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

Minerva Stomatol. 2017 Dec;66(6):255-266. doi: 10.23736/S0026-4970.17.04054-7. Epub 2017 Oct 3.

Abstract

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.

MeSH terms

  • Administration, Topical
  • Adult
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / therapeutic use*
  • Chlorhexidine / therapeutic use
  • Clinical Protocols
  • Combined Modality Therapy
  • Dental Implantation, Endosseous
  • Dental Plaque Index
  • Dental Polishing / methods
  • Dental Restoration Failure
  • Dental Scaling
  • Doxycycline / administration & dosage
  • Doxycycline / therapeutic use*
  • Erythritol / administration & dosage
  • Erythritol / therapeutic use*
  • Female
  • Gingiva / drug effects
  • Gingiva / pathology
  • Gingival Pocket / drug therapy
  • Gingival Pocket / therapy
  • Gingival Recession / etiology
  • Gingival Recession / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Mouthwashes
  • Peri-Implantitis / drug therapy
  • Peri-Implantitis / therapy*
  • Periodontal Debridement
  • Periodontal Index
  • Powders

Substances

  • Anti-Infective Agents
  • Mouthwashes
  • Powders
  • Doxycycline
  • Chlorhexidine
  • Erythritol