Reosseointegration after the surgical treatment of induced peri-implantitis: systematic review on current evidence and translation from the animal to the human model

INTRODUCTION: The aim of this study was to review the histologic evidence of reosseointegration and related influencing factors in experimental induced peri-implantitis. EVIDENCE ACQUISITION: An electronic search was performed on Medline for animal studies that included a histometric evaluation of the amount of regenerated bone in contact with an implant surface. Questions raised in the study focused on the role of implant surfaces, bone regeneration and decontamination treatments in achieving reosseointegration. A detailed electronic search was then conducted on MEDLINE (PubMed) up to July 2017. EVIDENCE SYNTHESIS: One hundred and one articles were selected as abstract, thirty-seven articles assessed as full-text and sixteen finally included in the study. Reported measurements of reosseointegration varied significantly in the study, from 0 to 3.37 mm. There is histological evidence that reosseointegration can occur after treatment of ligature-induced peri-implantitis. However regenerated bone in contact with bone is generally restricted to the most apical portion of the peri-implant defect. CONCLUSIONS: Animal studies of induced peri-implantitis seem to indicate that rough surfaces can enhance reosseointegration as compared to smooth surfaces. With regard to bone regeneration techniques and materials, submerged healing and barrier membranes have shown a positive effect on reosseointegration. No evidence exists, however, about the specific role of different bone substitutes and their ability to improve bone formation. Growth factors have been shown to improve reosseointegration in animal models, though additional study is required to confirm the data. Several decontamination treatments have been shown to promote reosseointegration compared to control; however no specific procedure has proven superior to others in achieving reosseointegration.