Isola Gaetano, Polizzi Alessandro, Santagati Maria, Alibrandi Angela, Iorio-Siciliano Vincenzo, Ramaglia Luca
Unit of Periodontology, Department of General Surgery and Medical-Surgical Specialities, University of Catania, Catania, Italy.
Unit of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Clin Oral Implants Res. 2025 May;36(5):566-577. doi: 10.1111/clr.14405. Epub 2025 Jan 25.
To evaluate the treatment of peri-implant mucositis (PM) using a nonsurgical submarginal peri-implant instrumentation (NSPI) with or without chlorhexidine (CHX) solutions.
Fifty-six patients (28 per group) were randomly assigned to the test (NSPI + 0.12% mouthwash and subgingival CHX irrigation plus tongue brushing with 1% CHX gel) or the control group (NSPI + placebo mouthwash and subgingival placebo irrigation plus tongue brushing with placebo gel). At baseline, 1, 3, 6 months, bleeding on probing (BOP), probing pocket depth (PPD), modified gingival index (mGI), modified plaque index (mPlI), full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and the proportions of Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis , Tannerella forsythia, and Treponema denticola were recorded. The BOP reduction was set as a primary outcome. Data were analyzed to assess BOP reduction at a 6-month follow-up and to identify significant predictors of implant-site BOP through mixed generalized linear regression.
After 6 months in both groups, a significant reduction of BOP, PD, mPlI, mGI, FMBS, and FMPS was noted (p < 0.05). However, at 6 months, the test group was more effective than the controls in reducing median BOP (∆values control/test: 39.3% [95% CI 37.4-42.3] vs. 48.7 [95% CI 46.5-51.2], p = 0.044), as well as mPlI (p = 0.041) and the proportion of Treponema denticola (p = 0.039). Moreover, the implant-sites BOP reduction was significantly influenced by test treatment (p < 0.001), history of periodontitis (p = 0.003), and a high number of cigarettes/day (p = 0.002), the proportion of Porphyromonas gingivalis (p = 0.021) and Tannerella forsythia (p = 0.032).
NSPI + CHX showed better results compared to placebo in implant-sites BOP reduction. The high number of cigarettes/day and the proportion of Porphyromonas gingivalis and T. forsythia negatively influenced the BOP reduction in PM-treated patients.
评估使用非手术性龈下种植体器械操作（NSPI）联合或不联合洗必泰（CHX）溶液治疗种植体周围黏膜炎（PM）的效果。
56例患者（每组28例）被随机分配至试验组（NSPI + 0.12%漱口水、龈下CHX冲洗以及用1% CHX凝胶刷舌）或对照组（NSPI + 安慰剂漱口水、龈下安慰剂冲洗以及用安慰剂凝胶刷舌）。在基线、1个月、3个月、6个月时，记录探诊出血（BOP）、探诊袋深度（PPD）、改良牙龈指数（mGI）、改良菌斑指数（mPlI）、全口菌斑评分（FMPS）、全口出血评分（FMBS）以及伴放线聚集杆菌、牙龈卟啉单胞菌、福赛坦纳菌和具核梭杆菌的比例。将BOP降低设定为主要观察指标。分析数据以评估6个月随访时的BOP降低情况，并通过混合广义线性回归确定种植部位BOP的显著预测因素。
两组在6个月后，BOP、PD、mPlI、mGI、FMBS和FMPS均显著降低（p < 0.05）。然而，在6个月时，试验组在降低BOP中位数方面比对照组更有效（对照组/试验组差值：39.3% [95% CI 37.4 - 42.3] 对48.7 [95% CI 46.5 - 51.2]，p = 0.044），mPlI（p = 0.041）和具核梭杆菌比例（p = 0.039）也是如此。此外，种植部位BOP降低受试验治疗（p < 0.001）、牙周炎病史（p = 0.003）、每日吸烟量多（p = 0.002）、牙龈卟啉单胞菌比例（p = 0.021）和福赛坦纳菌比例（p = 0.032）的显著影响。
与安慰剂相比，NSPI + CHX在降低种植部位BOP方面显示出更好的效果。每日吸烟量多以及牙龈卟啉单胞菌和福赛坦纳菌的比例对接受PM治疗患者的BOP降低有负面影响。
