Dieter Bosshardt^1,*; Urs Brodbeck²; Florian Rathe³; Thomas Stumpf³; Paul Weigl⁴; Markus Schlee^3,5

¹Periodontology, University of Bern, Bern; ²Private Practice, Zürich, Switzerland; ³Private Practice, Forchheim; ⁴Medical Technology Research, Carolinum University Dental Institute; ⁵Maxillofacial Surgery, Goethe University, Frankfurt am Main, Germany

Background: Peri-implantitis is a frequent biological complication. Numerous methods of implant surface decontamination have been tested and applied. However, none of the surface decontamination methods tested so far have proven to be superior. Very recently, re-osseointegration of contaminated implant surfaces was demonstrated after electrolytic cleaning in a preclinical study. Proof of this concept in humans, however, is missing.

Aim/Hypothesis: To evaluate whether the electrolytic cleaning technique together with regenerative therapy can achieve re-osseointegration of dental implants that developed peri-implantitis in humans.

Material and Methods: In a large clinical study, dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. Four implants developed recurrent peri-implantitis with implant exposure and explantation was indicated 6 to 13 months after treatment. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed.

Results: All four implants demonstrated radiographic and histological bone gain, reduced probing depth and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.15 mm and 5.21 mm, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface.

Conclusion and Clinical implications: Re-osseointegration of dental implants was proven in humans after electrolytic cleaning and regenerative therapy of peri-implantitis. New bone formation on residual calculus indicated that the electrolytic cleaning process had an effective decontamination effect.

Disclosure of Interest: D. Bosshardt: None Declared, U. Brodbeck Conflict with: financial interest, Conflict with: product inventor, F. Rathe: None Declared, T. Stumpf: None Declared, P. Weigl: None Declared, M. Schlee Conflict with: Consultant, Conflict with: financial interest

Keywords: dental implants, osseointegration, peri-implantitis

迪特·博斯哈特^1,* ; 乌尔斯·布罗德贝克² ; 弗洛里安·拉特³ ; 托马斯·斯通普夫³ ; 保罗威格尔⁴ ; 马库斯·施利^3,5

¹牙周病学，伯尔尼大学，伯尔尼；²私人执业，瑞士苏黎世；³私人执业，福希海姆；⁴卡罗来纳大学牙科研究所医疗技术研究；⁵颌面外科，歌德大学，法兰克福，德国

背景：种植体周围炎是一种常见的生物学并发症。已经测试并应用了多种植入物表面去污方法。然而，迄今为止测试的表面去污方法都没有被证明是优越的。最近，在一项临床前研究中证明了电解清洗后受污染的种植体表面的重新骨整合。然而，这个概念在人类中的证据却是缺失的。

目的/假设：评估电解清洗技术与再生疗法相结合是否可以实现人类发生种植体周围炎的牙种植体的再骨整合。

材料和方法：在一项大型临床研究中，对发生种植体周围炎的牙种植体进行电解清洗，然后进行引导骨再生的再生治疗。4 个种植体因种植体暴露而出现复发性种植体周围炎，并在治疗后 6 至 13 个月进行了移植。在手术时、6 个月后和取回种植体之前确定 X 线骨水平、探诊深度和探诊出血。对种植体周围组织进行组织学和组织形态学分析。

结果：所有四颗种植体均表现出放射学和组织学骨量增加、探诊深度减少和探诊出血。植入物#1 的射线照相骨增量为近中 5.8 毫米和远侧 4.8 毫米，种植体 #2 为 3.3 毫米和 2.3 毫米，种植体 #3 为 3.1 毫米和 0.5 毫米，种植体 #4 为 3.5 毫米和 2.8 毫米。种植体#1 至#4 的组织学平均和最大垂直骨增量分别为 1.65 毫米和 2.54 毫米、3.04 毫米和 3.47 毫米、0.43 毫米和 1.27 毫米以及 4.15 毫米和 5.21 毫米。在一个种植体中，新形成的骨直接沉积在种植体表面的牙结石上。

结论和临床意义：在种植体周围炎的电解清洁和再生治疗后，在人体中证明了种植体的再骨整合。残留牙石上的新骨形成表明电解清洗过程具有有效的去污效果。

利益披露：D. Bosshardt：未声明，U. Brodbeck 与：财务利益的冲突，与：产品发明者的冲突，F. Rathe：未声明，T. Stumpf：未声明，P. Weigl：未声明，M. Schlee冲突：顾问，冲突：经济利益

【关键词】： 种植牙 骨结合 种植体周围炎