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Treatment of Peri-implantitis With or Without Simultaneous Soft Tissue Augmentation

19 de junho de 2026 atualizado por: Lucrezia Paternò Holtzman, George Eastman Dental Hospital, Italy

Surgical Reconstructive Treatment of Peri-Implantitis With or Without Simultaneous Soft Tissue Augmentation: a Multi-center Randomized Controlled Trial

The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects. More specifically, the control group will be a reconstructive approach (xenograft bone graft granules and collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). The test group will be the same, with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to grafting materials.

Outcomes will include CAL, PD, MR, defect resolution, PI, BoP, SUPP, surgical characteristics, and patient-reported outcome measures, including an aesthetic self-evaluation.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects.

More specifically, the control group will be a "pure" reconstructive approach (xenograft bone graft granules and resorbable collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). This is in accordance with gold standard practices of reconstructive therapy of peri-implant defects.

The test group will be treated with the same approach and materials, with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to the grafting materials. The graft will be harvested from the homolateral palate (molar region).

Outcomes will include clinical attachment level (CAL; primary outcome), probing depth (PD), mucosal recession (MR), defect resolution (a composite outcome defined as the simultaneous absence of PD > 5 mm, bleeding on probing [BOP] and/or suppuration [SUP], and bone level changes > 0.5 mm), plaque index (PI), BOP, suppuration on probing, suppuration on palpation, surgical duration, the Early Wound Healing Index (EHI), and patient-reported outcome measures (PROMs), including aesthetic self-evaluation.

PROMs will assess patients' perception of surgery, pain intensity, perceived swelling, perceived bleeding, and analgesic intake.

Clinical measurements will be recorded at baseline and at 6, 12, 18, and 24 months. EHI will be assessed at 1 and 2 weeks postoperatively. Radiographic bone levels at 12 and 24 months will be compared with those recorded on radiographs obtained at baseline. All PROMs variables, as well as aesthetic self-evaluation, will be collected using specially designed questionnaires completed by the patients. PROMs data will be recorded at 4, 8, and 12 hours after surgery on the day of surgery (day 0), and daily from postoperative day 2 to day 7. Aesthetic self-evaluation will be recorded at baseline and at 6, 12, and 24 months postoperatively.

Tipo de estudo

Intervencional

Inscrição (Real)

32

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Lucrezia Paternò Holtzman, DMD
  • Número de telefone: +39.06.3241406
  • E-mail: lucreziaph@gmail.com

Estude backup de contato

Locais de estudo

      • Roma, Itália, 00100
        • George Eastman Dental Hospital

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Sim

Descrição

Inclusion Criteria:

  • · Be able and willing to provide consent and sign the informed consent form.

    • Be able and willing to comply with study procedures and follow-up appointments required by the study protocol.
    • Age>18 years
    • Presence of at least one implant affected with peri-implantitis, defined as the following con-dition: at least one site presenting peri-implant probing depth (PPD) >6 mm and simultane-ous presence of profuse BoP/SUP and a radiographically documented change in bone level greater than initial bone remodeling. In the likely event that a baseline radiographic image is absent, the bone level will be compared to where it would likely have been at the time of implant insertion and a difference of >3 mm from that level will be considered.
    • Implants in function (i.e. loaded) for at least 1 year.
    • Screw- and cement-retained suprastructures for both fixed and removable prostheses.

Exclusion Criteria:

  • Compromised systemic health which contraindicates the study procedures.
  • Pregnant or nursing women.
  • Cigarette smoking>5 per day
  • Systemic conditions compromising healing (i.e. diabetes mellitus). Patients with diabe-tes mellitus types I or II will be asked to provide information regarding their most re-cent HbA1c values. Only patients with HbA1c<7% will be enrolled.
  • Patients taking medications known to interfere with gingival or bone metabolism.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Xenograft+collagen membrane
Reconstructive approach (Xenograft+collegen membrane)

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

Experimental: Xenograft+collagen membrane+autologous soft tissue graft
Reconstructive approach (Xenograft+collegen membrane) plus soft tissue graft (autologous, harvested as FGG)

