Treatment Of Peri-implant Mucositis Research Articles

A Single Dose of Piperacillin Plus Tazobactam Gel as an Adjunct to Professional Mechanical Plaque Removal (PMPR) in Patients with Peri-Implant Mucositis: A 6-Month Double-Blind Randomized Clinical Trial.

This randomized, placebo-controlled, double-masked clinical trial aimed to evaluate the clinical and microbiological efficacy of professional mechanical plaque removal (PMPR) with or without adjunctive application of piperacillin plus tazobactam gel in the treatment of peri-implant mucositis (PiM) for up to 6 months. The study included 31 patients with peri-implant mucositis (bleeding on probing (BoP) > 1 at at least one site at baseline, absence of peri-implant bone loss compared with a previous radiograph). After randomized assignment to test and control groups, patients received full-mouth supragingival scaling with or without piperacillin plus tazobactam gel. Clinical examination was performed at baseline and after 3 and 6 months, and a microbiological examination was performed at baseline and after 3 months. After six months, both treatment modalities resulted in significant reductions and improvements in clinical parameters at the implant sites. Neither study group achieved a complete resolution of PiM (i.e., BoP ≤ 1 per implant). The number of implants with BoP decreased statistically significantly between subsequent time points (p < 0.001) in both the test and the control group. Significant BoP differences (p = 0.039) were observed between groups at 6 months (difference to baseline) following therapy. Within the limitations of the present study, the single use of a slow-release, locally applied antibiotic combination of piperacillin and tazobactam gel, adjunctive to PMPR, showed an improvement in clinical variable of implants diagnosed with PiM. The adjunctive treatment resulted in higher BoP reduction when compared to the control, but no significant differences were observed regarding the changes in other clinical and microbiological parameters.

Disease resolution following treatment of peri-implant diseases: A systematic review.

The aim of this PRISMA-compliant systematic review was to analyze the evidence pertaining to disease resolution after treatment of peri-implant diseases (PROSPERO: CRD42022306999) with the following PICO question: what is the rate of disease resolution following non-surgical and surgical therapy for peri-implant diseases in adult human subjects? A literature search to identify studies that fulfilled a pre-established eligibility criteria was conducted. Data on primary therapeutic outcomes, including treatment success, rate of disease resolution and/or recurrence, as well as a variety of secondary outcomes was extracted and categorized. Fifty-five articles were included. Few studies investigated the efficacy of different non-surgical and surgical therapies to treat peri-implant diseases using a set of pre-defined criteria and with follow-up periods of at least one year. The definition of treatment success and outcomes of disease resolution differed considerably among the included studies. Treatment of peri-implant mucositis was most commonly reported to be successful in arresting disease progression for ≤60% of the cases, whereas most studies on peri-implantitis treatment reported disease resolution occurring in <50% of the fixtures. In conclusion, disease resolution is generally unpredictable and infrequently achieved after the treatment of peri-implant diseases. A great variety of definitions have been used to define treatment success. Notably, percentages of treatment success and disease resolution were generally underreported. The use of standardized parameters to evaluate disease resolution should be considered an integral component in future clinical studies.

Effect of Adjunctive Use of Probiotics in the Treatment of Peri-Implant Mucositis: A Systematic Review and Meta-Analysis

