatment procedures. A mesial PD of 11 mm and a distal PD of 12 mm were recorded.</p></caption><graphic xlink:href="CRID2015-574676.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Preoperative intraoral radiography. A typical peri-implantitis crater-like defect was evident.</p></caption><graphic xlink:href="CRID2015-574676.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Clinical situation after the elevation of a mucoperiosteal flap. Granulation tissue delimitating the peri-implantitis defect was clearly visible around the implant.</p></caption><graphic xlink:href="CRID2015-574676.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Clinical situation after the careful removal of the granulation tissue. The typical crater-like peri-implantitis bone defect was present circumferentially around the implant.</p></caption><graphic xlink:href="CRID2015-574676.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>The bone defect was packed with heterologous DBBM graft.</p></caption><graphic xlink:href="CRID2015-574676.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>A bioabsorbable collagen membrane was placed in order to create a secluded space over the DBBM graft.</p></caption><graphic xlink:href="CRID2015-574676.006"></graphic></fig><fig id="fig7" orientation="portrait" position="float"><label>Figure 7</label><caption><p>Postoperative intraoral radiography. The graft filled into the bone defect was observable in close contact with the implant surfaces. During the healing period the implant was left unloaded.</p></caption><graphic xlink:href="CRID2015-574676.007"></graphic></fig><fig id="fig8" orientation="portrait" position="float"><label>Figure 8</label><caption><p>Clinical situation during the follow-up recall. Peri-implant soft tissues appeared healthy, with no sign of inflammation and suppuration.</p></caption><graphic xlink:href="CRID2015-574676.008"></graphic></fig><fig id="fig9" orientation="portrait" position="float"><label>Figure 9</label><caption><p>17-year follow-up intraoral radiography. The peri-implant marginal bone levels appeared radiographically stable, without any sign of bone resorption mesially and distally to the implant.</p></caption><graphic xlink:href="CRID2015-574676.009"></graphic></fig></floats-group></pmc><affiliations><list><country><li>Italie</li></country><region><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><country name="Italie"><region name="Lombardie"><name sortKey="Bassi, Fabrizio" sort="Bassi, Fabrizio" uniqKey="Bassi F" first="Fabrizio" last="Bassi">Fabrizio Bassi</name></region><name sortKey="Maiorana, Carlo" sort="Maiorana, Carlo" uniqKey="Maiorana C" first="Carlo" last="Maiorana">Carlo Maiorana</name><name sortKey="Poli, Pier Paolo" sort="Poli, Pier Paolo" uniqKey="Poli P" first="Pier Paolo" last="Poli">Pier Paolo Poli</name><name sortKey="Rancitelli, Davide" sort="Rancitelli, Davide" uniqKey="Rancitelli D" first="Davide" last="Rancitelli">Davide Rancitelli</name><name sortKey="Signorino, Fabrizio" sort="Signorino, Fabrizio" uniqKey="Signorino F" first="Fabrizio" last="Signorino">Fabrizio Signorino</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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