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Mariano Sanz

Mariano Sanz
Surgical treatment of peri-implant disease

The routine use of implants in dentistry proved to be successful and predictable in restoring masticatory function, aesthetics and the comfort of the partially or fully edentulous patient. Nevertheless, a certain proportion of implants are lost even after years of successful osseointegration. This loss may be caused by peri-implantitis, i.e. an inflammatory lesion of the surrounding peri-implant tissues characterized by loss of supporting bone (Claffey et al. 2008). Therefore, the prevention and/or treatment of peri-implant diseases are of importance in clinical dentistry, and the available scientific evidence should help define adequate preventive and therapeutic approaches. The limited available literature suggests that mechanical non-surgical therapy could be effective in the treatment of peri-implant mucositis (Renvert et al. 2008b).

Conversely, non-surgical approaches were not found to be effective in peri-implantitis, as unpredictable results were noticed (Renvert et al. 2008, Lindhe & Meyle 2008). Moreover, the available evidence for surgical therapy of peri-implantitis has been considered as “limited” (Claffey et al. 2008) since there are few controlled prospective studies evaluating this mode of therapy in the treatment of periimplantitis. All tested surgical approaches appeared to determine some improvements of clinical conditions. However, complete resolution of peri-implantitis was never reported and, furthermore, significant differences among the different surgical therapies were rarely noted. Access surgery has been investigated reporting resolution in about 60% of the lesions. Different methods of surface decontamination have been tested in conjunction with the surgical therapy (implantoplasty, chemical agents, air abrasives and lasers), but none was found to be superior. The use of regenerative procedures has also been reported with various degrees of success.

Learning objectives:

  • To assess the scientific evidence on the efficacy of the different surgical therapies in the treatment of peri-implantitis
  • To assess the scientific evidence on the efficacy of the different surface decontamination methods used during the surgical therapy of peri-implantitis
  • To assess the scientific evidence on the efficacy of the different regenerative techniques used during the surgical therapy of peri-implantitis
  • To present representative cases illustrating the expected outcomes of this surgical procedure


Professor Sanz received his MD and DDES degree from the Universidad Complutense de Madrid. He then completed his graduate training in Periodontology at the University of California, Los Angeles (UCLA). Additionally, he is Doctor in Medicine (PhD Degree) from the University Complutense of Madrid.  He is Professor of Periodontology, Dean of the Faculty of Odontology of the University Complutense of Madrid and Director of the Graduate Program “Master in Periodontology” also at the University Complutense of Madrid. Currently he is the Chairman of the European Council of Deans of Faculties of Odontology. Professor Sanz is the author of more than 200 scientific articles and book chapters and participates extensively in international lectures, courses and seminars in Periodontology, Implant Dentistry and Dental Education.