Impact of surface chemical treatment in surgical regenerative treatment of ligature‐induced peri‐implantitis: A canine study

Abstract Background Implant surface decontamination is a critical step in peri‐implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature‐inducted peri‐implantitis. Methods Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri‐implantitis. The peri‐implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration. Results Thirty‐five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl‐treated sites demonstrated reosseointegration with direct bone‐to‐implant‐contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls ( p < 0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50 ± 1.24 mm at baseline to 4.46 ± 1.70 mm at 6‐months postsurgery ( p = 0.006). CHX‐treated sites demonstrated a nonsignificant reosseointegration of 26% ( p > 0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p > 0.05). Conclusion Titanium implants with peri‐implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.