Nonsurgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine. Twelve-month follow-up of 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.
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ABSTRACT: Peri-implantitis is characterized by mucosal inflammation and loss of supporting peri-implant bone. The objective of this systematic review was to evaluate the efficacy and safety of non-surgical treatment of peri-implantitis. MEDLINE, Embase, and Web of Science were searched to identify randomized clinical trial studies that assessed non-surgical treatment of peri-implantitis with a minimum follow-up period of 3 months. From a total of 29 abstracts, nine trials were included in this systematic review. Adjunctive local delivery of antibiotics, submucosal glycine powder air polishing, or Er:YAG laser treatment resulted in greater reduction in bleeding on probing compared with submucosal debridement using curettes with adjunctive irrigation with chlorhexidine. In addition, greater reductions in probing depths were found following adjunctive local delivery of antibiotics. The evidence neither supported nor refuted the clinical efficacy of submucosal debridement using curettes or ultrasonic scalers alone. No progressive bone loss was found following any of the assessed treatments over a maximum observation period of 12 months. Only two studies reported implant survival rates, which were 100% over 6 months. The available evidence suggested that submucosal debridement with adjunctive local delivery of antibiotics, submucosal glycine powder air polishing, or Er:YAG laser treatment may reduce clinical signs of peri-implant mucosal inflammation to a greater extent relative to submucosal debridement using curettes with adjunctive irrigation with chlorhexidine. Long-term randomized controlled trials are needed to assess the efficacy of non-surgical therapy on progressing bone loss, implant survival rates, and measures of oral health-related quality of life.Clinical Oral Implants Research 10/2012; 23 Suppl 6:77-83. DOI:10.1111/j.1600-0501.2012.02542.x · 3.12 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of the present study was to evaluate morphological changes induced by glycine powder air polishing on titanium surfaces and its effect on bacteria recolonization in comparison with sodium bicarbonate powder. MATERIALS AND METHODS: 5 mm wide and 1 mm thick titanium grade II disks were divided into three groups of treatments: (i) no treatment; (ii) air polishing with glycine powder; (iii) air polishing with sodium bicarbonate powder. Specimens were characterized by laser profilometry, scanning electron microscopy (SEM) and then installed onto removable appliances worn for 24 h by healthy volunteers. Surface contamination was evaluated using SEM and counting the number of colony forming units (CFU). RESULTS: SEM observation revealed an increased roughness with the formation of craters on samples treated with sodium bicarbonate powder, while not in glycine ones. Statistical analysis failed to show significant differences of both R(a) and R(max) parameters in treated groups. SEM observation of specimens surfaces, after 24 h of permanence in the oral cavity, showed a higher contamination of the disks treated with sodium bicarbonate compared with those not treated (P < 0.05). Conversely, the group treated with glycine showed the lower contamination if compared with bicarbonate-treated group (P < 0.05). CONCLUSIONS: Air polishing with glycine powder may be considered as a better method to remove plaque from dental implant because glycine is less aggressive than sodium bicarbonate powder. Moreover, the use of glycine powder seems to have an active role on the inhibition of bacterial recolonization of implants in a short test period (24 h). Further studies are needed to demonstrate the bacteriostatic properties of glycine, envisaged on the basis of reduced contamination of the disks polished with glycine compared with those not treated.Clinical Oral Implants Research 05/2012; DOI:10.1111/j.1600-0501.2012.02490.x · 3.12 Impact Factor
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ABSTRACT: The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants. © 2015 Wiley Periodicals, Inc.Clinical Implant Dentistry and Related Research 04/2015; DOI:10.1111/cid.12343 · 2.80 Impact Factor