Non-surgical treatment of peri-implantitis using air abrasive device with or without adjunctive use of systematic antibiotics
Abstract
Introduction: Peri-implantitis is a serious disease affecting the tissues around the dental implant (DI). Non-surgical therapy (NCHT) plays an important role in the management of this disease. One method for NCHT is the treatment with an air abrasive device (MAP). The aim of this prospective, randomized controlled clinical trial was to compare the efficacy of MAP in NCHT of peri-implantitis in combination with or without systemic antibiotic (ATB) therapy.
Methods: The population included 33 patients (15 men and 18 women) with a mean age of 55.4 years at the time of first treatment and a total of 88 dental implants (DI) with diagnosed peri-implantitis. Patients were examined and the clinical parameters of probing depth (PD), bleeding on probing (BOP) and suppuration on probing (SOP) were recorded. The patients were then randomly divided into two groups. The first, the test group, initiated the treatment session using the systemic ATB and then continued to use ATB for 7 days after the therapy. The second, control group, underwent the same therapy, without adjunctive ATB treatment. The therapy itself was performed with Airflow plus powder with erythritol crystals applied using a MAP Perioflow(R) with a Perioflow nozzle (EMS; Nyon, Switzerland). Patients were subsequently called for a follow-up examination 1, 3, 6, 12, and 24 months after the treatment.
Results: As part of the control examinations, there was a significant reduction of the PD parameter in both the test and control groups compared to the baseline. The test group had significantly greater differences in PD sum values after 6 months (p = 0.003) and 12 months
(p < 0.0001) than in patients without ATB therapy.
Conclusion: A reduction in the values of clinical parameters (BOP, SOP, PD) is possible with the use of MAP and erythritol powder, regardless of the systemic administration of ATB. However, the systemic use of ATB as supportive therapy in NCHT of peri-implantitis significantly reduces both PD and BOP compared to the group of patients without systemic ATB.