J Periodontal Implant Sci.  2012 Feb;42(1):13-19. 10.5051/jpis.2012.42.1.13.

In situ dental implant installation after decontamination in a previously peri-implant diseased site: a pilot study

• Kim YT
• Cha JK
• Park JC
• Jung UW
• Kim CS
• Cho KS
• Choi SH

• KMID: 2212080
• DOI: http://doi.org/10.5051/jpis.2012.42.1.13

Abstract

PURPOSE
The aim of this study was to examine whether a previous peri-implantitis site can affect osseointegration, by comparing implant placement at a site where peri-implantitis was present and at a normal bone site. A second aim of this study was to identify the tissue and bone reaction after treating the contaminated implant surface to determine the optimal treatment for peri-implant diseases.
METHODS
A peri-implant mucositis model for dogs was prepared to determine the optimal treatment option for peri-implant mucositis or peri-implantitis. The implants were inserted partially to a length of 6 mm. The upper 4 mm part of the dental implants was exposed to the oral environment. Simple exposure for 2 weeks contaminated the implant surface. After 2 weeks, the implants were divided into three groups: untreated, swabbed with saline, and swabbed with H2O2. Three implants from each group were placed to the full length in the same spot. The other three implants were placed fully into newly prepared bone. After eight weeks of healing, the animals were sacrificed. Ground sections, representing the mid-buccal-lingual plane, were prepared for histological analysis. The analysis was evaluated clinically and histometrically.
RESULTS
The untreated implants and H2O2-swabbed implants showed gingival inflammation. Only the saline-swabbed implant group showed re-osseointegration and no gingival inflammation. There was no difference in regeneration height or bone-to-implant contact between in situ implant placement and implant placement in the new bone site.
CONCLUSIONS
It can be concluded that cleaning with saline may be effective in implant decontamination. After implant surface decontamination, implant installation in a previous peri-implant diseased site may not interfere with osseointegration.

Keyword

Dental implants; Decontamination; Hydrogen peroxide; Peri-implantitis

MeSH Terms

Animals
Decontamination
Dental Implants
Dogs
Hydrogen Peroxide
Inflammation
Mucositis
Osseointegration
Peri-Implantitis
Pilot Projects
Regeneration
Dental Implants
Hydrogen Peroxide

Figure

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  Figure 1 Clinical photograph illustrating the implants inserted partially into the alveolar bone.

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  Figure 2 Schematic drawing describing the installation sites of implants in the mandible.

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  Figure 3 Clinical photograph illustrating the peri-implant inflammation around partially installed implants. Arrows: gingival swelling with inflammatory tissue around implants.

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  Figure 4 Schematic drawing describing the full length implant installation after treatment. Implants in one side were re-installed in situ (blue circles). Implants in the other side were re-installed in the newly prepared bone site (red circles). Tx.: treatment.

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  Figure 5 Clinical photographs illustrating the re-installed implants after decontamination. Implants after each treatments were inserted in the edentulous normal bone site (A) and in the previously peri-implant diseased site (B).

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  Figure 6 Histological presentation of a specimen of the control group installed in situ. Note that the bone to implant contacts are limited below the defect margin. White line: defect margin, Arrows: regenerated bone height (Goldner trichrome staining, ×25).

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  Figure 7 Histological presentation of a specimen of the control group installed in an edentulous normal bone site. No bone regeneration was observed above the defect margin. Line: defect margin (Goldner trichrome staining, ×25).

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  Figure 8 Histological presentation of a specimen of the group treated with saline, and installed in situ. Note the pre-contaminated surface covered with newly regenerated bone. Line: defect margin, Arrows: regenerated bone height (Goldner trichrome staining, ×25).

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  Figure 9 Histological presentation of a specimen of the group treated with saline, and installed in an edentulous normal bone site. Line: defect margin, Arrows: regenerated bone height (Goldner trichrome staining, ×25).

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  Figure 10 Histological presentation of a specimen of the group treated with H2O2, and installed in situ. Note the pre-contaminated part of the implant surface, which was not fully covered. Line: defect margin, Arrows: regenerated bone height (Goldner trichrome staining, ×25).

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  Figure 11 Histological presentation of a specimen of the group treated with H2O2, and installed in an edentulous normal bone site. Line: defect margin, Arrows: regenerated bone height (Goldner trichrome staining, ×25).

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