Surgical Therapy for Peri-Implantitis Using Deproteinised Bovine Bone Mineral With 10% Collagen, Enamel Matrix Derivative and Doxycycline: A Prospective Cohort 10-Year Implant Study.
AIM To assess 10-year implant survival following surgical management of peri-implantitis using deproteinised bovine bone mineral with 10% collagen (DBBMC), enamel matrix derivative (EMD) and doxycycline powder. MATERIALS AND METHODS The original population comprised 30 non-smoking, periodontally stable patients (mean age = 44.9 ± 11 years; 64% female; full-mouth plaque and bleeding score < 20%, no bleeding residual periodontal pockets ≥ 4 mm), each with a single peri-implantitis-affected implant (bleeding on probing, probing depth > 6 mm, ≥ 20% radiographic bone loss, implants in function ≥ 2 years). The surgical procedure involved implant surface decontamination with 24% EDTA followed by defect fill with DBBMC/EMD/doxycycline mixture. Patients underwent individualised supportive peri-implant therapy (SPIT) comprising regular clinical monitoring, professional cleaning and antimicrobial protocols for 10 years. RESULTS Twenty-nine of the 30 implants survived (96.6% survival rate). Mean probing depth decreased from 8.90 ± 1.9 mm to 3.06 ± 0.98 mm; radiographic bone loss improved from 57% ± 16.5% to 13% ± 2.5%. During 10-year SPIT, 12 implants required adjunctive azithromycin. Fifty-eight percent achieved the successful treatment outcome criterion (SOTC: probing depth < 5 mm, no bone loss 10% from baseline, absence of bleeding on probing/suppuration and recession < 0.5 mm anterior/1.5 mm posterior implants). CONCLUSION Surgical management of peri-implantitis combined with DBBMC/EMD/doxycycline and personalised SPIT achieved high long-term implant survival and stable clinical outcomes over 10 years.