Bone regeneration as treatment of peri‐implant disease: A narrative review
Bibliographic record
Abstract
INTRODUCTION: Analysis of the 3-dimensional implant position, the bone defect morphology, and the soft tissue situation guides the decision to preserve or to remove an implant with a severe peri-implantitis lesion. The aim of this narrative review was to analyze and to comprehensively illustrate the treatment options focusing on peri-implant bone regeneration in presence of severe peri-implant bone loss. METHODS: A database search was performed independently by the two reviewers to identify case reports, case series, cohort, retrospective, and prospective studies about peri-implant bone regeneration with a follow-up of at least 6 months. Of the 344 studies issued during the database analysis, 96 publications were selected by the authors for this review. RESULTS: Deproteinized bovine bone mineral remains the best documented material for defect regeneration in peri-implantitis in combination with or without a barrier membrane. While studies using autogenous bone in peri-implantitis therapy are rarely found, they do report favorable potential of vertical bone regeneration. Moreover, while membranes are an inherent part of the guided bone regeneration, a 5-year follow-up study demonstrated clinical and radiographic improvements with and without a membrane. The administration of systemic antibiotics is frequently performed in clinical studies observing regenerative surgical peri-implantitis therapy, but the analysis of the literature does not support a positive effect of this medication. Most studies for regenerative peri-implantitis surgery recommend the removal of the prosthetic rehabilitation and the use a marginal incision with a full-thickness access flap elevation. This allows for a good overview for regenerative procedures with a certain risk of wound dehiscences and incomplete regeneration. An alternative approach referring to the poncho technique may reduce the risk of dehiscence. The effectiveness of implant surface decontamination might have an impact on peri-implant bone regeneration without any clinical superiority of a certain technique. CONCLUSION: The available literature reveals that the success of peri-implantitis therapy is limited to the reduction of bleeding on probing, the improvement of the peri-implant probing depth and a small amount of vertical defect fill. On this basis, no specific recommendations for bone regeneration in surgical peri-implantitis therapy can be made. Innovative approaches for flap design, surface decontamination, bone defect grafting material, and soft tissue augmentation should be followed closely to find advanced techniques for favorable peri-implant bone augmentation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".