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Non-Surgical Treatment of Peri-implantitis Associated Intrabony Defects with the Use of Adjunctive Systemic Azithromycin: Clinical and Radiographic Outcomes of a Dual-Centre Retrospective Study

Int J Oral Maxillofac Implants. 2026 Mar 6;0(0):1-24. doi: 10.11607/jomi.11673. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate both the clinical and radiographic effects of adjunctive systemic azithromycin in the non-surgical approach to treating peri-implantitis associated intrabony defects.

MATERIALS AND METHODS: This retrospective analysis included 28 patients (36 implants) presenting peri-implantitis, characterized by peri-implant lesions showing intrabony defects. All of them received non-surgical treatment consisting of submucosal debridement, implant surface decontamination, minor curettage together with submucosal irrigation with 0.12% chlorhexidine digluconate and with the administration of systemic azithromycin (500 mg/day for 3 days). Measurements of clinical and radiographic outcomes were recorded at baseline and after a minimum follow-up period of 12 months.

RESULTS: Mean follow-up of cases was 22.9±13.6 months. At follow-up, the average reduction in probing pocket depth (PPD) was 3.9 ± 1.5 mm. The radiographic intrabony defect depth decreased by 2.2 ± 1.6 mm and bone gain was 2.6 ± 1.7 mm. Baseline PPD and intrabony defect were statistically significant correlated with radiographic bone fill (r=0.499, p=0.002 and r=0.465, p=0.004; respectively). Disease resolution was achieved in 66.7% of treated implants.

CONCLUSIONS: Within the limitations of the study design, non-surgical approach with adjunctive use of systemic azithromycin for the treatment of peri-implantitis associated lesions with intrabony defects may lead to significant clinical and radiographic improvements.

PMID:41790997 | DOI:10.11607/jomi.11673

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