Combined surgical therapy of advanced peri-implantitis lesions with concomitant soft tissue volume augmentation. A case series.

OBJECTIVES: Mucosal recessions are a common finding following surgical treatment of peri-implantitis, thus compromising the overall esthetic outcome of implant therapy. This case series aimed at evaluating the clinical outcome of a combined surgical therapy of advanced peri-implantitis lesions with concomitant soft tissue volume augmentation. MATERIAL AND METHODS: Ten patients (n = 13 implants exhibiting combined supra- and intrabony defects) underwent access flap surgery, implantoplasty at bucally and supracrestally exposed implant parts, and augmentation of the intrabony components using a natural bone mineral and a native collagen membrane after surface decontamination. A subepithelial connective tissue graft was harvested from the palate and adapted to the wound area to support transmucosal healing. Clinical parameters (i.e. bleeding on probing--BOP; probing depths--PD; mucosal recession--MR; clinical attachment level--CAL) were recorded at baseline and after 6 months. RESULTS: At 6 months, the combined surgical procedure was associated with a significant reduction in mean BOP (74.39 +/- 28.52%), PD (2.53 +/- 1.80 mm), and CAL (2.07 +/- 1.93 mm) values. Site-level analysis has pointed to a slight increase in mean mucosal height (0.07 +/- 0.5 mm) at the buccal aspects (i.e. mb, b, db). CONCLUSION: The combined surgical procedure investigated may be effective in controlling advanced peri-implantitis lesions without compromising the overall esthetic outcome in the short term.