Comparison of the Effectiveness of Two Different Surgical Therapeutic Protocols of Peri-implantitis

Not Applicable

Recruiting

• Conditions: Peri-Implantitis; Peri-Implant Health
• Interventions: Procedure: Non-surgical peri-implant therapy; Procedure: Implantoplasty; Procedure: Erythritol Air-abrasive device; Procedure: Prophylaxis

• Registration Number: NCT05899933
• Lead Sponsor: National and Kapodistrian University of Athens

Brief Summary

The purpose of the present study is to compare the 1-year clinical, radiographic and microbiological outcomes and patients' satisfaction following surgical treatment of peri-implantitis after applying two different surface modification methods. Secondarily, analysis and comparison of the microbiological results of implants diagnosed and treated for peri-implantitis with healthy implants will be performed.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-06-02
• Study First Submitted QC: 2023-06-02
• Study First Posted: 2023-06-12
• Study Start: 2023-07-28
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-07
• Last Update Posted: 2025-05-08
• Primary Completion: 2026-12
• Study Completion: 2026-12

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 45

Inclusion Criteria

General Inclusion Criteria:

• Participants ≥ 18 years and ≤ 80 years of age
• Non-smokers based on the patients' self-reported smoking status, defined as patients who had never smoked or had quit smoking at least 2 years ago
• Implants in function for more than 1 year after suprastructure connection

Inclusion Criteria for implants diagnosed with Peri-Implantitis:

• Presence of at least one implant diagnosed with peri-implantitis defined as presence of bleeding on probing and/or suppuration, probing pocket depth ≥6 mm and ≥3 mm of detectable bone loss after initial re-modelling

• Absence of implant mobility

  • in participants with more than one implant, the implant with the worst clinical condition will be studied.

Inclusion Criteria for implants diagnosed with Peri-Implant Health:

• Absence of peri-implant signs of inflammation (redness, swelling)
• Lack of bleeding on probing
• Absence of bone loss beyond crestal bone level changes resulting from initial remodeling, which should not be ≥2 mm

Exclusion Criteria

• Smokers
• Uncontrolled diabetes mellitus (HBA1c >7)
• Treatment with bisphosphonates
• Needing antibiotic prophylaxis
• Currently pregnant or breast-feeding women
• History of systemic administration of antibiotic treatment during the preceding 3 months
• Systemic conditions that contraindicate treatment
• Use of medications known to induce gingival hyperplasia

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Implantoplasty group	Non-surgical peri-implant therapy	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implantoplasty will be applied as an implant surface modification method.
Erythritol Air-abrasive device group	Non-surgical peri-implant therapy	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implant surface decontamination with an air-abrasive device with erythritol powder will be applied.
Implantoplasty group	Implantoplasty	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implantoplasty will be applied as an implant surface modification method.
Implantoplasty group	Prophylaxis	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implantoplasty will be applied as an implant surface modification method.
Control group	Prophylaxis	Participants with healthy implants will be the comparator group for the microbiological analysis.
Erythritol Air-abrasive device group	Erythritol Air-abrasive device	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implant surface decontamination with an air-abrasive device with erythritol powder will be applied.
Erythritol Air-abrasive device group	Prophylaxis	6 weeks after completion of non-surgical peri-implant therapy, participants with peri-implant probing pocket depth ≥ 5mm and presence of bleeding on probing and/or suppuration will receive resective surgical treatment. Implant surface decontamination with an air-abrasive device with erythritol powder will be applied.

