Live Surgery Day: Andreas Stavropoulos highlights challenges of treating peri-implantitis

EFP president-elect Andreas Stavropoulos will perform live peri-implantitis surgery in the anterior zone as part of the live surgery day on 17 June organised by the EFP in collaboration with the Osteology Foundation.

He highlighted aesthetics as one of the main challenges involved in this kind of surgery, because some mucosal recession is common after treatment.

“Important factors are the extent of the peri-implantitis lesion, the soft-tissue phenotype, the appearance of the neighbouring teeth, and how much of the area the patient is showing,” he explained.

Discussing the various surgical treatment options for tackling peri-implantitis in the anterior zone, Prof Stavropoulos said that there were resective, reconstructive, and combined approaches.

“With a resective approach, one can more easily eliminate the deep pocket at the expense of aesthetics, while with a reconstructive approach, one may achieve pocket reduction with fewer aesthetic problems,” he noted. “Obviously, one prefers to perform a reconstructive approach as one may achieve sufficient pocket reduction with fewer aesthetic problems. However, the possibility of performing a reconstructive approach may not always be there, as it very much depends on the existing bone-defect morphology.”

One possible limitation of this kind of surgical treatment is that “one would not be as resective as the case may indicate, and in return one may end with a residual pocket that is deeper than what one would like to have.” 

He said that the biggest challenge in peri-implantitis treatment is how to decontaminate the implant surface efficiently and how to prevent recolonisation,

“Decontamination appears to be very difficult to achieve and it is very obvious that is not possible with hand or ultrasonic instruments,” he said. “Air-polishing devices seem more promising, while emerging technologies conceptually appear even better. However, there is still limited evidence on their potential.

The Live Surgery Day also features Anton Sculean performing surgery to treat mandibular recession. The event’s moderators will be Mariano Sanz and Giovanni Salvi, with speakers Frank Schwarz (peri-implantitis surgery) and Martina Stefanini (mandibular recession coverage).

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