Clinical, microbiological and biochemical impact of a supportive care protocol with an air‐polishing device, after surgical treatment of peri‐implantitis: Randomized clinical trial

Abstract

Objectives:The aim of the present study was to evaluate the efficacy of a supportive peri-implant care (SPIC) protocol after surgical therapy of peri-implantitis, combining ultrasonic mechanical debridement and glycine powder air polishing. Materials and Methods:Thirty subjects diagnosed with peri-implantitis and treated by means of access flap were randomized 6 months later into two different SPIC groups: the test group combined a piezoelectric ultrasonic instrumentation with a specific implant PEEK tip and glycine powder air polishing, while control group received the same ultrasonic instrumentation together with a rubber cup and a polishing paste. Patients were followed for 12 months, with intermediate SPIC visits every 3 months. Clinical, radiological, microbiological and biochemical outcome variables were registered and calculated.Results: After 12 months of SPIC, probing depths (PD) showed a mean reduction of 0.33 ± 0.11 mm, with significant differences (p < .001) between the test (−0.84 ± 0.43 mm) and the control group (+0.18 ± 0.73 mm). Healthy peri-implant tissues defined by PD <5 mm, absence of BoP (or in only one site around the implant), and no additional bone loss (<0.5 mm), were observed at the final visit in 83% of the implants (87% in the test group and 80% in the control group, p = .255). No adverse events were reported by the subjects participating in the study. Conclusions:The SPIC protocol including mechanical ultrasonic debridement and glycine powder air-polishing demonstrated significantly better efficacy in terms of PD reductions. A strict SPIC protocol can maintain for 1 year, or even improve, the results obtained after surgical treatment of peri-implantitis.

Treatment of peri‐implantitis with a flapless surgical access combined with implant surface decontamination and adjunctive systemic antibiotics: A retrospective case series study

“…The multilevel modelling, along with azithromycin and metronidazole, identified compliance with the SPIC programme after therapy and machined surfaces as predictors of achieving disease resolution. The positive impact of adherence to SPIC agrees with a recent RCT that compared different SPIC protocols after peri‐implantitis surgical therapy, demonstrating that with strict maintenance, the achieved outcomes are not only stable 1 year after therapy but may improve over time (Luengo et al, 2023). There is, however, insufficient evidence to define a specific supportive care protocol (Stiesch et al, 2023).…”

“…The positive impact of adherence to SPIC agrees with a recent RCT that compared different SPIC protocols after peri-implantitis surgical therapy, demonstrating that with strict maintenance, the achieved outcomes are not only stable 1 year after therapy but may improve over time (Luengo et al, 2023). There is, however, insufficient evidence to define a specific supportive care protocol (Stiesch et al, 2023).…”