Effects of Implant Surface Debridement and Systemic Antibiotics on the Clinical and Microbiological Variables of Periimplantitis

Abstract

Objective. To investigate the role of implant surface debridement alone and in conjunction with systemic antibiotics on the clinical and microbiological variables of periimplantitis. Materials and Methods. Data of forty-six patients with at least one dental implant having bleeding-on-probing (BoP), probing pocket depth (PPD) of more than 5 mm, and radiographic bone loss of more than 3 mm were retrieved from clinical records. Data was recorded for dental implant with the deepest PPD, BoP, and bone loss from each patient. “Group-A” received implant surface debridement alone, while “group-B” additionally received systemic antibiotics. Clinical and microbiological data of patients were compared before and after the treatment. Results. At the implant level, a significant reduction of PPD, mucosal recession (MR), and BoP was achieved for all patients. Group B achieved significant improvement in MR and BoP compared to group A at implant level. PPD, MR, and plaque scores showed improvement at implant site level. At 3 months recall visit, 44% of group A and 52% of group B implants required surgical treatment. The presence and proportions of studied bacteria of both groups did not differ significantly at the recall visit when compared to the initial visit. However, P. intermedia and P. micros showed a significant reduction in group A at the recall visit. Conclusions. Implant surface debridement improved the clinical parameters of periimplantitis. In addition, adjunctive use of systemic antibiotics increased mucosal recession and improved bleeding on probing in periimplantitis.

A Systematic Review and Meta-Analysis of Systemic Antibiotic Therapy in the Treatment of Peri-Implantitis

“…A generalized reduction of approximately 0.75 mm was obtained after 12 months of follow-up ( Table 3 ) when systemic antibiotics were administrated in conjunction with other therapies, such as mechanical debridement, bone graft plus membrane or even titanium granulates. Plaque score was also analyzed in eleven studies [ 1 , 6 , 16 , 22 , 47 , 48 , 50 , 52 , 54 , 56 , 57 ]. Plaque scores in all groups were significantly reduced from baseline to successive follow-up periods when systemic antibiotics were used in combination with complementary therapies.…”

“…Plaque scores in all groups were significantly reduced from baseline to successive follow-up periods when systemic antibiotics were used in combination with complementary therapies. Suppuration was determined in eight articles [ 6 , 24 , 47 , 48 , 50 , 52 , 53 , 57 ], and most showed a significant reduction after systemic antibiotic administration. Eight articles [ 1 , 6 , 16 , 24 , 30 , 55 , 56 , 57 ] also reported total bacterial counts, and Prevotella intermedia / nigrescens , Porphyromonas gingivalis , and Aggregatibacter actinomycetemcomitans were some of the most common bacteria associated with peri-implantitis.…”

“…Suppuration was determined in eight articles [ 6 , 24 , 47 , 48 , 50 , 52 , 53 , 57 ], and most showed a significant reduction after systemic antibiotic administration. Eight articles [ 1 , 6 , 16 , 24 , 30 , 55 , 56 , 57 ] also reported total bacterial counts, and Prevotella intermedia / nigrescens , Porphyromonas gingivalis , and Aggregatibacter actinomycetemcomitans were some of the most common bacteria associated with peri-implantitis. A reduction in bacterial count was observed when other therapeutic measurements were adopted in combination with systemic antibiotics.…”

Peri-Implantitis: Application of a Protocol for the Regeneration of Deep Osseous Defects. A Retrospective Case Series

“…Finally, the patients were prescribed post-surgical therapy based on antibiotics and vitamin supplements. Antibiotic prophylaxis, especially that based on a mix of amoxicillin and metronidazole, is widely used by clinicians for the treatment of peri-implantitis with excellent results [ 37 ], and in a retrospective clinical study, it has been shown to have superior results in terms of BoP and mucosal recession compared to the group of patients who did not receive systemic antibiotics [ 38 ]. Moreover, in a randomized clinical trial, the use of systemic metronidazole elicited excellent results in clinical, radiographic, and microbiological parameters in the non-surgical treatment of peri-implantitis [ 39 ].…”

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants—A Narrative Review

“…In general, prophylactic antibiotics are only recommended in surgery dedicated to patients at risk of infectious endocarditis (except in non-surgical dental procedures), immuno-compromised patients, prolonged and extensive surgical interventions, surgery in infected sites, and when large foreign materials are implanted. It was found that the adjunctive use of systemic antibiotics increased mucosal recession and improved bleeding on probing in peri-implantitis [ 10 , 11 , 12 ]. Very similar mechanisms may favor osseointegration disorders and premature loss of implants in smokers and people with parafunctions.…”