Peri-implantitis Management: Surgical and Maintenance Outcomes
Impact of Implantoplasty on Local and Systemic Inflammation in Peri-implantitis: A Randomized Controlled Trial
University of Pittsburgh
44 participants
Feb 16, 2026
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to learn how two standard surgical treatments for peri-implantitis affect inflammation around dental implants. Participants will be randomly assigned to receive resective surgery with implantoplasty or resective surgery with mechanical debridement only. Participants will provide blood samples before surgery, about 48 hours and 2 weeks after surgery. Participants will also provide a small gum tissue sample and fluid from around the implant at baseline and about 3 months after surgery. Participants will be followed in a maintenance program for up to 5 years.
Eligibility
Inclusion Criteria8
- Aged 18 or older.
- In good general health, classified as ASA Physical Status I or II.
- Diagnosed with peri-implantitis requiring resective surgical treatment, characterized by: Bleeding on probing (BOP) around dental implants. Probing pocket depths (PPD) greater than 6 mm. Implants in function for over 1 year with progressive bone loss exceeding 3 mm. Initial screening confirmed by panoramic radiographs, cone-beam computed tomography (CBCT), and clinical diagnosis.
- To be enrolled in the maintenance phase, participants must meet clinical stability criteria at the time of enrollment:
- Probing depth (PD) ≤ 5 mm
- Bleeding on probing (BOP) ≤ 1 point
- Absence of suppuration (SOP)
- Absence of progressive bone loss compared to pre-treatment bone levels
Exclusion Criteria8
- Patients with autoimmune or systemic inflammatory diseases (e.g., lupus, rheumatoid arthritis) that could alter immune cell profiles independent of local peri-implant inflammation.
- Chronic use of systemic corticosteroids or immunosuppressants within the past 3 months.
- Uncontrolled diabetes (HbA1c > 7.5%) due to its potential impact on healing and immune response.
- Active infection or antibiotic use in the 30 days prior to baseline sampling.
- Pregnancy or breastfeeding.
- Inability to undergo venipuncture or tolerate soft tissue biopsy.
- Inability to attend the 3-month follow-up visit or comply with study protocol.
- History of malignancy requiring systemic therapy within the past 5 years.
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Interventions
In the implantoplasty group, exposed and accessible titanium implant surfaces will be polished using a resective approach aimed at mechanically reducing macro- and micro-roughness to eliminate bacterial biofilm. No osteoplasty will be performed to avoid unnecessary soft tissue recession. Polishing will be carried out with round diamond burs (30 µm grit; diameters 1.8, 2.3, and 3.5 mm) mounted on a rotary handpiece operating at 15,000 rpm under continuous saline irrigation. The implantoplasty procedure will be standardized to approximately 5 minutes per implant.
Hard deposits will be debrided with plastic-tipped universal curettes, and all sites will be irrigated with 20 mL of sterile saline. In the control group, implant surfaces will be decontaminated using submucosal air-polishing with the Airflow Prophylaxis Master device. Copious saline irrigation will be performed prior to implant decontamination. Air-polishing will be carried out using AIR-FLOW powder PLUS, which contains erythritol (sugar alcohol, 14 µm), amorphous silica, and 0.3% chlorhexidine. The device will be set to full power with irrigation. After decontamination, surgical sites will be irrigated thoroughly with sterile saline to remove any residual granulation tissue, titanium debris, or polishing particles
Locations(1)
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NCT07550127