Advertisement

Clinical Oral Investigations

, Volume 19, Issue 8, pp 1807–1814 | Cite as

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

  • Gordon John
  • Narja Sahm
  • Jürgen Becker
  • Frank Schwarz
Original Article

Abstract

Objectives

The purpose of this prospective, parallel group-designed, randomized controlled clinical study was the evaluation of the effectiveness of an air-abrasive device (AAD) for nonsurgical treatment of peri-implantitis.

Material and methods

Twenty five patients, showing at least one implant with initial to moderate peri-implantitis, underwent an oral hygiene programme and were randomly treated using either (1) AAD (amino acid glycine powder) or (2) mechanical debridement using carbon curettes and antiseptic therapy with chlorhexidine digluconate (mechanical debridement (MDA)). Clinical parameters were measured at baseline and 12 months after treatment (e.g. bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL)).

Results

At 12 months, the AAD group revealed significantly higher (p < 0.05; unpaired t test) decrease in mean BOP scores when compared with MDA-treated sites (41.2 ± 29.5 vs. 16.6 ± 33.4 %). Both groups exhibited comparable PD reductions (AAD = 0.5 ± 0.9 mm vs. MDA = 0.4 ± 0.9 mm) and CAL gains (AAD = 0.6 ± 1.3 mm vs. MDA = 0.5 ± 1.1 mm) (p > 0.05; Mann-Whitney test, respectively).

Conclusions

Within its limitations, the present study has indicated that both treatment procedures resulted in comparable but limited CAL gains at 12 months. Furthermore, it could be detected that AAD was associated with significantly higher BOP decrease than MDA.

Clinical relevance

The present results have indicated that nonsurgical therapy of peri-implantitis using both AAD and MDA resulted in comparable PD reductions and CAL gains after 12 months of healing. The BOP reductions were significantly higher in the AAD in comparison to the MDA group. So, AAD may be more effective for nonsurgical therapy of peri-implantitis than MDA.

Keywords

Peri-implantitis Nonsurgical Air-powder flow Air-abrasive device Amino acid glycine powder Plastic curettes 

Notes

Source of Funding

The study was in part funded by Electric Medical Systems (EMS, Nyon, Switzerland).

Conflict of Interests

The authors declare that they have no conflict of interests related to this study.

