A Topical Desiccant Agent in Association with Manual Debridement in the Initial Treatment of Peri-Implant Mucositis: A Clinical and Microbiological Pilot Study.

Giorgio Lombardo,Alessia Pardo,Pier Francesco Nocini,Caterina Signoretto,Giovanni Corrocher,Gloria Burlacchini,Annarita Signoriello

doi:10.3390/antibiotics8020082

Abstract

In patients presenting mucositis, effective sub-gingival debridement is crucial to prevent peri-implantitis. The aim of this randomized study was to assess the three-month (T1) effects of a locally delivered liquid desiccant agent with molecular hygroscopic properties, in association with manual debridement, at sites with peri-implant mucositis. Twenty-three patients presenting at least one implant with no radiographically detectable bone loss, a pocket probing depth (PPD) ≥ 4 mm, and bleeding on probing (BOP), were included. At baseline (T0), patients were randomly assigned to receive the aforementioned desiccant agent before debridement (Test-Group), or a Chlorhexidine 1% disinfectant gel after debridement (Control-Group). Treatments were repeated after seven and 14 days. Peri-implant soft tissue assessment [PPD, BOP, Modified Bleeding Index (mBI), Visible Plaque Index (VPI), and Modified Plaque Index (mPLI)] and microbial sampling were performed at T0 and T1. At T1 the Test-Group presented significantly greater reductions for BOP, mBI, VPI, and mPLI. Concerning the deepest sites of the treated implants, both groups showed statistically significant reductions for BOP and mBI between T0 and T1. Furthermore, the Test-Group exhibited a significant decrease in anaerobic bacteria. Despite these valid outcomes, a complete resolution of the inflammatory conditions was not achieved by any of the groups.

Highlights

Over the past decades, the utilization of dental implants for oral rehabilitation has achieved predictable outcomes and high success rates [1].The main long-term causes of dental implants failure involve the onset of biological complications, such as mucositis and peri-implantitis, at the peri-implant soft tissue level
The most efficient proposed prevention of peri-implantitis development is the early resolution of pre-existing peri-implant mucositis [7,8]; its treatment goal consists in the eradication or significant reduction of the levels of pathogenic microorganisms, in order to allow proper soft tissue healing
Concerning the data obtained with Multiplex PCR, the Control-Group showed a decrease for all three periodontopathogenic bacteria detected (Prevotella intermedia 12 vs. 9, Porphyromonas gingivalis 17 vs. 14, Aggregatibacter actinomycetemcomitans 13 vs 12)

Summary

Introduction

The main long-term causes of dental implants failure involve the onset of biological complications, such as mucositis and peri-implantitis, at the peri-implant soft tissue level. Bacterial biofilm plays a fundamental role in the occurrence of periodontal and peri-implant diseases. It has been assumed that peri-implant mucositis is the precursor of peri-implantitis, as gingivitis for periodontitis. On this basis, the most efficient proposed prevention of peri-implantitis development is the early resolution of pre-existing peri-implant mucositis [7,8]; its treatment goal consists in the eradication or significant reduction of the levels of pathogenic microorganisms, in order to allow proper soft tissue healing

Methods

Results

Conclusion