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.
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References
Zitzmann NU, Berglundh T (2008) Definition and prevalence of peri-implant diseases. J Clin Periodontol 35(8):286–291
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 15:1–7
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 18:655–661
Heitz-Mayfield LJ (2008) Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol 35:292–304
Lindhe J, Meyle J (2008) Peri-implant diseases: consensus report of the sixth European workshop on periodontology. J Clin Periodontol 35:282–285
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 14:473–490
Quirynen M, De Soete M, van Steenberghe D (2002) Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res 13:1–19
Leonhardt A, Dahlen G, Renvert S (2003) Five year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodontol 74:1415–1422
Fürst MM, Salvi GE, Lang NP, Persson GR (2007) Bacterial colonization immediately after installation on oral titanium implants. Clin Oral Implants Res 18:501–508
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 19:242–248
Nakazato G, Tsuchiya H, Sato M, Yamauchi M (1989) In vivo plaque formation on implant materials. Int J OralMaxillofac Implants 4:321–326
Leonhardt A, Renvert S, Dahlen G (1999) Microbial findings at failing implants. Clin Oral Implants Res 10:339–345
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 33:232–238
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 79:836–844
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 61:485–490
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 88:83–91
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 15:78–86
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 46:64–71
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):872–8
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 66:962–965
Felo A, Shibly O, Ciancio SG, Lauciello FR, Ho A (1997) Effects of subgingival chlorhexidine irrigation on peri-implant maintenance. Am J Dent 10:107–110
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 20:103–107
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 20:99–108
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):237–41
Karring ES, Stavropoulos A, Ellegaard B, Karring T (2005) Treatment of peri-implantitis by the Vector system. Clin Oral Implants Res 16:288–293
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 16:44–52
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 33:362–369
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 38:663–671
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 10:279–288
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 36:604–609
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):287–94
Loe H (1967) The gingival index, the plaque index and the retention index systems. J Periodontol 38:610–616
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):65–73
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
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):281–5
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):381–7
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.
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John, G., Sahm, N., Becker, J. et al. 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. Clin Oral Invest 19, 1807–1814 (2015). https://doi.org/10.1007/s00784-015-1406-7
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DOI: https://doi.org/10.1007/s00784-015-1406-7