References

  1. 1.
    Zitzmann NU, Berglundh T (2008) Definition and prevalence of peri-implant diseases. J Clin Periodontol 35(8):286–291CrossRefPubMedGoogle Scholar
  2. 2.
    Karoussis IK, Muller S, Salvi GE, Heitz-Mayfield LJ, Bragger U, Lang NP (2004) Association between periodontal and peri-implant conditions: a 10-year prospective study. Clin Oral Implants Res 15:1–7CrossRefPubMedGoogle Scholar
  3. 3.
    Berglundh T, Gotfredsen K, Zitzmann NU, Lang NP, Lindhe J (2007) Spontaneous progression of ligature induced periimplantitis at implants with different surface roughness: an experimental study in dogs. Clin Oral Implants Res 18:655–661CrossRefPubMedGoogle Scholar
  4. 4.
    Heitz-Mayfield LJ (2008) Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol 35:292–304CrossRefPubMedGoogle Scholar
  5. 5.
    Lindhe J, Meyle J (2008) Peri-implant diseases: consensus report of the sixth European workshop on periodontology. J Clin Periodontol 35:282–285CrossRefPubMedGoogle Scholar
  6. 6.
    Esposito M, Hirsch J, Lekholm U, Thomsen P (1999) Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants 14:473–490PubMedGoogle Scholar
  7. 7.
    Quirynen M, De Soete M, van Steenberghe D (2002) Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res 13:1–19CrossRefPubMedGoogle Scholar
  8. 8.
    Leonhardt A, Dahlen G, Renvert S (2003) Five year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodontol 74:1415–1422CrossRefPubMedGoogle Scholar
  9. 9.
    Fürst MM, Salvi GE, Lang NP, Persson GR (2007) Bacterial colonization immediately after installation on oral titanium implants. Clin Oral Implants Res 18:501–508CrossRefPubMedGoogle Scholar
  10. 10.
    Salvi GE, Fürst MM, Lang NP, Persson GR (2008) One-year bacterial colonization patterns of Staphylococcus aureus and other bacteria at implants and adjacent teeth. Clin Oral Implants Res 19:242–248CrossRefPubMedGoogle Scholar
  11. 11.
    Nakazato G, Tsuchiya H, Sato M, Yamauchi M (1989) In vivo plaque formation on implant materials. Int J OralMaxillofac Implants 4:321–326Google Scholar
  12. 12.
    Leonhardt A, Renvert S, Dahlen G (1999) Microbial findings at failing implants. Clin Oral Implants Res 10:339–345CrossRefPubMedGoogle Scholar
  13. 13.
    Shibli JA, Vitussi TR, Garcia RV, Zenobio EG, Ota-Tsuzuki C, Cassoni A, Piatelli A, d’ Avila S (2007) Implant surface analysis and microbiologic evaluation of failed implants retrieved from smokers. J Oral Implantol 33:232–238CrossRefPubMedGoogle Scholar
  14. 14.
    Renvert S, Lessem J, Dahlen G, Renvert H, Lindahl C (2008) Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis: a randomized clinical trial. J Periodontol 79:836–844CrossRefPubMedGoogle Scholar
  15. 15.
    Fox SC, Moriarty JD, Kusy RP (1990) The effects of scaling a titanium implant surface with metal and plastic instruments: an in vitro study. J Periodontol 61:485–490CrossRefPubMedGoogle Scholar
  16. 16.
    Schwarz F, Ferrari D, Popovski K, Hartig B, Becker J (2009) Influence of different air-abrasive powders on cell viability at biologically contaminated titanium dental implants surfaces. J Biomed Mater Res B Appl Biomater 88:83–91CrossRefPubMedGoogle Scholar
  17. 17.
    Parham PL Jr, Cobb CM, French AA, Love JW, Drisko CL, Killoy WJ (1989) Effects of an air-powder abrasive system on plasma-sprayed titanium implant surfaces: an in vitro evaluation. J Oral Implantol 15:78–86PubMedGoogle Scholar
  18. 18.
    Van de Velde E, Thielens P, Schautteet H, Vanclooster R (1991) Subcutaneous emphysema of the oral floor during cleaning of a bridge fixed on an IMZ implant: case report. Rev Belg Med Dent 46:64–71Google Scholar
  19. 19.
    Sahm N, Becker J, Santel T, Schwarz F (2011) 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 38(9):872–8CrossRefPubMedGoogle Scholar
  20. 20.
    Ciancio SG, Lauciello F, Shibly O, Vitello M, Mather M (1995) The effect of an antiseptic mouthrinse on implant maintenance: plaque and periimplant gingival tissues. J Periodontol 66:962–965CrossRefPubMedGoogle Scholar
  21. 21.
    Felo A, Shibly O, Ciancio SG, Lauciello FR, Ho A (1997) Effects of subgingival chlorhexidine irrigation on peri-implant maintenance. Am J Dent 10:107–110PubMedGoogle Scholar
  22. 22.
    Ramberg P, Lindhe J, Botticelli D, Botticelli A (2009) The effect of a triclosan dentifrice on mucositis in subjects with dental implants: a six-month clinical study. J Clin Dent 20:103–107PubMedGoogle Scholar
  23. 23.
    Maximo MB, de Mendonca AC, Renata Santos V, Figueiredo LC, Feres M, Duarte PM (2009) Short-term clinical and microbiological evaluations of peri-implant diseases before and after mechanical anti-infective therapies. Clin Oral Implants Res 20:99–108CrossRefPubMedGoogle Scholar
  24. 24.
    Heitz-Mayfield LJ, Salvi GE, Botticelli D, Mombelli A, Faddy M, Lang NP (2011) Implant Complication Research Group. Anti-infective treatment of peri-implant mucositis: a randomised controlled clinical trial. Clin Oral Implants Res 22(3):237–41CrossRefPubMedGoogle Scholar
  25. 25.
    Karring ES, Stavropoulos A, Ellegaard B, Karring T (2005) Treatment of peri-implantitis by the Vector system. Clin Oral Implants Res 16:288–293CrossRefPubMedGoogle Scholar
  26. 26.
    Schwarz F, Sculean A, Rothamel D, Schwenzer K, Georg T, Becker J (2005) Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: a pilot study. Clin Oral Implants Res 16:44–52CrossRefPubMedGoogle Scholar
  27. 27.
    Renvert S, Lessem J, Dahlen G, Lindahl C, Svensson M (2006) Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial. J Clin Periodontol 33:362–369CrossRefPubMedGoogle Scholar
  28. 28.
    Schwarz F, Bieling K, Nuesry E, Sculean A, Becker J (2006) Clinical and histological healing pattern of peri-implantitis lesions following non-surgical treatment with an Er:YAG laser. Lasers Surg Med 38:663–671CrossRefPubMedGoogle Scholar
  29. 29.
    Schwarz F, Bieling K, Bonsmann M, Latz T, Becker J (2006) Nonsurgical treatment of moderate and advanced periimplantitis lesions: a controlled clinical study. Clin Oral Investig 10:279–288CrossRefPubMedGoogle Scholar
  30. 30.
    Renvert S, Samuelsson E, Lindahl C, Persson GR (2009) Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I: clinical results. J Clin Periodontol 36:604–609CrossRefPubMedGoogle Scholar
  31. 31.
    Mombelli A, Feloutzis A, Brägger U, Lang NP (2001) Treatment of peri-implantitis by local delivery of tetracycline. Clinical, microbiological and radiological results. Clin Oral Implants Res 12(4):287–94CrossRefPubMedGoogle Scholar
  32. 32.
    Loe H (1967) The gingival index, the plaque index and the retention index systems. J Periodontol 38:610–616CrossRefPubMedGoogle Scholar
  33. 33.
    Renvert S, Lindahl C, Roos Jansåker AM, Persson GR (2011) Treatment of peri-implantitis using an Er:YAG laser or an air-abrasive device: a randomized clinical trial. J Clin Periodontol 38(1):65–73CrossRefPubMedGoogle Scholar
  34. 34.
    Bassetti M, Schär D, Wicki B, Eick S, Ramseier CA, Arweiler NB, Sculean A, Salvi GE (2013) Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized controlled clinical trial. Clin Oral Implants Res. doi: 10.1111/clr.12155 PubMedGoogle Scholar
  35. 35.
    Salvi GE, Persson GR, Heitz-Mayfield LJ, Frei M, Lang NP (2007) Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes. Clin Oral Implants Res 18(3):281–5CrossRefPubMedGoogle Scholar
  36. 36.
    Karbach J, Callaway AS, Willershausen B, Wagner W, Al-Nawas B (2013) Multiple resistance to betalactam antibiotics, azithromycin or moxifloxacin in implant associated bacteria. Clin Lab 59(3–4):381–7PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gordon John
    • 1
  • Narja Sahm
    • 1
  • Jürgen Becker
    • 1
  • Frank Schwarz
    • 1
  1. 1.Department of Oral SurgeryHeinrich Heine UniversityDüsseldorfGermany

Personalised recommendations