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Clinical and biochemical evaluation of oral irrigation in patients with peri-implant mucositis: a randomized clinical trial

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Abstract

Objective

This randomized clinical trial aimed to compare the efficacy of an oral irrigator and an interdental brush in patients with peri-implant mucositis clinically and biochemically at different time points (at baseline and at the 2nd, 4th, and 12th weeks).

Materials and methods

Forty-five patients with at least one implant with peri-implant mucositis were included in the present study (n = 45). The patients were divided into three groups: oral irrigator + toothbrush (OI group, n = 15), interdental brush + toothbrush (IB group, n = 15), and toothbrush only (control) (C group, n = 15). The modified plaque index (mPlI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BOP) were recorded at baseline and at the 2nd, 4th, and 12th weeks. The levels of interleukin 1 beta (IL-1β), transforming growth factor-beta (TGF-β), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were also determined in the peri-implant crevicular fluid samples biochemically.

Results

The mSBI and t-PA at the 2nd week (p = 0.003; p = 0.003); the mPlI, mSBI, BOP, t-PA, and PAI-1 at the 4th week (p < 0.05; p < 0.001; p < 0.001; p = 0.015; p = 0.011); and the mPlI, mSBI, IL-1β, t-PA, and PAI-1 at the 12th week (p < 0.05; p < 0.001; p = 0.013; p < 0.001; p = 0.002) were significantly lower in the OI group compared with those in the C group. Meanwhile, PAI-1 at the 2nd week, mSBI at the 4th week, and t-PA at the 12th week were significantly lower in the OI group compared with those in the IB group (p < 0.001; p = 0.011; p = 0.003). At the 2nd, 4th, and 12th weeks, all other parameters were not statistically different in the three groups.

Conclusion

The clinical indexes (such as mSBI and BOP) that play an important role in the diagnosis of peri-implant mucositis showed the lowest means (although limited) in the OI group at all evaluation time points. Moreover, when the clinical and biochemistry results were interpreted altogether, it became apparent that the OI group exhibited similar or more effective results than the IB group in resolving peri-implant mucositis. In light of the foregoing, this study concluded that the use of an oral irrigator can be as effective as an interdental brush in interdental cleaning.

Clinical relevance

In this study, it is suggested that the regular use of an oral irrigator along with a toothbrush could be an appropriate alternative to other oral hygiene products such as dental floss and interdental brush for the management of peri-implant mucositis by preventing the accumulation of dental plaque (NCT03844035).

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Funding

This study was supported by the Ondokuz Mayis Research Fund (Project number: PYO.DIS.1904.14.006).

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Authors and Affiliations

  1. Samsun Oral and Dental Health Hospital, Samsun, Turkey

    Sema Tütüncüoğlu

  2. Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey

    Burcu Ozkan Cetinkaya & Müge Lütfioğlu

  3. Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey

    Ferda Pamuk

  4. Faculty of Medicine, Department of Biochemistry, Ondokuz Mayis University, Samsun, Turkey

    Bahattin Avci

  5. Faculty of Dentistry, Department of Periodontology, Istanbul Okan University, Istanbul, Turkey

    Gonca Cayir Keles

  6. Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, Turkey

    Sevda Kurt-Bayrakdar

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  1. Sema Tütüncüoğlu
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Contributions

All authors have made substantial contributions to the conception and design of the study. S.T. and B.O.C. have been involved in data collection and B.A. has been involved in data analysis. F.P., G.C.K., and S.K.B. have been involved in data interpretation and drafting of the manuscript. M.L. has been involved in revising it critically and has given the final approval of the version to be published.

Corresponding author

Correspondence to Sevda Kurt-Bayrakdar.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee (Human Ethical Committee of Ondokuz Mayis University, protocol no: 2014/644).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Tütüncüoğlu, S., Cetinkaya, B.O., Pamuk, F. et al. Clinical and biochemical evaluation of oral irrigation in patients with peri-implant mucositis: a randomized clinical trial. Clin Oral Invest 26, 659–671 (2022). https://doi.org/10.1007/s00784-021-04044-x

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