Surgical treatment of peri-implantitis

Objectives: To review the literature on surgical treatment of peri-implantitis. Material and Methods: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. Results: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. Animal studies: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. Human studies: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.