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Journal of Oral Science & Rehabilitation No. 4, 2016

Journal of Oral Science & Rehabilitation Volume 2 | Issue 4/2016 61 S u r g i c a l t r e a t m e n t o f p e r i i m p l a n t i t i s documented by Paolantonio et al., chlorhexidine was demonstrated to maintain the implant connection decontaminationfora period shorter than six months.20 Limitations of the present study clearly rela- te to the study design itself: The short follow-up period and small sample size suggested to care- fully handle the even promising reported outco- mes.Afurtherlimitation isthat onlyless challen- ging bone defects were included in this preliminary study; hence, the regenerative out- comes should be considered in light of this. For this study, only contained circumferenti- al or semicircumferential defects were included that represented the most predictive defect shape, as documented by Schwarz et al., com- pared with two- or one-wall bone defects.6 Ac- cording to the literature, despite profuse efforts, massive soft-tissue shrinkage has been re- ported.6 Forthis reason, newsurgicaltechniques should be applied to counteract this phenome- non. For this purpose, as suggested by Schwarz et al., the use of a connective tissue graft might beeffectiveincontrollingsoft-tissuearchitecture ifadaptedoverthe regeneratedsite.21 Inaddition, a new flap design, as reported by Zucchelli and Mounssif, might represent an alternative strat- egy.22 Furthermore, a studywith a longerfollow- up, larger sample size and different defect types should be designed to corroborate the findings of the present study. However, it can be conclu- ded that, within the limitations of the present preliminary study, the proposed technique, in combination with a self-stabilizing graft materi- al, offers promising results in the treatment of circumferential and semicircumferential bone defects around implants affected byperiimplan- titis, without the use of a barrier membrane. Competing interests The authorsdeclarethattheyhave nocompeting interests. 1. Muthukuru M, Zainvi A, Esplugues EO, Flemmig TF. Non-surgical therapy 0for the management of peri-implantitis: a systematic review. → Clin Oral Implants Res. 2012 Oct;23 Suppl 6:77–83. 2. Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. → Clin Oral Implants Res. 2011 Nov;22(11):1214–20. 3. Renvert S, Polyzois I, Claffey N. Surgical therapy for the control of peri-implantitis. → Clin Oral Implants Res. 2012 Oct;23 Suppl 6:84–94. 4. Serino G, Turri A, Lang NP. Maintenance therapy in patients following the surgical treatment of peri-implantitis: a 5-year follow-up study. → Clin Oral Implants Res. 2015 Aug;26(8):950–6. 5. Heitz-Mayfield LJ, Mombelli A. The therapy of peri-implantitis: a systematic review. → Int J Oral Maxillofac Implants. 2014;29 Suppl:325–45. 6. Schwarz F, Sahm N, Schwarz K, Becker J. Impact of defect configuration on the clinical outcome following surgical regenerative therapy of peri-implantitis. → J Clin Periodontol. 2010 May;37(5):449–55. 7. Graziani F, Figuero E, Herrera D. Systematic review of quality of reporting, outcome measurements and methods to study efficacy of preventive and therapeutic approaches to peri-implant diseases. → J Clin Periodontol. 2012 Feb;39 Suppl 12:224–44. 8. Pesce P, Menini M, Tealdo T, Bevilacqua M, Pera F, Pera P. Peri-implantitis: a systematic review of recently published papers. → Int J Prosthodont. 2014 Jan-Feb;27(1):15–25. 9. Canullo L, Penarrocha-Oltra D, Soldini C, Mazzocco F, Penarrocha M, Covani U. Microbiological assessment of the implant-abutment interface in different connections: cross-sectional study after 5 years of functional loading. → Clin Oral Implants Res. 2015 Apr;26(4):426–34. Epub 2014 Mar 26. 10. Sanz M, Chapple IL; Working Group 4 of the VIII European Workshop on Periodontology. Clinical research on peri-implant diseases: consensus report of Working Group 4. → J Clin Periodontol. 2012 Feb;39 Suppl 12:202–6. 11. Schmidlin PR, Nicholls F, Kruse A, Zwahlen RA, Weber FE. Evaluation of moldable, in situ hardening calcium phosphate bone graft substitutes. → Clin Oral Implants Res. 2013 Feb;24(2):149–57. Epub 2011 Nov 1. 12. Leventis MD, Fairbairn P, Kakar A, Leventis AD, Maragaritis V, Lückerath W, Horowitz RA, Nagursky H. Minimally invasive alveolar ridge preservation utilizing an in situ hardening ʹ-tricalcium phosphate bone substitute: a multicenter case series. → Int J Dent. 2016;2016:5406736. doi:10.1155/2016/5406736. 13. Cordaro L, Bosshardt DD, Palattella P, Rao W, Serino G, Chiapasco M. Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial. → Clin Oral Implants Res. 2008 Aug;19(8):796–803. 14. Canullo L, Micarelli C, Lembo-Fazio L, Iannello G, Clementini M. Microscopical and microbiologic characterization of customized titanium abutments after different cleaning procedures. → Clin Oral Implants Res. 2014 Mar;25(3):328–36. Epub 2012 Dec 5. 15. Slots J, Ashimoto A, Flynn MJ, Li G, Chen C. Detection of putative periodontal pathogens in subgingival specimens by 16S ribosomal DNA amplification with the polymerase chain reaction. → Clin Infect Dis. 1995 Jun;20 Suppl 2:S304–7. 16. Suzuki N, Yoshida A, Nakano Y. Quantitative analysis of multi-species oral biofilms by TaqMan Real-Time PCR. → Clin Med Res. 2005 Aug;3(3):176–85. 17. Buser D, von Arx T, ten Bruggenkate C, Weingart D. Basic surgical principles with ITI implants. → Clin Oral Implants Res. 2000;11 Suppl 1:59–68. 18. Jensen OT, Bell W, Cotta, J. Osteoperiosteal flaps and local osteotomies for alveolar reconstruction. → Oral Maxillofac Surg Clin North Am. 2010 Aug;22(3):331–46, vi. 19. Renvert S, Polyzois IN. Clinical approaches to treat peri-implant mucositis and peri-implantitis. → Periodontol 2000. 2015 Jun;68(1):369–404. 20. Paolantonio M, Perinetti G, D’Ercole S, Graziani F, Catamo G, Sammartino G, Piccolomini R. Internal decontamination of dental implants: an in vivo randomized microbiologic 6-month trial on the effects of a chlorhexidine gel. → J Periodontol. 2008 Aug;79(8):1419–25. 21. Schwarz F, Sahm N, Becker J. Combined surgical therapy of advanced peri- implantitis lesions with concomitant soft tissue volume augmentation. A case series. → Clin Oral Implants Res. 2014 Jan;25(1):132–6. 22. Zucchelli G, Mounssif I. Periodontal plastic surgery. → Periodontol 2000. 2015 Jun;68(1):333–68. References Volume 2 | Issue 4/201661

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