This review was performed to analyze evidence from the scientific literature of the adjunctive effect of probiotics in the treatment of peri-implant mucositis (PiM). Only randomized clinical trials evaluating the effect of probiotics as an adjunct to mechanical debridement in PiM were included. A search was performed in PubMed/MEDLINE, LILACS, ScienceDirect, and Web of Science to identify articles published in English up to January 2023. The quality of the studies was evaluated using the JADAD scale, and the risk of bias was assessed with the Cochrane Collaboration assessment tool. Of the 159 potentially relevant studies, only 9 studies were included. The most commonly used strain was Lactobacillus reuteri, and the meta-analysis was conducted on studies with a follow-up period of 3 to 6 months, observing an overall effect on the reduction of bleeding on probing (BOP) at 3 and 6 months (WMD = −1.13, 95% CI = −1.95 to −0.30, p = 0.007; and WMD = −1.32, 95% CI = −2.15 to −0.48, p = 0.002), plaque index (PI) at 3 months (WMD = −1.22, 95% CI = −2.25 to −0.19, p = 0.02), and probing pocket depth (PPD) at 3 and 6 months, which was statistically significant in favor of the probiotic group (WMD = −1.34, 95% CI = −2.42 to −0.25, p = 0.02 and WMD = −1.36, 95% CI = −2.61 to −0.11, p = 0.03). On the other hand, there were no significant changes in the subgingival microflora around the implants with the use of probiotics. Probiotic therapy, as an adjunct to mechanical debridement, promotes a greater reduction in BOP, PPD, and PI, in relation to the control group without probiotics.

Is Laser Therapy an Adjuvant in the Treatment of Peri-Implant Mucositis? A Randomized Clinical Trial.

(1) Background: Early diagnosis and treatment of peri-implant mucositis may reduce inflammatory markers and halt the progression of the condition to peri-implantitis. Adjunctive laser treatment may have therapeutic benefits that are not yet well known. The aim of this study was to determine the advantages and limitations of laser therapy as an adjuvant in the treatment of peri-implant mucositis. (2) Methods: A total of 42 patients with at least 2 implants situated in different hemiarches were included in this study and divided into two groups: G1 (received laser therapy) and G2 (no laser therapy). Periodontal health status indices were recorded at the initial moment (T0), and all patients underwent non-surgical debridement therapy accompanied by oral hygiene training. In patients from group G1, one implant site received adjuvant laser therapy (subgroup IL), and the other one did not receive active laser light (IC). The plaque index (PI), probing pocket depth (PPD), and bleeding on probing (BOP) values recorded after 3 months (T1) and 6 months (T2) were analyzed and compared with those at T0. (3) Results: PI values considerably reduced at moment T1 and T2 for both G1 and G2 (p = 0.0031). PPD was also reduced, but the difference between the groups and the three recording moments was not statistically significant. Statistically significant differences were found when comparing the BOP values between G1 IL and G1 IC for T0/T1 (p = 0.0182) and T1/T2 (p < 0.0001), but there was no significant difference between G2 and G1 IL or G1 IC. (4) Conclusions: Laser therapy as an adjunct to conventional treatment of peri-implant mucositis leads to a statistically significant reduction in bleeding on probing at 3-month and 6-month re-evaluations. Moreover, it leads to an evident reduction in probing depth but with no statistical significance. These results should be interpreted with caution, and more in-depth research should be performed to create a complete laser therapy protocol for peri-implant mucositis.

Resolution of peri-implant mucositis at tissue- and bone-level implants: A 6-month prospective controlled clinical trial.

The objective of the study was to compare resolution of inflammation of naturally occurring peri-implant mucositis (PM) at tissue-level (TL) and bone-level (BL) implants after non-surgical mechanical debridement. Fifty-four patients with 74 Implants with PM were allocated in two groups (39 TL and 35 BL implants) and treated by means of subgingival debridement using a sonic scaler with a plastic tip without adjunctive measures. At baseline and at 1, 3, 6months, the full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), bleeding on probing (BOP), and modified plaque index (mPlI) were recorded. The primary outcome was BOP change. After 6months, the FMPS, FMBS, PD, and number of implants with plaque decreased statistically significantly in each group (p < .05); however, no statistically significant differences were found between TL and BL implants (p > .05). After 6months, 17 (43.6%) TL and 14 (40%) BL implants showed a BOP change in (17.9%) and (11.4%), respectively. No statistical difference was recorded between groups. Within the limitations of present study, the findings showed no statistically significant differences in terms of changes in clinical parameters following non-surgical mechanical treatment of PM at TL and BL implants. A complete resolution of PM (i.e., no BOP at all implant sites) was not achieved in both groups.

