Estudo clínico de tratamento da peri-implantite com uma nova proposta de descontaminação de superfície e enxertia óssea: avaliação clínica e radiográfica

Abstract

Peri-implantitis prevalence is increasing in the population and it is negatively influencing the longevity of osseointegrated implants. The aim of this study was to evaluate the clinical and radiographic outcomes of peri-implantitis treatment with adisinfection protocol, followed by guided bone regeneration, of affected implants. Thirteen patients with 21 implants diagnosed with peri-implantitis were selected and were randomly divided into a Test Group (TG) and a Control Group (CG). The TG included 9 patients with a mean age of 57.5 years (SD = 5.03) and 15 implants. The CG comprised 4 patients with a mean age of 58.7 years (SD = 10.75) and 6 implants. Implants' surface disinfection in the TG was performed using a 0.25% sodium hypochlorite solution, followed by a 1.5% hydrogen peroxide solution and saline solution. In the CG, a 2% chlorhexedine solution was used. Bone regeneration was performed using bovine bone matrix grafting associated with calcium sulfate and a porcine collagen membrane. Clinical and radiographic evaluations were performed after 3 and 6 months interval follow-up. Statistically significant difference was found between groups for pocket probing depth at T0 and T6 intervals, with an average reduction of 1.3 mm for the CG and 3.6 mm for the TG (p <0.05). A significant difference in bone level was observed between the groups on T0 and T6 intervals, with a mean reduction of 0.5 mm for the CG and 2.2 mm for the TG (p <0.05). Regarding bleeding on probing and / or suppuration, there was a significant difference between the groups on T0 and T6 intervals, with an average reduction of 41% in the CG and 100% in the TG (p <0.05). Although both groups showed favorable results, the use of the proposed surgical protocol for peri-implantitis with 0.25% sodium hypochlorite solution, followed by a 1.5% hydrogen peroxide solution and saline solution showed superior results than the control group. Further studies with long-term follow-up are needed to confirm these results.