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. J Clin Periodontol

Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
Journal Of Clinical Periodontology (Impact Factor: 4.01). 09/2011; 38(9):872-8. DOI: 10.1111/j.1600-051X.2011.01762.x
Source: PubMed


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.

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    • "Zahlreiche prospektive randomisierte klinische Vergleichsstudien belegen, dass ein konventionelles mechanisches Debridement mittels Handinstrumenten und lokaler Applikation von Chlorhexidindigluconat eine nur begrenzte Effektivität bei der nicht-chirurgischen Therapie der Periimplantitis zu haben scheint [15]. Durch den adjuvanten Einsatz eines chlorhexidinhaltigen Chips, lokaler Antibiotika , einer antimikrobiellen photodynamischen Therapie sowie einer Monotherapie mittels eines Er:YAG-Lasers oder eines modifizierten Pulverstrahlgeräts konnten dagegen die klinischen und mikrobiologischen Ergebnisse temporär verbessert werden [16] [17]. "
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    ABSTRACT: DENT IMPLANTOL 19, 5 332-337 (2015)
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    • "An abrasive air polishing medium can modify the surface of implants. After air powder treatment cell attachment and cell viability still showed sufficient levels, but cell response was decreased compared with sterile surfaces [64,65,67]. The extent of re-osseointegration of titanium implants after air polishing therapy has been reported between 39% and 46% with increased clinical implant attachment and pocket depth reduction [65]. "
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    ABSTRACT: Peri-implant inflammations represent serious diseases after dental implant treatment, which affect both the surrounding hard and soft tissue. Due to prevalence rates up to 56%, peri-implantitis can lead to the loss of the implant without multilateral prevention and therapy concepts. Specific continuous check-ups with evaluation and elimination of risk factors (e.g. smoking, systemic diseases and periodontitis) are effective precautions. In addition to aspects of osseointegration, type and structure of the implant surface are of importance. For the treatment of peri-implant disease various conservative and surgical approaches are available. Mucositis and moderate forms of peri-implantitis can obviously be treated effectively using conservative methods. These include the utilization of different manual ablations, laser-supported systems as well as photodynamic therapy, which may be extended by local or systemic antibiotics. It is possible to regain osseointegration. In cases with advanced peri-implantitis surgical therapies are more effective than conservative approaches. Depending on the configuration of the defects, resective surgery can be carried out for elimination of peri-implant lesions, whereas regenerative therapies may be applicable for defect filling. The cumulative interceptive supportive therapy (CIST) protocol serves as guidance for the treatment of the peri-implantitis. The aim of this review is to provide an overview about current data and to give advices regarding diagnosis, prevention and treatment of peri-implant disease for practitioners.
    Head & Face Medicine 09/2014; 10(1):34. DOI:10.1186/1746-160X-10-34 · 0.85 Impact Factor
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    • "AP using amino acid glycine powder (AGP) has been compared to mechanical debridement using carbon curettes and antiseptic therapy with chlorhexidine digluconate. Both groups exhibited comparable PD reductions and CAL at 6 months, however, AGP showed significantly higher BOP reductions [21]. "
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    ABSTRACT: Objective: 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. Materials and methods: A literature search was conducted using MEDLINE (Pubmed) from 1966 to 2013. In vitro and in vivo studies as well as clinical trials on non-surgical therapy were evaluated. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters including probing depth, clinical attachment levels, bleeding on probing; radiographic bone fill and histological re-osseointegration. Results: From 134 articles found 35 were analyzed. The findings, advantages and disadvantages of using lasers as well as mechanical and chemical methods are discussed. Most of the in vivo and human studies used combination therapies which makes determining the efficacy of one specific method difficult. Most human studies are case series with short term longitudinal analysis without survival or failure reports. Conclusion: Complete elimination of the biofilms is difficult to achieve using these approaches. All therapies induce changes of the chemical and physical properties of the implant surface. Re-osseointegration may be difficult to achieve if not impossible without surgical access to ensure thorough debridement of the defect and detoxification of the implant surface. Combination protocols for non-surgical treatment of peri-implantitis in humans have shown some positive clinical results but long-term evaluation to evaluate the validity and reliability of the techniques is needed.
    The Open Dentistry Journal 05/2014; 8(1):77-84. DOI:10.2174/1874210601408010077
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