Wohlfahrt J C, Evensen B J, Zeza B, Jansson H, Pilloni A, Roos-Jansåker A M, Di Tanna G L, Aass A M, Klepp M, Koldsland O C
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway.
Private Practice, Tønsberg, Norway.
Int J Implant Dent. 2017 Dec;3(1):38. doi: 10.1186/s40729-017-0098-y. Epub 2017 Aug 3.
The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers.
In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally included. The subjects had mild peri-implantitis defined as radiographic bone loss of 1-2 mm, pocket probing depth (PPD) ≥4 mm and a positive bleeding on probing (mBoP) score. The patients were clinically examined at baseline and after 2, 4, 12 and 24 weeks, and radiographs were taken at baseline and at 3 and 6 months. Treatment of the implants with the chitosan brush seated in an oscillating dental drill piece was performed at baseline and at 3 months. Reductions in the clinical parameters (PPD and mBoP) were compared between baseline and the later examination time points.
Significant reductions in both PPD and mBoP were observed at all time points compared with the baseline clinical measurements (p < 0.001). The mean PPD and mBoP at baseline were 5.15 mm (4.97; 5.32) and 1.86 (1.78; 1.93), respectively, whereas the mean PPD and mBoP at 6 months were 4.0 mm (3.91; 4.19) and 0.64 (0.54; 0.75), respectively. Stable reductions in PPD and mBoP were evident up to 6 months after the initial treatment and 3 months after the second treatment. All 63 implants were reported to have stable radiographic levels of osseous support.
This case series demonstrated that an oscillating chitosan brush is safe to use and seems to have merits in the non-surgical treatment of dental implants with mild peri-implantitis. To measure the effectiveness of the method, a multicenter randomized clinical trial needs to be undertaken.
本研究旨在评估在多个临床中心使用一种新型壳聚糖制成的器械对轻度种植体周围炎进行非手术治疗时，其对种植体周围黏膜炎症的影响。
在六个不同的牙周专科诊所进行的为期6个月的多中心前瞻性连续病例系列研究中，最终纳入了63例患者的63颗种植体。这些受试者患有轻度种植体周围炎，定义为影像学骨丧失1 - 2毫米、探诊深度（PPD）≥4毫米且探诊出血阳性（mBoP）评分。在基线以及2、4、12和24周后对患者进行临床检查，并在基线以及3和6个月时拍摄X光片。在基线和3个月时，使用安装在振荡牙科钻头上的壳聚糖刷对种植体进行治疗。比较基线和后续检查时间点临床参数（PPD和mBoP）的降低情况。
与基线临床测量值相比，在所有时间点均观察到PPD和mBoP显著降低（p < 0.001）。基线时的平均PPD和mBoP分别为5.15毫米（4.97；5.32）和1.86（1.78；1.93），而6个月时的平均PPD和mBoP分别为4.0毫米（3.91；4.19）和0.64（0.54；0.75）。在初始治疗后6个月以及第二次治疗后3个月，PPD和mBoP持续稳定降低。据报告，所有63颗种植体的骨支持影像学水平均稳定。
该病例系列表明，振荡壳聚糖刷使用安全，在轻度种植体周围炎的种植体非手术治疗中似乎具有优势。为了衡量该方法的有效性，需要进行多中心随机临床试验。
