ORIGINAL ARTICLE   

Minerva Stomatologica 2017 December;66(6):255-66

DOI: 10.23736/S0026-4970.17.04054-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

A new multiple anti-infective non-surgical therapy in the treatment of peri-implantitis: a case series

Magda MENSI ¹ ✉, Eleonora SCOTTI ¹, Stefano CALZA ², Andrea PILLONI ³, Maria G. GRUSOVIN ⁴, Claudio MONGARDINI ³

¹ Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy; ² Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy; ³ Section of Periodontics, School of Dentistry, Department of Odontostomatology and Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy; ⁴ Vita-Salute San Raffaele University, School of Dentistry, Milan, Italy

BACKGROUND: Peri-implantitis is a frequent disease that may lead to implant loss. The aim of this case series was to evaluate the clinical results of a new non-surgical treatment protocol.
METHODS: Fifteen patients with dental implants affected by peri-implantitis were treated with a multiple anti-infective non-surgical treatment (MAINST) which included two steps: 1) supra-gingival decontamination of the lesion and sub-gingival treatment with a controlled-release topical doxycycline; 2) after one week, a session of supra and sub gingival air polishing with Erythritol powder and ultrasonic debridement (where calculus was present) of the whole oral cavity was performed along with a second application of topical doxycycline around the infected implant. Primary outcome measures were: implant failure; complications and adverse events; recurrence of peri-implantitis; secondary outcome measure were presence of Plaque (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD). Recession (REC), Relative Attachment level (RAL).
RESULTS: Neither implant failure nor complications nor adverse events were reported. Statistically (P<0.01) and clinically significant reductions between baseline and 1 year of PI (100% vs. 13.9%, 95% CI: 72.4% to 93.7%); BOP (98.5% vs. 4.5%, 95% CI: 85.4% to 98.5%) and PPD (7.89 vs. 3.16 mm, 95% CI: -5.67 to -3.77), were detected. At baseline, all 15 patients had a PPD>5 mm at the affected implant(s), whereas only 3.7% at 3-month follow-up a PPD>5 mm, and none at 6 and 12 months.
CONCLUSIONS: Within the limits of this study, the MAINST protocol showed improvement of clinical parameters for the treatment of peri-implantitis, which were maintained for up to 12 months.

KEY WORDS: Oral implants - Anti-bacterial agents - Biofilms - Professional practice - Peri-implantitis