Plain English Summary
Background and study aims
Periimplantitis is a pathological condition that occurs in the tissues surrounding dental implants. It is characterized by inflammation of the peri-implant connective tissue and loss of progressive support bone. In a recent systematic review, a 22% prevalence of peri-implantitis has been described. If the literature is analyzed, it can be verified how different percentages of prevalence are reported due to the different definition of this pathological condition depending on the study analyzed, being from 1% to 47%. In addition, it has been suggested that this bone loss is time-dependent and that the follow-up time of the different studies can also affect the percentage of prevalence described. The potential benefit of using bone substitutes / biological agents in reconstructive procedures for the treatment of periimplantitis remains undefined for the time being due to the existence of few clinical studies with very heterogeneous designs and different follow-up times. Concerning the material that should be used during the reconstructive procedure, the existing literature is heterogeneous. Several studies evaluate the effectiveness of material without comparing with any control group, while others either compare the use of a material with the performance of only mechanical debridement or with the use of a different material. For this reason, it is difficult to draw solid conclusions about the ideal material.
Who can participate?
1. Age ≥ 18 years
2. Peri-implant bone defect ≥ 3mm assessed radiographically
3. PPD ≥ 5mm combined with bleeding on probing or supuration
4. Intra-surgically, bone defect must have at least a intraosseous component of 3mm and a width of no more than 4mm
5. implants ≥ 1 year in function
What does the study involve?
The test group will be treated with xenograft cover with a resorbable collagen membrane and the control group will be treated with xenograft only.
What are the possible benefits and risks of participating?
The benefit is the reconstruction of the peri-implant bone previously lost and arrest the peri-implant pathology.
The risk is not being able to stop the disease.
Where is the study run from?
1. Periocentrum Bilbao. Bilbao. 48008. Spain.
2. Periodontology postgraduate program at the University of Basque Country Lejona, 48940 Spain.
When is the study starting and how long is it expected to run for?
The study has started at 28-05-2019 and we need to treat 40 patients and follow the evolution for 12 months. We have estimated to end the trial around 01/06/2021.
Who is funding the study?
Who is the main contact?
Reconstructive surgical therapy of peri-implantitis-related bone defects: Application of a bovine-derived bone xenograft with or without a resorbable collagen membrane. Multicenter controlled randomized clinical trial
The use of a resorbable membrane in combination with a xenograft of bovine origin offers an additional benefit in the treatment of peri-implant bone defects compared to the use of the xenograft alone.
Approved 29/04/2019, Ethical Committee of the Basque Country (CEIm de Euskadi [Comité de Ética de la Investigación Clínica con medicamentos] Farmaziako Zuzendaritza / Dirección de Farmacia. Osasun saila / Departamento de Salud. Eusko Jaurlaritza / Gobierno Vasco C/ Donostia-San Sebastián, 1 – 01010 Vitoria-Gasteiz; email@example.com; 945 01 64 59; http://www.euskadi.eus/comite-etico-investigacion-clinica/), ref: PS2019012.
Multicenter randomized controlled clinical trial.
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet.
Intraosseous peri-implant defects
The test group will be treated with xenograft cover with a resorbable collagen membrane.
Control group will be treated with xenograft only.
The intervention will we realized in a single session and the follow-up will be 12 months after the surgical procedure. Randomization will be carried out by means of 5 blocks by a sequence generated by the computer.
Primary outcome measure
Probing depth (PS) is measured in 6 locations per implant. It consists of probing from the margin of the peri-implant mucosa to the most apical part of the peri-implant defect at baseline, at 6 months and at 12 months.
Secondary outcome measures
1. Filling of the radiographic defect is measured using intraoral radiographs of the implant at baseline, 6 months and 12 months. The defect that is appreciated in the initial radiography with the filling in the following ones will be compared.
2. Mucosal recession is measured at one vestibular point of each implant. Measured from the apical margin of the implant-supported restoration to the margin of the peri-implant mucosa at baseline, at 6 months and at 12 months.
3. Bleeding on probing is measured in 6 locations per implant in basal at 6 months and 12 months.
4. Plaque control is measured in 6 locations per implant in basal at 6 months and 12 months.
5. Presence of complications is measured using membrane exposure at healing period. It will be checked if there is primary closure of the lesion or if there is membrane exposure.
6. Intervention time. Is measured by a chronometer since the first incision until the last suture.
7. Patient satisfaction and morbidity are measured using a visual analogic scale at 2 weeks, 6 months and 12 months to know the postoperative morbidity and perception and satisfaction with the procedure.
8. Volumetric changes are measured using an intraoral scanner and a digital computer program that superimposes an initial scanner with the posterior ones to see the volumetric changes at baseline, at 6 months and 12 months.
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Show radiographically peri-implant intraosseous defects of at least 3mm depth.
2. Depth of clinical probing ≥ 5mm with bleeding and/or suppuration.
3. Intra-surgically, the infra-osseous defect must have at least one intraosseous component of 3mm and a width of no more than 4mm.
4. The implant to be treated must have been in function for at least 12 months.
Target number of participants
40 patients divided in two groups being 20 patients per group
Participant exclusion criteria
1. Has iabetes mellitus, hyperparathyroidism and/or osteomalacia.
2. Treated with corticosteroids.
3. Medicated with drugs that induce gingival hyperplasia.
4. Allergic to penicillin or who have taken antibiotics in the last 6 months.
5. Pregnant or breast-feeding patients.
6. Patients with osteoporosis.
7. Impossibility of stabilizing bovine bone with collagen or primary closure of soft tissue.
8. Patients with collagen allergy.
9. Patients treated with radiotherapy.
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Alameda Urquijo street 2, 7th floor
Trial participating centre
University of basque country
C/ alameda urquijo 2 7º planta
+34 662 025 988
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
When we reach the total number of patients treated we will follow them for 12months. After we will prepare the manuscript and publish it before finishing 2021 in a high impact journal.
IPD sharing statement: the datasets generated and/or analysed during the current study during this study will be included in the subsequent results publication.
Intention to publish date
Participant level data
Basic results (scientific)
- ISRCTN67095066_protocol_3Jun19.pdf Uploaded 04/06/2019