Therapy of peri-implantitis: A systematic review: Review article

Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece.
Journal Of Clinical Periodontology (Impact Factor: 4.01). 08/2008; 35(7):621-9. DOI: 10.1111/j.1600-051X.2008.01240.x
Source: PubMed


The objective of this study was to provide a systematic review of randomized controlled and/or comparative clinical trials published in the international peer-reviewed literature in the English language, up to and including July 2007, concerning the efficacy of all treatment modalities implemented for the therapy of peri-implantitis.
PubMed and The Cochrane Library databases were searched electronically and numerous journals were examined manually. In the first phase of selection, the titles and abstracts, and in the second phase, complete papers were screened independently and in duplicate by three reviewers (S. K., I. K. K. and M. T.).
The search yielded 1304 possibly relevant titles and abstracts. After the first phase of selection, 13 publications were singled out for a rigorous evaluation. Following the second phase, five studies were selected.
The selected studies are too limited in number and exhibit small sample sizes and short follow-up periods. Therefore, there is a definite need for more well-designed, preferably longitudinal, randomized controlled clinical trials. Within the limitations of the selected studies, mechanical debridement combined with antiseptic/antibiotic therapy, the Er:YAG laser or regenerative techniques may be used for treating peri-implantitis, but the indications for each of these techniques have not been delineated clearly.

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    • "The underlying principle in any type of treatment is to reduce bacterial load in peri-implant sites and to achieve peri-implant mucosal health [13] [14]. However, current evidence for the efficacy of each type of treatment is weak and limited, and the superiority of any modality over the others is unknown [1] [14] [15]. "
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    ABSTRACT: Purpose. The aims of this in vitro study were to evaluate morphological changes induced by glycine powder air-polishing on titanium surfaces, biofilm removal, and biocompatibility. Material and Methods. Titanium grade IV discs were allocated into two groups: (1) discs without biofilm and (2) discs for Streptococcus mutans biofilm formation. Discs in each group were further subdivided into (a) no treatment and (b) air-polishing treatment with glycine powder. Discs were characterized by scanning electron microscopy (SEM), electron-dispersive spectroscopy (EDS), and confocal microscopy. Bacterial biofilms were quantified using a crystal violet dye-binding assay. Biocompatibility was evaluated by measuring the coverage and viability of L929 fibroblast cells cultured on the discs. Results. Air-polishing increased the roughness of treated discs ( P < 0.05 ). EDS analysis did not show significant differences in the chemical composition of treated and nontreated discs. The amount of residual biofilm on treated discs was 8.6-fold lower than untreated controls ( P < 0.05 ). Coverage of treated discs by fibroblasts was half that of untreated discs ( P < 0.05 ) although both groups had the same cell viability. Conclusions. Air-polishing removed a significant amount of biofilm from titanium surfaces. The “polishing” was accompanied by increased surface roughness, but there were no changes in chemical and elemental compositions, nor the biocompatibility.
    Full-text · Article · Dec 2015
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    • "Peri-implantitis is defined as an inflammatory process affecting the implant’s supporting bone [4, 5]. By the growing popularity of dental implants the prevalence of peri-implantitis has increased as well [6]. The basics of peri-implantitis treatment include elimination of inflammation by removing calculus and granulation tissue and decontamination of implant surface without modifying the surface structure [7]. "
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    ABSTRACT: Objective: Peri-implantitis is one of the most common reasons for implant failure. Decontamination of infected implant surfaces can be achieved effectively by laser irradiation; although the associated thermal rise may cause irreversible bone damage and lead to implant loss. Temperature increments of over 10ºC during laser application may suffice for irreversible bone damage. Purpose of Study: The purpose of this study was to evaluate the temperature increment of implant surface during Er:YAG laser irradiation with different cooling systems. Materials and Methods: Three implants were placed in a resected block of sheep mandible and irradiated with Er:YAG laser with 3 different cooling systems namely water and air spray, air spray alone and no water or air spray. Temperature changes of the implant surface were monitored during laser irradiation with a K-type thermocouple at the apical area of the fixture. Results: In all 3 groups, the maximum temperature rise was lower than 10°C. Temperature changes were significantly different with different cooling systems used (P<0.001). Conclusion: Based on the results, no thermal damage was observed during implant surface decontamination by Er:YAG laser with and without refrigeration. Thus, Er:YAG laser irradiation can be a safe method for treatment of periimplantitis.
    Full-text · Article · Mar 2014
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    • "Effective decontamination of dental implant surfaces is one of the most difficult steps; and for this reason, several different treatments have been proposed in the literature [3–8]. Titanium implant surfaces can be cleaned by mechanical means (dental curettes, ultrasonic scalers, air–powder abrasive) and/or chemical procedures (citric acid, H2O2, chlorhexidine digluconate, and EDTA), usually associated with local or systemic antibiotics [9–12]. However, some of these methods can damage the surface properties of implants or promote bacterial resistance [13–15]. "
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    ABSTRACT: Several implant surface debridement methods have been reported for the treatment of peri-implantitis, however, some of them can damage the implant surface or promote bacterial resistance. Photodynamic therapy (PDT) is a new treatment option for peri-implantitis. The aim of this in vitro study was to analyze implant surface decontamination by means of PDT. Sixty implants were equally distributed (n = 10) into four groups and two subgroups. In group G1 there was no decontamination, while in G2 decontamination was performed with chlorhexidine. G3 (PDT - laser + dye) and G4 (laser, without dye) were divided into two subgroups each; with PDT performed for 3 min in G3a and G4a, and for 5 min in G3b and G4b. After 5 min in contact with methylene blue dye (G3), the implants were irradiated (G3 and G4) with a low-level laser (GaAlAs, 660 nm, 30 mW) for 3 or 5 min (7.2 and 12 J). After the dilutions, culture media were kept in an anaerobic atmosphere for 1 week, and then colony forming units were counted. There was a significant difference (p < 0.001) between G1 and the other groups, and between G4 in comparison with G2 and G3. Better decontamination was obtained in G2 and G3, with no statistically significant difference between them. The results of this study suggest that photodynamic therapy can be considered an efficient method for reducing bacteria on implant surfaces, whereas laser irradiation without dye was less efficient than PDT.
    Full-text · Article · Jul 2012 · Lasers in Medical Science
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