Porous titanium granules in the treatment of peri-implant osseous defects-a 7-year follow-up study

Background: A great number of different treatment protocols for peri-implantitis have been suggested but there is no consensus regarding the most effective intervention. The aim of the present study was to evaluate the long-term clinical and radiographic results from a study on peri-implant osseous defect reconstruction. Patients having participated in a randomized clinical study 7 years earlier were invited for a re-examination. The treatment procedures included open flap debridement (OFD) with or without defect reconstruction with porous titanium granules (PTGs). Clinical parameters (probing pocket depth and bleeding on probing) and radiographic measurements were registered. Findings: Of the original 32 patients, 12 patients with 12 implants were finally examined after 7 years (7.3 years [6.7-8]). Patients had been maintained one to two times yearly. The PTG group showed a mean probing pocket depth of 4.3 mm +/- 2.4 compared with 3.5 mm +/- 1.2 in the OFD group, at the deepest site. The change between the 12 months and the 7-year examination was similar in both groups. Five of the test implants and five of the control implants had at least one site with positive bleeding on probing score. The mean radiographic defect depth change as compared to 12 months was an increase of 1.9 mm +/- 2.0 in the PTG group and a mean radiographic defect depth increase of 1.3 mm +/- 1.4 in the OFD group. Due to the small number of patients, a statistical analysis was not performed, but the results indicated a minimal difference in osseous defect depth as compared with baseline and between groups. No PTG exposed to the oral cavity was observed, but the graft particles were seemingly scattered in the peri-implant soft tissue. Conclusions: This long-term follow-up of surgical treatment of peri-implant osseous defects showed unpredictable results.