Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Int J Dent Hyg. 2024 Nov;22(4):982-990. doi: 10.1111/idh.12814. Epub 2024 Apr 24.
Peri-implant mucositis is a biofilm-related, reversible inflammatory disease that can evolve into peri-implantitis if not adequately treated. The aim of the present randomized controlled clinical trial was to evaluate the efficacy of air-abrasive powder as compared to chlorhexidine (CHX) for the treatment of peri-implant mucositis, in terms of clinical and patient-reported outcomes (PROMs) and occurrence of peri-implantitis 12 months after treatment.
In the control group, full-mouth calculus and plaque removal was performed with ultrasound and manual devices, and a 1.0% CHX gel was applied; in the test group, supra- and subgingival biofilm removal was performed using erythritol powder with a dedicated nozzle and calculus removal was performed with ultrasonic instruments if needed. Bleeding and plaque indexes, peri-implant probing depth and tissue level were measured at 1 week, and 1, 3, 6 and 12 months after treatment, while PROMs were evaluated up to 7 days after treatment.
Among 80 included implants, 70 were analysed at 12 months follow-up (30 in the test group, 40 in the control group, and 20 subjects). Success rates (implant-level) in terms of bleeding index were significantly different between the test (96.7%) and control group (92.5%); as for PROMs, only taste sensation was significantly better in the test group. The test group was significantly correlated to the smallest changes in peri-implant probing depth between baseline and 3 months.
The study showed that both treatment strategies are effective. This suggests that the use of air-abrasive powders could be used as an alternative biofilm removal method instead of adjunctive treatments with antiseptics.
种植体周围黏膜炎是一种生物膜相关的、可逆转的炎症性疾病，如果不进行适当治疗，可能会发展为种植体周围炎。本随机对照临床试验的目的是评估空气喷砂粉与洗必泰（CHX）治疗种植体周围黏膜炎的疗效，比较两组在临床和患者报告结局（PROMs）方面的差异，并评估治疗后 12 个月种植体周围炎的发生情况。
对照组采用超声和手动器械进行全口牙石和菌斑去除，并应用 1.0% CHX 凝胶；试验组采用专用喷嘴的赤藓糖醇粉末进行龈上和龈下生物膜去除，如果需要则使用超声器械进行牙石去除。在治疗后 1 周、1、3、6 和 12 个月时测量出血和菌斑指数、种植体探诊深度和组织水平，在治疗后 7 天内评估 PROMs。
在纳入的 80 个种植体中，有 70 个在 12 个月的随访中进行了分析（试验组 30 个，对照组 40 个，20 名受试者）。在出血指数方面，试验组（96.7%）和对照组（92.5%）的成功率（种植体水平）差异有统计学意义；对于 PROMs，只有味觉在试验组中明显更好。试验组与基线至 3 个月时种植体探诊深度的最小变化呈显著相关。
本研究表明两种治疗策略均有效。这表明空气喷砂粉的使用可以作为替代生物膜去除方法，而无需使用防腐剂进行辅助治疗。
