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Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri-implantitis: a 1-year follow-up case series

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Abstract

Objectives

To assess the clinical and radiographic outcomes of the regenerative treatment of peri-implantitis using a vancomycin and tobramycin impregnated allograft (VTA) after a 12-month period.

Material and methods

Thirteen consecutive patients who required a regenerative treatment of peri-implantitis were recruited. For the 17 implant sites, a flap was raised, and after mechanical and chemical implant decontamination, a vancomycin and tobramycin impregnated allograft was placed in the defect and then covered with a collagen membrane. Soft tissues were sutured allowing a non-submerged healing. Clinical and radiographic variables were evaluated at baseline and at 12 months after treatment.

Results

No signs of continuous bone loss were observed and no implant was lost, yielding a 100% survival rate. All patient’s clinical examination at 12 months revealed peri-implant health showing absence of suppuration and a statistically significant reduction in terms of bleeding on probing scores (70.6%, P = 0.001). Initial probing pocket depth (7.88 ± 1.22 mm) was significantly reduced at 12 months healing, a mean reduction of 4.23 ± 1.47 mm (P = 0.001) was achieved. The mean radiological infrabony defect at baseline reached 4.33 ± 1.62 mm, and was significantly reduced up to 0.56 ± 0.88 mm, which represents an 86.99 ± 18.2% bone fill from the original infrabony defect.

Conclusions

Within the limits of the study, the application of VTA with a collagen membrane yielded positive outcomes in terms of radiographic bone fill, pocket depth reduction, and attachment gain after a 12-month period. Thus, VTA plus a collagen membrane seem to be suitable for the regenerative treatment of peri-implantitis.

Clinical relevance

The use of locally delivered antibiotic together with the bone graft may reduce the undesirable effects related to the systemic administration and the risk of resistances. In the light of the results obtained, these grafting materials might offer new treatment strategies in the surgical regenerative treatment of peri-implantitis.

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Authors and Affiliations

  1. Deparment of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Josep Trueta s/n, 08194, Sant Cugat del Vallés, Barcelona, Spain

    José Nart, Beatriz de Tapia, Àngels Pujol, Andrés Pascual & Cristina Valles

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  1. José Nart
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  2. Beatriz de Tapia
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Correspondence to Cristina Valles.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study involving human participants, were in accordance with ethical standards of the institutional research committee and with the principles stated in the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Nart, J., de Tapia, B., Pujol, À. et al. Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri-implantitis: a 1-year follow-up case series. Clin Oral Invest 22, 2199–2207 (2018). https://doi.org/10.1007/s00784-017-2310-0

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