Effect of Ozonated Extra Virgin Olive Oil Gel in The Treatment of Peri-Implant Mucositis: A Retrospective Analysis of 20 Cases

Effect of Ozonated Extra Virgin Olive Oil Gel in The Treatment of Peri-Implant Mucositis: A Retrospective Analysis of 20 Cases

Adjunctive Use of Active Compounds such as Chlorhexidine in the Nonsurgical Treatment of Peri-Implant Mucositis for Oral Health: A Systematic Review and Meta-Analysis.

Background Peri-implant mucositis (PiM) is characterized as a reversible inflammatory change of the peri-implant soft tissues without alveolar bone loss or continuing marginal bone loss. Without proper control of PiM, the reversible inflammation may advance to peri-implantitis (PI). Mechanical debridement (MD) by the implant surface is the most common and conventional nonsurgical approach to treat PiM but with limitations in complete resolution of diseases. For more than a decade, chlorhexidine (CHX) and active compounds has been investigated in the treatment of PiM. Therefore, the aim of this systematic review and meta-analysis was to evaluate the efficacy of CHX treatment in combination with MD versus MD alone or MD+placebo in patients with PiM on their oral health problems. Methods A search using electronic databases (Ovid MEDLINE, EMBASE, Science Direct databases, and Cochrane Central Register of Controlled Trials) and a manual search up to May 2022 were performed independently by 2 reviewers and included eligible randomized controlled trials (RCTs) comparing MD+CHX versus MD alone or MD+placebo. The assessment of quality for all the selected RCTs was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. Disease resolution of PiM (absence of BOP), IPPD reduction, IBOP% reduction, and PI% reduction after treatment as primary outcomes were selected as the primary outcomes. Weighted mean differences (WMD) and 95% confidence interval (CI) were for continuous outcomes, and odds ratio (OR) and 95% CI was for dichotomous outcomes using random effect models. This review is registered on the PROSPERO database (CRD42020221989). Results After independent screening, nine eligible studies were included in this systematic review and meta-analysis. Meta-analysis showed OR of disease resolution between test and control groups amounted to 1.41 (95% CI (0.43, 4.65), P = 0.57, I2 = 65%) not favoring adjunctive CHX treatment over MD alone. Through subgroup analysis, the results indicated that oral irrigation of CHX may have more benefits on the resolution of PiM. Similarly, CHX did not significantly improve IPPD reduction at both short-, medium-, and long-term follow-up. Only a short-term effect has been observed at IBOP% reduction (WMD = 13.88, 95% CI (10.94, 16.81), P < 0.00001, I2 = 9%), IPI reduction (WMD = 0.12, 95% CI (0.09, 0.14), P < 0.00001, I2 = 0%), and FMPPD reduction (WMD = 0.19 mm, 95% CI (0.03, 0.35), P = 0.02, I2 = 0%) with adjunctive CHX application. Conclusion Adjunctive CHX application may have some benefits to improve the efficacy of MD in PiM treatment by reducing IBOP%, IPI, and FMPPD in short-term. But these benefits disappeared at medium- and long-term follow-up. In order to achieve better disease resolution of PiM, adjunctive CHX irrigation with MD may be suggested and has positive potential. Well-designed large clinical trials are needed in future.

Clinical outcomes and associated factors in the treatment of peri-implant mucositis, combining mechanical debridement and prosthesis modification: A 30-month follow-up prospective case series.

