Clinical evaluation of non-surgical cleaning modalities on titanium dental implants during maintenance care: a 1-year follow-up on prosthodontic superstructures.

Abstract

To investigate tissue health around implants with newly attached superstructures over 12months of preventive maintenance appointments and instrumentation when necessary. In a randomized, split-mouth study 32 implants (8 participants with 4 implants each) received followed-up care every 3months after superstructure attachment. Implants and superstructures were randomly assigned to four treatment groups and treated if necessary: (1) titanium curettes (TC), (2) stainless steel ultrasonic tip (PS), (3) erythritol air-polishing powder (EP), or (4) rubber cup polishing (CON). Probing depths (PDs), bleeding on probing (BOP), modified gingival (mucosal) bleeding index (GBI) around implants, and full-mouth Plaque Control Record (PCR) were measured every 3months. Clinical attachment levels (CALs) and height of keratinized mucosa (KM)/gingival margins (GMs) for implants/teeth and PD, BOP, and GBI for teeth were documented at baseline, 6months, and 12months. Matrix metalloproteinase 8 (MMP-8) and periopathogens were measured at baseline and 12months. Participants exhibited minimal signs of periodontal inflammation with statistically significant PD improvement (3.0 ± 0.2 to 2.8 ± 0.3mm; p = 0.022) and overall CAL (4.3 ± 0.8 to 4.0 ± 0.7mm; p = 0.048) after 1year. Implants showed no statistically significant differences (p > 0.05) between or within groups at baseline or 12months for any parameter, except MMP-8 decreased significantly for PS (14.50 ± 17.58 to 4.63 ± 7.56ng; p = 0.044), and after 12months, PCR showed a significant difference between TC and PS (p = 0.018). Treatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements. Early assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.