Lethal photosensitization, autogenous bone, and e-PTFE membrane for the treatment of peri-implantitis: Preliminary results

This clinical study reports on the results of a new method in the treatment of peri-implantitis. The surfaces of 24 plasma flame-sprayed cylindric imp lants in 17 patients who were diagnosed with peri-implantitis were decontam inated with a combination of toluidine blue (100 mu g/mL) and laser irradia tion at a wavelength of 906 nm. Bone defects were filled with autogenous bo ne using e-PTFE membranes for retention of the grafting material. Premature membrane exposure occurred in all patients after an average of 3 weeks (+/ - 10 days), which required immediate removal of the exposed membrane in 1 p atient Since the soft tissue showed minimal signs of inflammation, the memb ranes were left in situ for another 6 weeks in all other patients. The mean radiographic peri-implant bone gain was 2 mm +/- 1.90 mm after 9.5 months (maxilla 2.5 mm +/- 2.38 mm; mandible 1.9 mm +/- 1.87 mm). Two implants aro und which the initial bone defect had already reached the basket had to be removed after 10 months and 35 months, respectively, despite radiographic e vidence of improvement of the peri-implant defect. The longer the membrane stayed in situ, the more bone was gained, as long as the membrane was cover ed by soft tissue (P = .01). However, the longer an exposed membrane was le ft in place, the smaller the resultant bone gain (P = .0001). Therefore, de spite the absence of clinical signs of inflammation, exposed membranes shou ld be removed immediately. The short-term results of this study corroborate the efficacy of the applied treatment method in prolonging the service tim e of dental implants involved with peri-implantitis.