To evaluate the clinical outcome and the associated factors of a treatment protocol for peri-implant mucositis. Patients were evaluated 30 months after a treatment protocol including professional mechanical debridement and modification of the prosthesis contours to improve access for biofilm control. Clinical performance was assessed by means of probing with an electronic pressure-calibrated periodontal probe. The possible impact of implant- and patient-level factors on the changes in peri-implant mucosal inflammation measured with the modified bleeding index (mBI) was evaluated. Twenty patients and 61 implants were included in the analysis. At the final visit, 50% of the patients presented bleeding on probing, with a mean mBI of 0.22 (SD 0.27). The adjusted linear regression model showed a significant association between patient's compliance with supportive care visits (p= .006) and mucosal inflammation. Similarly, at the implant level, modified plaque index (p&lt; .001) and an irregular use of interdental brushes (p= .017) had a significant impact on final mBI. Prosthesis modification when needed in association with non-surgical treatment may be an important intervention in the treatment of peri-implant mucositis. Compliance with supportive care visits and the regular use of inter-dental brushes were identified as important factors to achieve mucosal inflammation control.

An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients

This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.

Assessment of salivary alpha amylase and mucin-4 before and after non-surgical treatment of peri-implant mucositis

BackgroundThe present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM.MethodsPatients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01.ResultsTwenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2.ConclusionsThe AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.

Adjuvant use of multispecies probiotic in the treatment of peri-implant mucositis: A randomized controlled trial.

This randomized placebo-controlled clinical trial evaluated the effects of multispecies probiotic containing Lactobacillus rhamnosus HN001™, Lactobacillus paracasei Lpc-37®, and Bifidobacterium animalis subsp lactis HN019™ as an adjunct to mechanical debridement (MD) on changes in bleeding on probing (BOP) in edentulous patients with peri-implant mucositis (PiM). Patients were randomly assigned to test (probiotic) or control (placebo) groups. All sites with PiM received MD and topical gel application (probiotic or placebo) at baseline and 12 weeks. After initial MD, patients consumed probiotic or placebo capsules twice a day for 12 weeks. Clinical (modified sulcus bleeding index [mSBI]; modified plaque index [mPI]; probing depth [PD]; and BOP) and immunological parameters were collected at baseline and after 12 and 24 weeks. Data were statistically analysed (p < .05). Thirty-six patients with PiM were recruited. The test group presented higher prevalence (p< .05) of cases of restored peri-implant health at 24 weeks than did the control group (72.2% and 33.3%, respectively). No significant difference was observed between test (n= 18) and control (n= 18) groups for mPI and PD. mSBI %-score 0 was higher in the test group than in the control group at 24 weeks (p< .05). When compared with baseline, both groups presented reduced BOP at 12 and 24 weeks (p< .05). BOP was lower in the test group than in the control group at 12 (mean difference=-14.54%; 95% confidence interval [CI]=-28.87 to 0.22; p= .0163) and 24 (mean difference=-12.56%; 95% CI=-26.51 to 1.37; p= .0090) weeks. At 24 weeks, only the test group presented lower levels of interleukin (IL)-1β, IL-6, IL-8, and tumour necrosis factor (TNF)-α than those at baseline (p< .05). The multispecies probiotic (administered locally and systemically) containing L. rhamnosus HN001™, L. paracasei Lpc-37®, and B. lactis HN019™ as an adjunct to repeated MD promotes additional clinical and immunological benefits in the treatment of PiM in edentulous patients (ClinicalTrials.gov NCT04187222).

Microbiota analysis of peri-implant mucositis in patients with periodontitis history

