In a recent episode of EAO’s Just Ask, host Garrett Heiko joined Professor Frank Schwarz, a leading expert in peri-implantitis, for a deep dive into reconstructive approaches for the surgical management of the condition. Peri-implantitis, a complex issue involving inflammation and bone loss around dental implants, is a common concern in implant dentistry, and finding effective treatment strategies is crucial.
Professor Schwarz outlined four main surgical approaches for peri-implantitis: the open debridement, the resective approach (implantoplasty), the reconstructive approach, and the combination approach. The focus of the evening was on the reconstructive approach, which aims to regenerate lost bone and soft tissue around the implant site. This method uses bone grafts, barrier membranes, and sometimes biological agents to promote healing.
Key to the success of the reconstructive approach is proper case selection. Factors such as the presence of buccal bone and the size of the defect are crucial in determining whether a reconstructive procedure is appropriate. Defects with compromised bony support, particularly those lacking buccal bone, present challenges and may lead to poorer outcomes.
Professor Schwarz stressed that patient factors, including smoking, diabetes, and medication use, should also be considered. He noted that while these risk factors are critical to assess before implant placement, they are not necessarily grounds for exclusion from surgical treatment once peri-implantitis develops. The primary goal is to carefully plan based on the type of defect, the available bony support, and the patient's overall health.
Another important aspect discussed was the decontamination of the implant surface. While complete bacterial removal is challenging, controlling biofilm formation is essential to prevent recurrence. The session also explored the role of membranes and bone grafting materials, with a preference for composite grafts that combine autologous bone with more stable materials like xenografts to support bone regeneration.
The session was packed with clinical insights, and viewers were encouraged to subscribe to Just Ask for more educational content and updates on upcoming events, including the EAO Congress in Geneva.
Overall, this session provided valuable insights into the reconstructive management of peri-implantitis, emphasizing personalized treatment strategies and careful patient selection to ensure long-term success.