Four-year follow-up of combined surgical therapy of advanced peri-implantitis evaluating two methods of surface decontamination


  • Conflict of interest and sources of funding statement

    The authors declare that they have no conflict of interests. Frank Schwarz is a member of the Expert Council of the Osteology Foundation and has received lecture fees from Geistlich Biomaterials. The study materials were kindly provided by Elexxion AG, Radolfzell, Germany and Geistlich Biomaterials. The long-term follow-up was funded by the authors' own department.



To investigate the impact of two surface decontamination methods on the long-term outcomes following combined surgical resective/regenerative therapy of advanced peri-implantitis lesions.

Material and Methods

Seventeen patients (n = 17 combined supra- and intrabony-defects) completed the 48 months follow-up observation following access flap surgery, granulation tissue removal and implantoplasty at bucally and supracrestally exposed implant parts. The remaining unmodified implant surface areas were randomly treated using either (i) an Er:YAG laser (ERL), or (ii) plastic curets + cotton pellets + sterile saline (CPS), and augmented with a natural bone mineral + collagen membrane.


At 48 months, CPS-treated sites tended to reveal higher reductions in mean BOP (CPS: 85.2 ± 16.4% versus ERL: 71.6 ± 24.9%) and CAL values (CPS: 1.5 ± 2.0 mm versus ERL: 1.2 ± 2.0 mm) when compared with the ERL group. In both groups, clinical outcomes were not directly influenced by the initial defect configuration.


The 4-year clinical outcomes obtained following combined surgical resective/regenerative therapy of advanced peri-implantitis were not influenced by the method of surface decontamination.