ObjectivesTo investigate the bacterial diversity in peri-implant plaques and the effect of periodontitis history on the occurrence of peri-implant mucositis.Materials and methodsThree groups of subgingival plaques were collected from peri-implant sulci in the first molar area. The three groups included healthy implants in patients without periodontitis (NH implant), healthy implants in patients with periodontitis history (PH implant), and peri-implant mucositis implants in patients with periodontitis history (PM implant). Subgingival plaques in periodontal pockets of contralateral natural first molars were also collected. Bacterial DNA was extracted and the V4 region of the 16S rDNA sequence was amplified and sequenced on an Illumina HiSeq platform. The operational taxonomic units obtained from amplicon sequencing were used to analyze the prevalence and identity of bacteria based on public databases and advanced techniques.ResultsAnalysis of similarities indicated a significant difference in bacterial structures between the NH implant and PM implant groups. Additionally, a significantly higher relative abundance of the genera Actinomyces and Streptococcus was found in the samples of the NH implant group. The genera Fusobacterium and Prevotella could be considered as potential biomarkers for peri-implant mucositis. Moreover, more gram-negative anaerobic bacteria (Porphyromonas and Prevotella) were detected in the samples from patients with periodontitis history.ConclusionsThe increased accumulation of Fusobacterium and Prevotella is associated with a higher risk of peri-implant mucositis. In addition, patients with periodontal history may be more likely to develop peri-implant mucositis.Clinical relevanceThe increase in periodontal pathogens and the decrease in health-associated bacteria in patients with periodontitis history may be more likely to develop peri-implant mucositis. These results provide a bacteriological basis for the prevention and treatment of peri-implant mucositis in patients with periodontitis history.

Efficacy of Antibiotics Used as an Adjunct in the Treatment of Peri-implant Mucositis and Peri-implantitis: A Systematic Review and Meta-analysis.

This systematic review aimed to assess the clinical efficacy of antibiotics when used as an adjunct in treating peri-implant diseases. A systematic search of papers published between January 1980 and March 2020 was conducted. Randomized clinical trials with at least 10 patients who had peri-implant diseases, treated with or without adjunctive antibiotics in combination with surgical or nonsurgical therapies, and with a minimum of at least 3 months of follow-up were included. Meta-analyses were conducted to analyze weighted mean differences in probing depth reduction, radiographic bone level gain, and odds ratio of treatment success. From the 856 articles identified, 10 articles met the inclusion criteria and were selected. Of these, 7 articles were used for the meta-analysis. The adjunctive use of antibiotics in the treatment of peri-implant diseases yielded significantly greater probing depth reduction (weighted mean differences = 0.56 mm at 3 months, P = .001; 0.77 mm at 6 months, P < .00001; 0.92 mm at 12 months, P < .00001), radiographic bone level gain (weighted mean differences = 0.64 mm, P = .03), and treatment success (odds ratio = 1.74, P = .04) compared to the same treatment without antibiotics. Based on the existing evidence, the use of adjunctive antibiotics to treat peri-implant diseases, especially peri-implantitis, provided potential benefits in clinical outcomes for up to 12 months posttherapy.

Recognition and treatment of peri-implant mucositis: Do we have the right perception? A structured review.

Peri-implant mucositis is a common inflammatory lesion of the soft tissues surrounding endosseous implants, with no loss of the supporting bone. Its prevention or early diagnosis are vital for dental implant success.The aim of this review was to investigate knowledge strengths and gaps in clinicians' perceptions of periimplant mucositis prevalence and evidence for successful treatment.A literature search for articles published until 2020, reporting on the prevalence of peri-implant mucositis and its treatment was performed in standard online databases. The inclusion criteria were as follows: studies in English; studies with an available abstract; studies on humans with at least 1 dental implant; and studies reporting on the prevalence and/or treatment of peri-implant mucositis. Sixty-five studies fulfilled the inclusion criteria. The included papers were analyzed to identify data on the prevalence and treatment of peri-implant mucositis. The prevalence statistics for peri-implant mucositis had wide ranges in both the patient-based (PB) analysis and the implant-based (IB) analysis; the possible reasons for these wide ranges are discussed. Treatment methods for peri-implant mucositis were analyzed individually and compared to the management of gingivitis.It was determined that the currently available information on the prevalence rates and the standardized therapeutic protocols for peri-implant mucositis are insufficient. Since the mean gingivitis and peri-implant mucositis prevalence rates in the PB analysis were similar, it is possible that peri-implant mucositis is underestimated due to variables related to implant rehabilitation itself.