Primary Outcome Measures

Name	Time	Method
Treatment success as described by the composite outcome of probing pocket depth (PPD) ≤5 mm, absence of bleeding on probing (BoP) and/or suppuration and bone loss ≤0.5 mm between week 2 and 12 months post-surgery, at 12-month examination post-surgery	12 months post-surgery	The percentage of treatment success will be calculated from the total amount of treated implants.; * PPD will be measured in mm as the distance from the mucosal peri-implant margin to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the targeted implants.; * BoP will be assessed dichotomously (1=presence, 0=absence) within 30 seconds after probing at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the targeted implants.; * Mean change in mm in mean marginal bone level (mesial and distal) will be assessed using an image-processing software.; Standardized intra-oral radiographs will be obtained at each time point using a reproducible technique.; Marginal bone level will be calculated as the distance from the implant shoulder to the most coronal bone-to-implant contact.
Mean total colony forming units (CFU) counts of the bacterial species under study in targeted implants with peri-implantitis from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean total CFU counts from Baseline to Week 6 after non-surgical therapy will be assessed at each experimental group.; Mean total CFU counts will result from microbiological analysis of subgingival samples by quantitative PCR (qPCR).; Subgingival samples will be obtained with three sterile paper points from the deepest pocket of targeted implants at Baseline and at Week 6 after completion of non-surgical therapy.; Detection and quantification of bacterial DNA of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus will be performed.
Mean total colony forming units (CFU) counts of the bacterial species under study in targeted implants with peri-implantitis from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean total CFU counts from Baseline to 12 months after surgical therapy will be assessed at each experimental group.; Mean total CFU counts will result from microbiological analysis of subgingival samples by quantitative PCR (qPCR).; Subgingival samples will be obtained with three sterile paper points from the deepest pocket of targeted implants at Baseline, 3 months post-surgery, 6 months post-surgery and 12 months post-surgery.; Detection and quantification of bacterial DNA of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus will be performed.
Mean total colony forming units (CFU) counts of the bacterial species under study in targeted implants of the control group from Baseline to 12 months follow-up visit	Baseline, 3 months follow-up visit, 6 months follow-up visit, 12 months follow-up visit	Mean total CFU counts from Baseline to 12 months after Baseline examination will be assessed.; Mean total CFU counts will result from microbiological analysis of subgingival samples by quantitative PCR (qPCR).; Subgingival samples will be obtained with three sterile paper points from the implant site with the easiest access for sampling at Baseline, 3 months follow-up visit, 6 months follow-up visit, 12 months follow-up visit.; Detection and quantification of bacterial DNA of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus will be performed.

