Nonsurgical Treatment of Peri-implantitis Without Eliminating Granulation Tissue: A 3-Year Study

Implant Dent. 2019 Feb;28(1):4-10. doi: 10.1097/ID.0000000000000832.


Objectives: The purpose of this study was to evaluate a nonsurgical approach toward peri-implantitis by means of mechanical debridement and local detoxification leaving granulation tissue into the peri-implant pockets.

Materials and methods: An analysis was performed on the outcomes of 2 nonsurgical protocols: mechanical debridement plus chemical detoxification with 0.2% chlorhexidine and chlortetracycline hydrochloride (test), and mechanical debridement alone (control). Measures were collected at baseline, 3, 24, and 36 months after treatment.

Results: Seventy-five implants with peri-implantitis were included. At a 36-month evaluation, mean pocket probing depth was 3.15 ± 0.32 mm for the test group and 5.97 ± 0.90 mm for the control group, the difference being significant. An improvement of marginal bone level was recorded for the test group, whether the control group showed a further marginal bone loss. Treatment success was 100% in the test group and 31.4% in the control group.

Conclusion: Nonsurgical implant debridement alone seemed not efficient in the treatment of peri-implantitis. Further longitudinal studies are required to evaluate the efficacy of mechanical debridement with chemical detoxification and removal of granulation tissues against mechanical debridement with chemical detoxification alone.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Chlorhexidine / therapeutic use*
  • Chlortetracycline / therapeutic use*
  • Debridement / methods*
  • Female
  • Granulation Tissue
  • Humans
  • Male
  • Middle Aged
  • Peri-Implantitis / therapy*
  • Periodontal Index
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Chlorhexidine
  • Chlortetracycline