A Comparative Study To Evaluate Healing Mechanism Of Late Stage Of Periodontitis And Peri-Implantitis

Abstract

Background
Periodontitis and peri-implantitis are inflammatory conditions affecting the supporting structures of teeth and dental implants, respectively. Understanding the differences and similarities in their healing mechanisms can enhance therapeutic approaches and improve outcomes. This study compares the healing mechanisms in the late stages of periodontitis and peri-implantitis following standardized treatment protocols.

Materials and Methods

This comparative clinical study included 40 patients, 20 with advanced periodontitis and 20 with peri-implantitis, divided into two groups. Both groups underwent non-surgical debridement followed by adjunctive antimicrobial therapy. Periodontitis cases received guided tissue regeneration (GTR) using bioresorbable membranes, while peri-implantitis cases underwent implant surface decontamination with a combination of chemical and mechanical methods. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were recorded at baseline, 3 months, and 6 months post-treatment. Radiographic bone changes were assessed using cone-beam computed tomography (CBCT).

Results
Significant improvement was observed in both groups at 6 months. In the periodontitis group, mean PD reduction was 3.5 mm (±0.4), and CAL gain was 2.8 mm (±0.3). In the peri-implantitis group, mean PD reduction was 2.9 mm (±0.5), and CAL gain was 2.3 mm (±0.4). Bone regeneration, as seen on CBCT, was more pronounced in periodontitis cases (mean bone fill: 4.2 mm³) compared to peri-implantitis cases (mean bone fill: 2.8 mm³). However, peri-implantitis cases showed a slower but stable healing trajectory, with reduced BOP.

Conclusion
The healing mechanisms of periodontitis and peri-implantitis differ due to the structural and biological variations of periodontal tissues and peri-implant tissues. While periodontitis showed more pronounced bone regeneration, peri-implantitis required meticulous implant surface decontamination to achieve stability. This study highlights the importance of tailored treatment protocols for these conditions.