A non-surgical treatment of peri-implantitis using mechanic, antiseptic and anti-inflammatory treatment- 1-year follow-up

15266 ORAL COMMUNICATION CLINICAL RESEARCH - PERI-IMPLANT BIOLOGY

Background

Peri-implantitis is major concern in the current implantology with growing incidence. Surgical intervention includes resective surgery, open flap debridement or bone augmentation, all with chance of complications and morbidity. Surgical treatment outcomes are controversial in current literature. Non-surgical intervention includes debridement of soft tissue with various materials and instrumentations and slow release devices. Non-surgical treatment exhibit limited success and predictability.

Aim/Hypothesis

To assess the clinical outcome six and twelve months after a non-surgical treatment of peri-implantitis per se or conjunction with combination of local antiseptic and anti-inflammatory treatment.

Material and Methods

Sixty-eight patients with periodontitis (grade 1–3, and stage A-B) with a total of 102 implants with peri-implantitis were included. Peri-implantitis was defined as radiographic bone loss more or equal to 3 mm, probing depth (PD) more or equal to 6 mm with bleeding on probing (BOP). Treatment of implants was performed with ultrasonic debridement, soft tissue curettage (group MEC), or addition (group MEC+LPA) of implant's surface treatment with rotatory hand piece composed of chitosan bristle, soft tissue curettage combined with application of 0.95% hypochlorite and amino acid and at the end application of 1 mg minocycline HCl.

Results

After 6 months, both groups (MEC and MEC+LPA) demonstrated significant reductions (P < 0.05) of mean PD (1.8 ± 0.6 mm, 2.5 ± 0.5 mm), clinical attachment level (CAL) (1.5 ± 0.8 mm, 1.9 ± 0.6 mm), and BOP (21.4% ± 14.2%, 33.2% ± 12.3%). The improvement was demonstrated after 12 months without significant differences between 6 and 12 months. After 12 months, the MEC+LPA group showed significant better results compared to MEC alone in PD (4.2 ± 0.3 mm, 5.1 ± 0.5 mm, respectively, P < 0.05) and BOP (15.3% ± 6.2%, 25% ± 8.2%, respectively, P < 0.05).

Conclusion and clinical implications

It is suggested that adjunctive of local antiseptic and anti-inflammatory during mechanical phase is positively associated with inflammation reduction and adhesion of connective tissue attachment.