Paul Rosen: Successful treatment of peri-implantitis: advisability and predictability
- Review of measures and options for treatment of peri-implantitis
- Etiologies to periodontitis and peri-implantitis share a number of common analogies, discussion of comparable treatment approaches
- The 7 essential factors for success in peri-implantitis treatment
- Treatment might require combination and layering of various approaches and sometimes involves soft tissue grafting
- Tokyo 2014 symposium presentation
The presentation reviews the measures and options for treatment of peri-implantitis. Dr Rosen discusses that the etiologies to periodontitis and peri-implantitis share a number of common analogies, and advocates comparable treatment approaches. The initiator isn't always plaque, but development of peri-implantitis has a plaque related component to it. Non surgical treatment is quite ineffective and and a layered, combined therapeutic approach including implantoplasty, resection and regeneration is recommended. Based on literature evidence and own clinical experiences, Dr Rosen presents the 7 essential factors for success: 1 flap access and adequate blood supply, 2 surface decontamination with powder spray and citric acid, 3 defect debridement with biologic agent on implant surface, 4 defect fill with FDBA and/or other anorganic bovine bone, 5 coverage with absorbable membrane and subethitelial connective tissue graft, 6 coronal positioning of flap and complete coverage of membrane and graft, 7 professional maintenance and excellent homecare. Dr Rosen summarizes and concludes, that no one approach can be used to manage all problems, surface decontamination is imperative and regenerative care has shown good success.