Implantoplasty Versus Glycine Air Abrasion for the Surgical Treatment of Peri-implantitis: A Randomized Clinical Trial

Lasserre, J; Brecx, M; Toma, Selena

doi:10.11607/jomi.6677

Cited by 50 publications

(94 citation statements)

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“…These in vitro results were then suggested to improve the outcome of surgically managing peri-implantitis. However, when the same group compared IP with air polishing in a randomized clinical trial, no differences were found in any parameter (Lasserre et al 2020). Indeed, our results showed that MBL was the only determinantal factor for implant survival (i.e., not treatment modality).…”

Section: Discussionmentioning

confidence: 98%

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Lack of Clinical Benefit of Implantoplasty to Improve Implant Survival Rate

et al. 2020

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The objective of this study was to compare postsurgical outcomes of resective treatment for peri-implantitis with and without implant surface modification (implantoplasty [IP]). This was accomplished by a retrospective analysis with data from patients with ≥1 implant who were surgically treated for peri-implantitis by resective therapy. Patients were divided into 2 groups regarding treatment approach: IP (test) and no IP (control). Retrospective data were obtained after implant placement (T0) and the day of peri-implantitis surgical treatment (T1). Patients were then recalled (≥1 y after T1) for clinical and radiographic examination (T2). The findings were conclusive. A total of 41 patients (68 implants; mean ± SD follow-up, 41.6 ± 24.4 mo) were included in this study. The survival rate at the implant level was 90% in the test group and 81.6% in the control group ( P > 0.05). Multilevel regression analysis showed that the probability of implant failure was influenced by marginal bone loss (MBL) at T1 and not surgical modality. For example, peri-implantitis defects ≥50% and 25% to 50% MBL were 18.6 and 8.86 times more likely to lose the implant, respectively, when compared with <25% MBL. Nonetheless, MBL changes were similar in the test and control groups ( P = 0.592). Similarly, changes in bleeding on probing, probing pocket depth, and suppuration at T2 did not differ between groups ( P > 0.05). Multilevel regression analysis indicated that clinical improvement of these parameters was influenced by the number of supportive peri-implant therapy visits ( P < 0.01). The results demonstrate little difference between the procedures. Regardless of the implant surface modification (IP) being performed or not, the survival rate of implants treated for peri-implantitis was primarily influenced by the amount of bone loss at the time of treatment. Other clinical parameters (MBL, probing pocket depth, bleeding on probing, suppuration) were influenced by the frequency of supportive peri-implant therapy visits and not by the IP procedure (ClinicalTrials.gov NCT04259840).

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Section: Discussionmentioning

confidence: 98%

“…To the best of our knowledge, only 2 studies assessed the benefit of IP in conjunction with resective surgical treatment of peri-implantitis in a controlled clinical human study (Romeo et al 2007; Lasserre et al 2020). Hence, the aim of this study was to assess the clinical outcomes of the peri-implant resective surgery with or without IP.…”

Section: Introductionmentioning

confidence: 99%

Lack of Clinical Benefit of Implantoplasty to Improve Implant Survival Rate

et al. 2020

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“…In general, various systematic reviews [9,11,21] as well as recent clinical studies [23,40] show advantageous results in the use of glycine-based air-polishing devices for the (non-)surgical treatment of peri-implantitis. However, their ability to restore the biocompatibility of the implant surface [41] and to maintain achieved results in the long term [42] are questioned.…”

Section: Discussionmentioning

confidence: 99%

In vitro surgical and non-surgical air-polishing efficacy for implant surface decontamination in three different defect configurations

Tuchscheerer¹,

Eickholz

Dannewitz

et al. 2020

Clin Oral Invest

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Objectives Evaluation of surgical and non-surgical air-polishing in vitro efficacy for implant surface decontamination. Material and methods One hundred eighty implants were distributed to three differently angulated bone defect models (30°, 60°, 90°). Biofilm was imitated using indelible red color. Sixty implants were used for each defect, 20 of which were air-polished with three different types of glycine air powder abrasion (GAPA1-3) combinations. Within 20 equally air-polished implants, a surgical and non-surgical (with/without mucosa mask) procedure were simulated. All implants were photographed to determine the uncleaned surface. Changes in surface morphology were assessed using scanning electron micrographs (SEM). Results Cleaning efficacy did not show any significant differences between GAPA1-3 for surgical and non-surgical application. Within a cleaning method significant (p < 0.001) differences for GAPA2 between 30°(11.77 ± 2.73%) and 90°(7.25 ± 1.42%) in the non-surgical and 30°(8.26 ± 1.02%) and 60°(5.02 ± 0.84%) in the surgical simulation occurred. The surgical use of air-polishing (6.68 ± 1.66%) was significantly superior (p < 0.001) to the non-surgical (10.13 ± 2.75%). SEM micrographs showed no surface damages after use of GAPA. Conclusions Air-polishing is an efficient, surface protective method for surgical and non-surgical implant surface decontamination in this in vitro model. No method resulted in a complete cleaning of the implant surface. Clinical relevance Air-polishing appears to be promising for implant surface decontamination regardless of the device.