Secondary Outcome Measures

Name	Time	Method
Mean peri-implant probing pocket depth from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean peri-implant probing pocket depth (PPD) will be assessed at Baseline examination and Week 6 after non-surgical therapy.; At each examination, PPD will be recorded at six sites per targeted implant. PPD will be measured in mm as the distance from the mucosal peri-implant margin to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Percentage of sites with bleeding on probing from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Bleeding on probing will be assessed dichotomously as present (1 for bleeding presence) or absent (0 for bleeding absence) within 30 seconds after probing.; BoP will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Mean peri-implant probing pocket depth from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean peri-implant probing pocket depth (PPD) will be assessed at Baseline examination and 12 months after surgical therapy.; At each examination, PPD will be recorded at six sites per targeted implant. PPD will be measured in mm as the distance from the mucosal peri-implant margin to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean change from Baseline in peri-implant probing pocket depth at Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean change in mm in peri-implant probing pocket depth (PPD) will be assessed between Baseline examination and Week 6 after non-surgical therapy.; At each examination, PPD will be recorded at six sites per targeted implant. PPD will be measured in mm as the distance from the mucosal peri-implant margin to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean change from Baseline in peri-implant clinical attachment level to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean change in mm in peri-implant clinical attachment level (CAL) will be assessed from Baseline examination to 12 months after completion of surgical therapy.; CAL will be recorded at six sites per targeted implant. CAL will be measured in mm as the distance from the most apical portion of the crown or the prosthetic connection platform for removable implant-supported restorations to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean change from Baseline in peri-implant recession at Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean change in mm in peri-implant recession (REC) will be assessed between Baseline examination and Week 6 after non-surgical therapy.; REC will be recorded at six sites per targeted implant. REC will be measured in mm as the distance from the free marginal mucosa to the most apical portion of the crown or the prosthetic connection platform for removable implant- supported restorations with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Evaluation of patients' willingness to recommend the treatment on the visual analogue scale (VAS) at Week 2 post-surgery	Week 2 post-surgery	Participants will complete a questionnaire at Week 2 post-surgery in order to assess satisfaction with the treatment provided using a visual analogue scale (VAS, 10cm). The followed questions will be asked: -Would you recommend the treatment to a relative or friend? (0 represents that you would not recommend it under any circumstances and 10 that you would absolutely recommend it, if necessary).
Evaluation of patients' willingness to recommend the treatment on the visual analogue scale (VAS) at 12 months post-surgery	12 months post-surgery	Participants will complete a questionnaire at 12 months post-surgery in order to assess satisfaction with the treatment provided using a visual analogue scale (VAS, 10cm). The followed questions will be asked: -Would you recommend the treatment to a relative or friend? (0 represents that you would not recommend it under any circumstances and 10 that you would absolutely recommend it, if necessary).
Mean change from Baseline in peri-implant probing pocket depth to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean change in mm in peri-implant probing pocket depth (PPD) will be assessed between Baseline and 12 months after completion of surgical therapy.; PPD will be recorded at six sites per targeted implant. PPD will be measured in mm as the distance from the mucosal peri-implant margin to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Percentage of sites with bleeding on probing from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Bleeding on probing will be assessed dichotomously as present (1 for bleeding presence) or absent (0 for bleeding absence) within 30 seconds after probing.; BoP will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Change from Baseline in bleeding index score to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Change in percentage of sites with bleeding index score (BI) from 0 to 3 will be recorded between Baseline and 12 months after completion of surgical therapy.; BI will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual) within 30 seconds after probing.; Bleeding will be graded as: 0= no bleeding, 1= dot of bleeding, 2= line of bleeding, 3= profuse bleeding
Percentage of sites with suppuration on probing from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Suppuration on probing (SoP) will be assessed dichotomously as present (1 for suppuration presence) or absent (0 for suppuration absence) within 30 seconds after probing.; SoP will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Mean local plaque score from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean number of sites with plaque presence at targeted implants will be assessed from Baseline to 12 months after completion of surgical therapy.; Local plaque score (LPS) will be calculated by assigning a binary score at each surface ( 1 for plaque presence, 0 for plaque absence) and calculating the percentage of total tooth/ implant surfaces with plaque presence.; Presence or absence of plaque will be recorded at 4sites per tooth/ implant (mesial, buccal, distal, lingual)