Effectiveness of orally administered probiotic Lactobacillus reuteri in patients with peri-implant mucositis: a prospective clinical study

Aim The aim of the present prospective clinical study was to evaluate the effectiveness of orally administered probiotic Lactobacillus reuteri in the treatment of peri-implant mucositis. Materials and methods Eighty patients showing peri-implant mucositis were enrolled and assigned to two different treatment groups. In the test group subjects were instructed to take one probiotic lozenge daily for 30 days. In the control group, patients received placebo. Periodontal indices including plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were clinically recorded around natural teeth and implants at baseline and after a period of 1 month and 3 months. Results After 3-month evaluation in the test group the differences of plaque and bleeding indices remained statistically significantly lower compared to baseline at both teeth and implants. Contrariwise, no statistically significant differences of PI and BOP were observed in the control group. The intergroup comparison at 3 months yielded statistically significantly lower values for all periodontal parameters around teeth when the probiotic was used. Conversely, no statistically significant differences in periodontal parameters were observed between test and control groups at 3 months around implants. Conclusions Probiotic intake was effective in reducing PI, BOP, and PD scores around natural teeth and dental implants affected by peri-mucositis, in particular around natural teeth at 3 months.

Short-term efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E on peri-implant mucositis: A double-blind, randomized, clinical trial.

To determine the efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E as adjuvant to mechanical debridement in the treatment of peri-implant mucositis (PM). Propolis has anti-inflammatory and antibacterial effect that may improve peri-implant health. A randomized, double-blind study was performed on patients with at least one implant with PM. Participants received a professional prophylaxis and were instructed to use either test or a control gel as toothpaste three times/day for 1month. Clinical and microbiological parameters were evaluated. PM resolution was considered in absence of bleeding on probing (BOP). Data were analysed with Mann-Whitney U, Wilcoxon signed-rank and chi-square tests. Forty-six patients participated (23 in each group). After treatment, 26.1% of test patients showed complete PM resolution versus 0% in control group (p=.02). Significant reductions were observed in plaque index (p=.03), BOP (p=.04) and probing depths (p=.027) in test compared with control group. The reduction in Tannerella forsythia was statistically greater in test than in control group at 1-month follow-up (p=.02). Porphyromonas gingivalis was statistically reduced in test group from baseline to 1-month follow-up (p=.05). Test gel clinically improved PM and showed certain antimicrobial effect after 1month in comparison with control group. Further long-term clinical trials are required to confirm these results.

Efficacy of Antibiotic Versus Probiotics As Adjuncts to Mechanical Debridement for the Treatment of Peri-Implant Mucositis.

The objective was to compare the efficiency of probiotic therapy (PT) vs antibiotic therapy (AT) as adjuvants to nonsurgical-mechanical debridement (NSMD) for the treatment of peri-implant mucositis (Pi-M). Volunteers with Pi-M were encompassed. Therapeutically, patients were randomly divided into 3 groups: (a) Group 1: NSMD + PT; (b) Group 2: NSMD + AT; and (c) Group 3: NSMD alone. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone loss (CBL) were recorded at baseline and at 3 and 6 months follow-up. P < .05 was selected as the indicator of statistical significance. Forty-two male individuals (14, 14, and 14 in Groups 1, 2, and 3, respectively) were included. At 3 and 6 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 2 than Group 1. At 3 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 3 than Group 2. At 6 months of follow-up, PI, BOP, and PD were comparable in Groups 2 and 3. In Group 3, PI, BOP, and PD were comparable with the respective baseline values at 6 months of follow-up. The CBL in all groups remained unchanged up to 6 months of follow-up. The NSMD with adjuvant PT is more effective than adjunct AT for the treatment of Pi-M for up to 3 months.

