Prospective longitudinal comparison study of surgical therapies for peri-implantitis: 3-year follow-up.

BACKGROUND: The aim of this study was to compare different surgical therapies to treat peri-implantitis. METHODS: Twenty-three patients presenting one implant affected by peri-implantitis were divided into three groups: (i) open flap debridement (OFD) and citric acid decontamination (CAD); (ii) OFD, CAD and subepithelial connective tissue graft (SCTG); (iii) OFD, CAD and implantoplasty. Modified plaque index (MPI), gingival bleeding index (GBI), keratinized mucosa (KM) width, probing depth (PD), bleeding or suppuration on probing (B/SOP), and radiographic crestal bone level were registered 1(T1), 2(T2) and 3(T3) years after treatment. RESULTS: In Group 1 there was a significant improvement in MPI from baseline to T1, and a significant reduction in PD over time. In Group 2, none of the assessed clinical parameters showed any statistically significant variation over time. In Group 3, there was a significant decrease in PD and B/SOP over time. When comparing the 3 Groups, KM was significanlty greater in Group 2 vs. Group 1 and Group 3 at T1 and T2, and in Group 2 vs. Group 3 at T3. CONCLUSION: All therapies were successful in the management of peri-implantitis; however, SCTG maintained the greatest KM width. Surgical therapies combined with mechanical and chemical decontamination contributed to peri-implant tissue health.

VEGF and MVD expression in sinus augmentation with autologous bone and several graft materials.

OBJECTIVE: The aim of this study was to assess vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in maxillary sinus augmentation with autogenous bone and different graft materials for evaluating their angiogenic potential. METHODS: Biopsies were harvested 10 months after sinus augmentation with a combination of autogenous bone and different graft materials: hydroxyapatite (HA, n = 6 patients), demineralized freeze-dried bone allograft (DFDBA, n = 5 patients), calcium phosphate (CP, n = 5 patients), Ricinus communis polymer (n = 5 patients) and control group--autogenous bone only (n = 13 patients). RESULTS: In all the samples, higher intensities of VEGF expression were prevalent in the newly formed bone, while lower intensities of VEGF expression were predominant in the areas of mature bone. The highest intensity of VEGF expression in the newly formed bone was expressed by HA (P < 0.001) and CP in relation to control (P < 0.01) groups. The lowest intensities of VEGF expression in newly formed bone were shown by DFDBA and polymer groups (P < 0.05). When comparing the different grafting materials, higher MVD were found in the newly formed bone around control, HA and CP (P < 0.001). CONCLUSION: Various graft materials could be successfully used for sinus floor augmentation; however, the interactions between bone formation and angiogenesis remain to be fully characterized.