Regenerative Surgical Treatment of Peri-Implantitis: a one-year Randomized Clinical Trial Comparing Autogenous Bone and Xenograft

Background Peri-implant diseases are plaque-associated inflammatory conditions leading to progressive bone loss and clinical signs such as bleeding on probing, suppuration, and increased probing depths.

Non-surgical measures have demonstrated limited effectiveness in achieving disease resolution; therefore, surgical strategies are often required to re-establish peri-implant health.

Aim This randomized controlled clinical trial aimed to compare the clinical and radiographic outcomes of autogenous bone graft (AB) and xenograft (BDX) in the reconstructive surgical treatment of peri-implant intrabony defects after one year of follow-up.

Materials and Methods Ten patients presenting bilateral peri-implant intrabony defects were enrolled and randomly allocated to receive either autogenous bone or xenograft grafting materials. All sites underwent flap surgery, mechanical surface decontamination, and defect reconstruction under a non-submerged healing protocol. Cone beam computed tomography (CBCT) and intraoral radiographs were used to assess changes in marginal bone level. Clinical parameters (PD, BOP, SUP, MR), linear radiographic bone level changes, and CBCT-based bone mineral density (HU) were evaluated at baseline, 6, and 12 months.

Results Both groups showed significant clinical improvement after one year. Linear radiographic evaluation demonstrated a mean bone gain of 0.2 mm in the AB group and 1.6 mm in the BDX group. CBCT measurements showed significantly higher bone density in xenograft-treated sites (314 HU) compared with autogenous bone (298 HU; P < 0.05).

Conclusions Within the limitations of this study, both autogenous and xenograft bone grafts were effective for the reconstructive treatment of peri-implant intrabony defects. However, xenografts exhibited greater bone density, suggesting superior space-maintenance properties over time.