Clinical and microbiological evaluation of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis

The aim of this study was to evaluate the effectiveness of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis. Clinical and microbiological studies were conducted before and 14 days, 1, 3 and 6 months after the periodontal treatment in 46 patients (144 implants with fixed dentures) with peri-implant mucositis. The patients were divided into 3 groups: test, comparison and control. Basic periodontal therapy in all groups included professional cleaning and individual oral hygiene training. Test group (15 patients) received basic periodontal therapy plus 0.20% chlorhexidine with hyaluronic acid mouthwash, the comparison group (15 patients) - basic periodontal therapy +0.05% chlorhexidine mouthwash. In control group (16 patients), treatment was limited to basic periodontal therapy only. At the initial stages of observations, there was a statistically significant improvement in the clinical indices in all treatment groups (p<0.001). The use of 0.20% chlorhexidine with hyaluronic acid mouthwash revealed a higher quality of treatment. After 6 months of observation, the clinical features in patients of the control group was almost similar to the state before treatment. The patients of the test group had a more pronounced elimination of facultative and periodontal pathogens in comparison with other groups. The use of 0.20% chlorhexidine with hyaluronic acid containing mouthwash allows the clinician to achieve a better results in the treatment of peri-implant mucositis. The evaluation the oral microflora in patients with peri-implant mucositis can be used as a prognostic criterion for the outcomes of rehabilitation.

Role of Probiotics for the Treatment of Peri-Implant Mucositis in Patients With and Without Type 2 Diabetes Mellitus.

This study hypothesized that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for the treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type 2 diabetic and nondiabetic patients over a 12-month follow-up period. Patients with and without type 2 diabetes were included. PM patients were categorized into 2 groups based on the treatment procedure: (1) nonsurgical + PT and (2) nonsurgical MD alone. Demographics and education statuses were recorded. Gingival index (GI) and plaque index (PI), crestal bone loss (CBL), and probing depth (PD) were measured at baseline and after 6 and 12 months. Significant differences were detected with P < .01. The hemoglobin A1c level was significantly higher in patients with diabetes at all time durations than in patients without type 2 diabetes (P < .001). Baseline GI, PI, PD, and CBL were comparable in all groups. In patients with type 2 diabetes, there was no difference in PI, GI, PD, and CBL at 6- and 12-month follow-up. In patients without type 2 diabetes, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01) at 6-month and 1-year follow-up as compared with baseline. In patients without type 2 diabetes, MD with or without adjunct PT reduced soft-tissue inflammatory parameters in patients with PM.

Efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in reducing inflammation around the teeth and implants: a randomized clinical trial.

To evaluate the efficacy of a 0.03% chlorhexidine (CHX) and 0.05% cetylpyridinium chloride (CPC) mouth rinse, as an adjunct to professional plaque removal (PPR) and mechanical hygiene, in the treatment of peri-implant mucositis (PiM) and gingivitis. Patients displaying PiM in, at least, one implant were included in this randomized, double-blinded, clinical trial. Subjects received PPR (at baseline and 6-month visits) and were instructed to rinse, twice daily, during 1year with the tested mouth rinse or a placebo. Clinical and patient-reported outcomes were recorded at baseline and 6 and 12months. Fifty-four patients were included in the study and 46 attended the final visit. In the teeth and implants with inflammation, a higher reduction in BOP was observed in the test group. Statistically significant differences between groups were only observed in the lingual sites of the teeth with gingivitis (mean difference = 11.96%; 95% confidence interval [1.09; 22.83]; p = 0.03). Overall, compliance and satisfaction were good, even though staining were higher for the test group (p < 0.05). The combined use of mechanical debridement with a 0.03% CHX and 0.05% CPC mouth rinse may have adjunctive benefits in the management of gingivitis, and it is associated with a higher degree of staining. The control of gingivitis can be improved, after professional mechanical debridement, with toothbrushing and the supplementary use of a 0.03% CHX and 0.05% CPC mouth rinse at home. NCT03533166.