Non-surgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine: a prospective, randomized, controlled clinical study.
ABSTRACT The aim of this prospective, parallel group designed, randomized controlled clinical study was to evaluate the effectiveness of an air-abrasive device (AAD) for non-surgical treatment of peri-implantitis.
Thirty patients, each of whom displayed at least one implant with initial to moderate peri-implantitis, were enrolled in an oral hygiene program (OHI) and randomly instrumented using either (1) AAD (amino acid glycine powder) or (2) mechanical debridement using carbon curets and antiseptic therapy with chlorhexidine digluconate (MDA). Clinical parameters were measured at baseline, 3 and 6 months after treatment [e.g. bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL)].
At 6 months, AAD group revealed significantly higher (p<0.05; unpaired t-test) changes in mean BOP scores when compared with MDA-treated sites (43.5 ± 27.7%versus 11.0 ± 15.7%). Both groups exhibited comparable PD reductions (AAD: 0.6 ± 0.6 mm versus MDA: 0.5 ± 0.6 mm) and CAL gains (AAD: 0.4 ± 0.7 mm versus MDA: 0.5 ± 0.8 mm) (p>0.05; unpaired t-test, respectively).
Within its limitations, the present study has indicated that (i) both treatment procedures resulted in comparable but limited CAL gains at 6 months, and (ii) OHI+AAD was associated with significantly higher BOP reductions than OHI+MDA.
- SourceAvailable from: Ramón Torrecillas[Show abstract] [Hide abstract]
ABSTRACT: The aim of the present study was to evaluate bone loss at implants connected to abutments coated with a soda-lime glass containing silver nanoparticles, subjected to experimental peri-implantitis. Also the aging and erosion of the coating in mouth was studied. Five beagle dogs were used in the experiments. Three implants were placed in each mandible quadrant: in 2 of them, Glass/n-Ag coated abutments were connected to implant platform, 1 was covered with a Ti-mechanized abutment. Experimental peri-implantitis was induced in all implants after the submarginal placement of cotton ligatures, and three months after animals were euthanatized. Thickness and morphology of coating was studied in abutment cross-sections by SEM. Histology and histo-morphometric studies were carried on in undecalfied ground slides. After the induced peri-implantitis: 1.The abutment coating shown losing of thickness and cracking. 2. The histometry showed a significant less bone loss in the implants with glass/n-Ag coated abutments. A more symmetric cone of bone resorption was observed in the coated group. There were no significant differences in the peri-implantitis histological characteristics between both groups of implants. Within the limits of this in-vivo study, it could be affirmed that abutments coated with biocide soda-lime-glass-silver nanoparticles can reduce bone loss in experimental peri-implantitis. This achievement makes this coating a suggestive material to control peri-implantitis development and progression.PLoS ONE 01/2014; 9(1):e86926. · 3.73 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The aim of this review is to summarize the findings of studies that have evaluated non-surgical approaches for detoxification of implant body surfaces in vitro and in vivo, and to evaluate clinical trials on the use of these methodologies for treating peri-implant disease.The Open Dentistry Journal 01/2014; 8:77-84.
- [Show abstract] [Hide abstract]
ABSTRACT: The use of dental implants for supporting prosthetic rehabilitations has shown highly satisfactory results regarding restoration of the patient's function and esthetics, as well as in terms of long-term survival (2). However, dental implants can lose supportive bone, even in cases of successful osseointegration. The main cause of this loss of crestal bone surrounding an implant is local inflammation during the course of peri-implant diseases. These diseases are defined as inflammatory lesions of the surrounding peri-implant tissues and include two different entities: peri-implant mucositis and peri-implantitis (7). Peri-implant mucositis is defined as an inflammatory lesion limited to the surrounding mucosa of an implant, whereas peri-implantitis is an inflammatory lesion of the mucosa that affects the supporting bone with loss of osseointegration (19). Both peri-implant diseases are infectious in nature and are caused by bacteria from dental biofilms (18). A recent review concluded that the microbiota associ-ated with peri-implant diseases is a mixed anaerobic infection, with a composition similar to that of the subgingival microbiota of chronic periodontitis, although some cases of peri-implant disease may be specifically associated with other bacterial species, such as Peptostreptococcus spp. or Staphylococcus spp. (22). Although bacterial pathogens represent the initial step of the disease process, the ensuing local inflammatory response and the misbalance in the host–parasite interaction seem key in the pathogene-sis of the tissue destruction defining these diseases. Different risk indicators that may influence the path-ogenesis in favor of tissue destruction include poor oral hygiene, a history of periodontitis and cigarette smoking. Less evidence has been demonstrated for the role of diabetes and alcohol consumption (13). The possible role of other factors, such as genetic traits, the implant surface or the lack of keratinized mucosa, are also under investigation (63). Different methods have been used to assess peri-implant tissue health and to diagnose these disease entities. These methods include peri-implant prob-ing, analyses of peri-implant crevicular fluid or saliva, evaluation of the peri-implant microbiota and radio-graphic evaluation of the peri-implant bone levels. The current consensus indicates that changes in probing depth, and the presence of bleeding on prob-ing and suppuration, must be evaluated to assess the peri-implant tissues, whilst radiographs should be used to confirm peri-implant bone loss (13, 57). Peri-implant diseases are important disease entities as a result of their high prevalence and the lack of a standard mode of therapy (7, 35). Although the current epidemiological data are limited, peri-implant mucosi-tis has been reported to affect 80% of the subjects with dental implants and 50% of the implants, whilst peri-implantitis affects 28–56% of the subjects and 12–43% of the implants. This reviews aims to describe the dif-ferent approaches to treat peri-implant diseases and to evaluate critically the evidence available to support the different proposed therapies. With this purpose we used a recently published systematic review from our research group in which only controlled studies were considered (11). In addition, relevant recently pub-lished studies were included.01/2014;