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“…41–43 Mean age of patients ranged from 54.3 to 71.7 years, while the proportion of females varied from 25% to 80.9%. In three studies smokers were excluded; 33, 36, 37 two studies did not report any information on smoking habits; 32, 44 while the remaining trials included a variable number of smokers, ranging from 14.2% to 50%. Five studies presented implants with machined surface, with proportions ranging from 1.3 to 35%; four studies did not treat turned implant surfaces, 32, 33, 36, 37 without this being a specific exclusion criteria; while for seven studies this information was not available.…”

Section: Resultsmentioning

confidence: 99%

Impact of surface decontamination and systemic antimicrobials for surgical treatment of peri-implantitis: A systematic review and meta-analysis of randomized clinical trials

Baima

Citterio

Romano

et al. 2021

Preprint

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BackgroundEfficient control of infection is essential to achieve desired outcomes in the surgical treatment of peri-implantitis lesions, although methods employed are largely heterogeneous.PurposeTo compare the impact of different decontamination protocols and adjunctive systemic antimicrobials on the outcomes of surgical treatment of peri-implantitis.Materials and methodsRandomized clinical trials (RCTs) on surgical treatment of peri-implantitis were selected through an electronic search on Medline, Embase, Scopus, and Central databases. Only studies comparing two or more anti-infective strategies were included. Following data extraction, two different sets of meta-analyses were performed. Firstly, overall impact of different implant surface decontamination methods was assessed by comparing baseline values with outcomes at 6-12 months. Secondly, pairwise comparisons evaluated the potential benefit of adjunctive systemic antimicrobials over placebo. Results were expressed as weighted mean effect (WME), weighed mean difference (WMD) or risk ratio (RR).ResultsSixteen RCTs were included. No pairwise comparisons were available for different surface decontamination methods. Use of curettes resulted in improved probing depth (PD) (WME = 2.13 mm), but the results in terms of marginal bone levels (MBL) and percentage of disease resolution were unsatisfactory. Moreover, the adjunctive benefit of systemic antimicrobials over placebo was evaluated in two studies, representing a total of 178 implants. Despite not being statistically significant, the meta-analyses identified a higher probability of disease resolution (RR = 1.50) for test procedures. In terms of overall outcome, systemic antimicrobials with open flap debridement resulted in improved MBL (WME = 0.44 mm), reduced PD (WME = 2.46 mm) and 51.4% of disease resolution.ConclusionsThere is not enough evidence to support adjunctive usage of systemic antimicrobials together with the surgical treatment of peri-implantitis. Moreover, higher consistency is required to prove the superiority of a surface decontamination protocol over another (PROSPERO CRD42020182303).SUMMARY BOXWhat is knownPeri-implantitis is a common biological complication occurring at dental implants, and surgery is usually required to obtain thorough peri-implant infection control.No systematic reviews with meta-analysis have assessed surface decontamination protocols for surgical treatment of peri-implantitis, as well as the adjunctive benefit of peri-operative systemic antimicrobials.What this study addsThis study offered the first evidence-based synthesis of randomized clinical trials regarding this relevant topic.Although protocol heterogeneity was high, a combination of mechanical and chemical implant surface decontamination is recommendable.Titanium brushes and local delivery of minocycline showed encouraging results; while the additional benefit of systemic antimicrobials needs to be further determined.

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Implantoplasty Versus Glycine Air Abrasion for the Surgical Treatment of Peri-implantitis: A Randomized Clinical Trial

Cited by 50 publications

References 0 publications

Lack of Clinical Benefit of Implantoplasty to Improve Implant Survival Rate

Lack of Clinical Benefit of Implantoplasty to Improve Implant Survival Rate

In vitro surgical and non-surgical air-polishing efficacy for implant surface decontamination in three different defect configurations

Impact of surface decontamination and systemic antimicrobials for surgical treatment of peri-implantitis: A systematic review and meta-analysis of randomized clinical trials

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