Peri-implant diseases are common post-restorative complications in implant rehabilitations and they occur with an incidence of 12-43%. Based on the available data in literature, the surgical therapy for peri-implantitis is effective in disease resolution. Surgical access to peri-implant lesions facilitates the removal of all granulation tissue from the defect area as well as debridement and decontamination of the exposed implant surface defect area. Different techniques have been used for implant surface decontamination during peri-implant surgery, including mechanical, chemical and laser treatments.
Peri-implantitis are defined as inflammatory diseases caused by bacterial biofilm around implant surface characterized by bleeding on probing, probing depth and eventually bone loss; if not successfully treated they may lead to implant loss. Based on the available parameters that have been reported in literature non surgical therapy doesn't seem to be effective on peri-implantitis. Therefore it is recommended to consider advanced therapies such as surgical interventions when non surgical peri-implant therapy fails to achieve significant improvements in clinical parameters. Numerous approaches have been used for implant surface decontamination during per-implant surgery, including mechanical, chemical and laser treatments. Conventional mechanical means don't seem to be effective on peri-implant diseases. In addition, the rough implant surface is a retentive factor for bacterial colonization and therefore makes implant surface difficult to debride. Another problem in maintaining implant health concerns the presence or absence of keratinised tissue around implant: if present, it seams to help the patient to maintain an optimal level of oral hygiene around implant and therefore the implant survival itself. The aim of the present randomized controlled clinical trial is to assess the influence of keratinised tissue around implant in improving clinical parameters. In particular, implant surface will be decontaminated mechanically with titanium curettes and chemically using chlorhexidine; after this a CTG around tissue implant will be randomized
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Inflammatory tissue, excess cement or plaque deposits will be removed using titanium curettes and the implant surface will be cleaned by copious irrigation with sterile saline and surgical gauze soaked in chlorhexidine.
CTG will be positioned in the buccal aspect of the peri-implant tissue
Università Vita-Salute San Raffaele
Milan, Italy
RECRUITINGBleeding on probing changes
changes of bleeding on probing, evaluated as present if bleeding will be evident within 30 s after probing, or absent, if no bleeding will be noticed within 30 s after probing
Time frame: baseline, 3, 6 and 12 months after treatment
clinical attachment level changes
changes in clinical attachment level, measured from CEJ to the tip of the probe
Time frame: baseline, 3, 6 and 12 months after treatment
probing pocket depth changes
changes in probing depth probing, measured from gingival margin to te tip of the probe
Time frame: baseline, 3, 6 and 12 months after treatment
mucosal recession changes
changes in mucosal recession, measured from CEJ to gingival margin
Time frame: baseline, 3, 6 and 12 months after treatment
bone level changes
changes in bone level at mesial and distal aspect, measured on periapical X-ray
Time frame: baseline and 12 months after treatment
De Sanctis
CONTACT
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Masking
SINGLE
Enrollment
30