Full mouth plaque score from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Percentage of full mouth plaque score (FMPS) presence from Baseline to Week 6 after completion of non-surgical therapy.; FMPS will be calculated by assigning a binary score at each surface ( 1 for plaque presence, 0 for plaque absence) and calculating the percentage of total tooth/ implant surfaces with plaque presence.; Presence or absence of plaque will be recorded at four sites per tooth/ implant (mesial, buccal, distal, lingual)
Full mouth bleeding score from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Percentage of full mouth bleeding score (FMBS) presence from Baseline to Week 6 after completion of non-surgical therapy.; FMBS will be calculated by assigning a binary score at each surface ( 1 for bleeding presence, 0 for bleeding absence) within 30 seconds after probing and calculating the percentage of total tooth/ implant surfaces that bled upon probing.; Presence or absence of bleeding will be recorded at six sites per tooth/ implant (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Full mouth bleeding score from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Percentage of full mouth bleeding score (FMBS) presence from Baseline to 12 months after completion of surgical therapy.; FMBS will be calculated by assigning a binary score at each surface ( 1 for bleeding presence, 0 for bleeding absence) within 30 seconds after probing and calculating the percentage of total tooth/ implant surfaces that bled upon probing.; Presence or absence of bleeding will be recorded at 6 sites per tooth/ implant (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Evaluation of participants' pain on the visual analogue scale (VAS, 10cm) at 12 months post-surgery	12 months post-surgery	Participants will complete a questionnaire at 12 months post-surgery in order to assess the intensity of pain at the treated sites at 12 months after surgery using a visual analogue scale (VAS, 10cm). The following question will be asked: From 0-10, rate the intensity of pain after surgery in the treated areas. (0 represents "no pain" and 10 represents "unbearable pain").
Change from Baseline in bleeding index score at Week 6 after completion of non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Change in percentage of sites with bleeding index score (BI) from 0 to 3 will be recorded between Baseline and Week 6 after completion of non-surgical therapy.; BI will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual) within 30 seconds after probing.; Bleeding will be graded as: 0= no bleeding, 1= dot of bleeding, 2= line of bleeding, 3= profuse bleeding.
Mean change from Baseline in peri-implant recession to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean change in mm in peri-implant recession (REC) will be assessed from Baseline examination to 12 months after completion of surgical therapy.; REC will be recorded at six sites per targeted implant. REC will be measured in mm as the distance from the free marginal mucosa to the most apical portion of the crown or the prosthetic connection platform for removable implant- supported restorations with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Full mouth plaque score from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Percentage of full mouth plaque score (FMPS) presence from Baseline to 12 months after completion of surgical therapy.; FMPS will be calculated by assigning a binary score at each surface ( 1 for plaque presence, 0 for plaque absence) and calculating the percentage of total tooth/ implant surfaces with plaque presence.; Presence or absence of plaque will be recorded at 4sites per tooth/ implant (mesial, buccal, distal, lingual)
Evaluation of participants' pain on the visual analogue scale (VAS, 10cm) at Week 2 post-surgery	Week 2 post-surgery	Participants will complete a questionnaire at Week 2 post-surgery in order to assess the intensity of post-surgical pain using a visual analogue scale (VAS, 10cm). The following question will be asked: -From 0-10, rate the intensity of pain after surgery in the treated areas. (0 represents "no pain" and 10 represents "unbearable pain").
Evaluation of participants' pain during toothbrushing on the visual analogue scale (VAS, 10cm) at 12 months post-surgery	12 months post-surgery	Participants will complete a questionnaire at 12 months post-surgery in order to assess the intensity of pain during toothbrushing at the treated sites at 12 months after surgery using a visual analogue scale (VAS, 10cm). The following question will be asked: From 0-10, rate the intensity of pain after surgery in the treated areas. (0 represents "no pain" and 10 represents "unbearable pain").
Number of days of analgesic consumption at Week 2 post-surgery	Week 2 post-surgery	Participants will complete a questionnaire at Week 2 post-surgery in order to record the number of days analgesics were needed .
Evaluation of patients' satisfaction on the visual analogue scale (VAS) at 12 months post-surgery	12 months post-surgery	Participants will complete a questionnaire at 12 months post-surgery in order to assess satisfaction with the treatment provided using a visual analogue scale (VAS, 10cm). The followed questions will be asked: -Are you satisfied with the treatment you received? (0 represents "not at all satisfied" and 10 "completely satisfied").
Percentage of sites with suppuration on probing from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Suppuration on probing (SoP) will be assessed dichotomously as present (1 for suppuration presence) or absent (0 for suppuration absence) within 30 seconds after probing.; SoP will be recorded at 6 sites per targeted implants (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual)
