Mensi Magda, Scotti Eleonora, Calza Stefano, Pilloni Andrea, Grusovin Maria G, Mongardini Claudio
Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy -
Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.
Minerva Stomatol. 2017 Dec;66(6):255-266. doi: 10.23736/S0026-4970.17.04054-7. Epub 2017 Oct 3.
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.
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).
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.
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.
种植体周围炎是一种常见疾病,可能导致种植体脱落。本病例系列的目的是评估一种新的非手术治疗方案的临床效果。
15例患有种植体周围炎的牙种植体患者接受了一种多重抗感染非手术治疗(MAINST),该治疗包括两个步骤:1)对病变进行龈上洁治,并使用控释局部多西环素进行龈下治疗;2)一周后,使用赤藓糖醇粉末进行龈上和龈下空气抛光,并对整个口腔进行超声清创(如有牙结石),同时在感染种植体周围再次应用局部多西环素。主要观察指标为:种植体失败;并发症和不良事件;种植体周围炎复发;次要观察指标为菌斑(PI)、探诊出血(BOP)、探诊深度(PPD)、牙龈退缩(REC)、相对附着水平(RAL)。
未报告种植体失败、并发症或不良事件。在统计学上(P<0.01)和临床上,PI在基线和1年之间有显著降低(100%对13.9%,95%CI:72.4%至93.7%);BOP(98.5%对4.5%,95%CI:85.4%至98.5%)和PPD(7.89对3.16mm,95%CI:-5.67至-3.77)。基线时,所有15例患者受影响种植体处的PPD>5mm,而在3个月随访时只有3.7%的患者PPD>5mm,在6个月和12个月时均无。
在本研究的范围内,MAINST方案显示出治疗种植体周围炎的临床参数有所改善,且这种改善可持续长达12个月。