Dental implants represent a predictable and effective procedure for replacing missing teeth. However, the massive use of dental implants over the last decades has also developed a "man-made" disease known as peri-implant disease. Derks and Tomasi in 2015 reported 22% of dental implants affected by peri-implantitis after a mean follow-up of 9 years.
The aim of this project is to realize a clinical trial to clarify the efficacy and effectiveness of the application of autologous Dental pulp stem cells (DPSCs) to regenerate peri-implant defects in peri-implantitis patients. Specific aims of this research are to:
(i) Develop and implement a new successful treatment strategy for peri-implantitis using dental pulp stem cells
(ii) Evaluate the microbiological factors associated to peri-implantitis
(iii) Evaluate patient¿s therapeutic response after stem cells application.
To address the research purpose, the investigators will develop and implement a two-armed randomized controlled clinical trial of 2-year duration. Twenty patients, aged between 18 and 65 years old, with dental implants ¿1 year in function and diagnosed with advanced peri-implantitis (Proping pocket depth> 7 mm, Bleeding at probing and/or suppuration) at ¿1 implants will be enrolled and randomly assigned to one of two intervention groups, at the first stage surgery. Control group will be treated by flap elevation, debridement of the peri-implant defect and decontamination of the implant surfaces using sterile saline for irrigation. Flaps will be replaced in their original position and carefully sutured. In the experimental group, the surgical procedure will be identical to the control procedure with the exception of the application of Human dental pulp-derived stem cells obtained from impacted third molars. The whole saliva, peri-implantitis plaque and peri-implant fluid collection will be performed following SOPs at baseline and follow-up (i.e. 6 and 12 months) in the control and experimental groups.
