¿Cuál es la indicación y eficacia de la terapia quirúrgica regenerativa en el tratamiento de la periimplantitis?

Abstract

Objectives: To review the literature on the indication and efficacy of regenerative surgical therapy in the treatment of peri-implantitis. Search Strategy: A search of PubMed and a hand search of articles were conducted. English language articles published up to September 8, 2010 were included. Results: Indication of regenerative therapy: Sites and patient related factors seem to have some kind of influence on the sensitive process of periimplant regeneration. However, neither animal nor human studies give clear data on the weight of each individual factor on the clinical and histological outcomes of periimplant regeneration. Efficacy of regenerative therapy: a) Animal studies: Bone formation and re-osseointegration are feasible goals in previously infected implants. However, the amount of the newly formed bone in contact with the implant is not predictable. The implant surface features and implant design could be limiting factors in obtaining re-osseointegration. b) Human studies: The surgical approach associated with regenerative procedures resulted in being effective in reducing probing depth and gaining clinical attachment level. A moderate percentage of clinical and radiographic bone filling was also found. Contrasting results are found on the real adjunctive benefit of barrier membrane placement in conjunction with bone graft materials. Clinical implications: even if the tecnique involves two simultaneous surgery sites, needing an high compliance by the patient, is unquestionable the vantage to can operate without narcosis, only availing of local anesthesia.