Mean change from Baseline in peri-implant clinical attachment level to Week 6 after surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean change in mm in peri-implant clinical attachment level (CAL) will be assessed from Baseline examination to Week 6 after completion of surgical therapy.; CAL will be recorded at six sites per targeted implant. CAL will be measured in mm as the distance from the most apical portion of the crown or the prosthetic connection platform for removable implant-supported restorations to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean peri-implant recession from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean peri-implant recession (REC) in mm will be assessed at Baseline examination and Week 6 after non-surgical therapy.; REC will be recorded at six sites per targeted implant. REC will be measured in mm as the distance from the free marginal mucosa to the most apical portion of the crown or the prosthetic connection platform for removable implant- supported restorations with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean local plaque score from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean number of sites with plaque presence at targeted implants will be assessed between Baseline examination and Week 6 after non-surgical therapy.; Local plaque score (LPS) will be calculated by assigning a binary score at each implant surface (1 for plaque presence, 0 for plaque absence) Presence or absence of plaque will be recorded at four sites per targeted implant (mesial, buccal, distal, lingual)
Evaluation of participants' swelling on the visual analogue scale (VAS) at Week 2 post-surgery	Week 2 post-surgery	Participants will complete a questionnaire at Week 2 post-surgery in order to assess the intensity of post-surgical swelling using a visual analogue scale (VAS, 10cm). The following question will be asked: -From 0-10 rate the amount of post-surgery swelling in the treated areas. (0 represents "no swelling" and 10 "maximum swelling").
Mean change in marginal bone level at the implant site between Week 2 after surgery and 12 months after surgery measured in intraoral radiographs	Week 2 post-surgery, 12 months post-surgery	Mean change in mm between week 2 and 12 months post-surgery in mean marginal bone level (mesial and distal) will be assessed using an image-processing software.; Standardized intra-oral radiographs will be obtained at Week 2 post-surgery and at 12 months post-surgery examination, using a reproducible technique with an occlusal bite index with acrylic resin mounted on a film holder.; Marginal bone level will be calculated as the distance from the implant shoulder to the most coronal bone-to-implant contact, measured at the mesial and distal aspects of the studied implants at each time-point.
Mean peri-implant clinical attachment level from Baseline to Week 6 after non-surgical therapy	Baseline, Week 6 after non-surgical therapy	Mean change in mm in peri-implant clinical attachment level (CAL) will be assessed at Baseline examination and Week 6 after non-surgical therapy.; CAL will be recorded at six sites per targeted implant. CAL will be measured in mm as the distance from the most apical portion of the crown or the prosthetic connection platform for removable implant-supported restorations to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean peri-implant clinical attachment level from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean change in mm in peri-implant clinical attachment level (CAL) will be assessed at Baseline examination and Week 6 after non-surgical therapy.; CAL will be recorded at six sites per targeted implant. CAL will be measured in mm as the distance from the most apical portion of the crown or the prosthetic connection platform for removable implant-supported restorations to the bottom of the probeable peri-implant pocket with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Mean peri-implant recession from Baseline to 12 months after surgical therapy	Baseline, 3 months post-surgery, 6 months post-surgery, 12 months post-surgery	Mean peri-implant recession (REC) will be assessed in mm from Baseline examination to 12 months after surgical therapy.; REC will be recorded at six sites per targeted implant. REC will be measured in mm as the distance from the free marginal mucosa to the most apical portion of the crown or the prosthetic connection platform for removable implant- supported restorations with a manual periodontal probe to the closest millimeter at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, disto-lingual site of the studied implant.
Evaluation of participants' bleeding tendency when applying oral hygiene on the visual analogue scale (VAS, 10cm) at 12 months post-surgery	12 months post-surgery	Participants will complete a questionnaire at 12 months post-surgery in order to assess the intensity of bleeding during toothbrushing or interdental cleaning at the treated sites at 12 months after surgery using a visual analogue scale (VAS, 10cm). The following question will be asked: assess the presence and intensity of pain during toothbrushing at the treated sites at 12 months after surgery using a visual analogue scale (VAS, 10cm). The following question will be asked: -From 0-10 rate the amount of bleeding when applying oral hygiene to the areas you treated. (0 represents "no bleeding" and 10 "maximum bleeding").
Evaluation of patients' satisfaction on the visual analogue scale (VAS) at Week 2 post-surgery	Week 2 post-surgery	Participants will complete a questionnaire at Week 2 post-surgery in order to assess satisfaction with the treatment provided using a visual analogue scale (VAS, 10cm). The followed questions will be asked: -If necessary, would you do this treatment again? (0 represents aversion to repeating the treatment and 10 that you would repeat it comfortably).

Trial Locations

Locations (1)

Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens; 🇬🇷 Athens, Greece