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Clinical attachment level
Prazo: change from baseline to: 6, 12, 18, 24 months
linear distance (mm) from the implant platform to the bottom of the pocket
change from baseline to: 6, 12, 18, 24 months

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Probing depth
Prazo: 6, 12, 18, 24 months
linear distance (mm) from the gingival margin to the bottom of the pocket
6, 12, 18, 24 months
Disease resolution
Prazo: 6, 12, 18, 24 months
No PD greater than or equal to 5 mm and simultaneous absence of BOP/SUP and no more than 0.5 mm change between 2 weeks and 12 and 24 months on radiograph
6, 12, 18, 24 months
Mucosal recession
Prazo: 6, 12, 18, 24 months
linear distance (mm) from the implant platform to the gingival margin
6, 12, 18, 24 months
plaque index (minimum value 0, maximum 1)
Prazo: 6, 12, 18, 24 months
binary outcome: yes/ no detected running the probe into the peri-implant sulcus
6, 12, 18, 24 months
profuse bleeding
Prazo: 6, 12, 18, 24 months
abundant bleeding evoked upon probing immediately after
6, 12, 18, 24 months
BOP
Prazo: 6, 12, 18, 24 months
bleeding upon probing: bleeding evoked upon probing after 1 second
6, 12, 18, 24 months
suppuration
Prazo: 6, 12, 18, 24 months
Binary: yes or no, detected upon probing or digital palpation
6, 12, 18, 24 months
Gingival thickness
Prazo: 6, 12, 18, 24 months
Measured in a horizontal direction at 1 mm from the gingival margin
6, 12, 18, 24 months
Radiographic bone levels
Prazo: 2 weeks, 12 months, 24 months
radiographic bone level changes between the 2 week and 12 and 24 month follow-ups
2 weeks, 12 months, 24 months
PROMs - Patient perception of surgery
Prazo: 4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
Assessed using a 100-mm visual analog scale (VAS), where higher scores indicate a more positive perception of the surgical procedure.
4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
PROMs - Patient-reported pain intensity
Prazo: 4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
Assessed using a 100-mm visual analog scale (VAS), where higher scores indicate greater pain intensity.
4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
PROMs - Patient-reported swelling
Prazo: 4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
Assessed using a 100-mm visual analog scale (VAS), where higher scores indicate greater perceived swelling.
4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
PROMs - Patient-reported bleeding
Prazo: 4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
Assessed using a 100-mm visual analog scale (VAS), where higher scores indicate greater perceived bleeding.
4 hours, 8 hours, 12 hours, and Days 2-7 after surgery
PROMs - Analgesic consumption
Prazo: 12 hours after surgery and daily from day 2 through day 7 after surgery
Number of analgesic tablets consumed by the patient during the first postoperative week.
12 hours after surgery and daily from day 2 through day 7 after surgery
PROMs - aesthetic self-evaluation
Prazo: Baseline, 6 months, 12 months, and 24 months
Assessed using a 100-mm visual analog scale (VAS), where higher scores indicate greater satisfaction with the esthetic outcome.
Baseline, 6 months, 12 months, and 24 months
Early wound healing
Prazo: 1 week and 2 weeks after surgery
Wound healing scores ranging from 1 to 5 by the surgeon
1 week and 2 weeks after surgery
Surgical duration
Prazo: at the surgery
The interval between the initial incision and placement of the final suture, measured in minutes.
at the surgery

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Luca Cordaro, MD, PhD, G. Eastman Dental Hospital Rome, Italy

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

5 de fevereiro de 2021

Conclusão Primária (Real)

1 de janeiro de 2025

Conclusão do estudo (Real)

1 de janeiro de 2025

Datas de inscrição no estudo

Enviado pela primeira vez

23 de março de 2020

Enviado pela primeira vez que atendeu aos critérios de CQ

25 de março de 2020

Primeira postagem (Real)

26 de março de 2020

Atualizações de registro de estudo

Última Atualização Postada (Real)

24 de junho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

19 de junho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 18117 (Outro identificador: City of Hope Medical Center)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .