Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri‐implantitis: A prospective clinical case series

Abstract Background Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri‐implantitis, with variable results. Purpose To evaluate the 1‐year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri‐implantitis. Material and Methods Forty‐three patients diagnosed with peri‐implantitis were included. Surgical treatment consisted of implantoplasty of the supra‐crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra‐osseous component of the peri‐implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri‐implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri‐implant marginal bone levels. One implant per patient was included in the analysis. Results The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm ( p < 0.001) and 14% ( p < 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery ( p < 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded ( p < 0.001). Conclusions The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow‐up and constitutes a viable option for the management of peri‐implantitis.