Treatment of peri‐implantitis: clinical outcome of chloramine as an adjunctive to non‐surgical therapy, a randomized clinical trial

Roos‐Jansåker, Ann‐Marie; Almhöjd, Ulrica; Jansson, Henrik

doi:10.1111/clr.12612

Cited by 35 publications

(48 citation statements)

References 28 publications

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“…After excluding articles based on their titles and abstracts, 39 studies were left for full-text assessment. Following a discussion after full-text analysis, 18 studies were included for systematic review [9,10,12,13,16,17,19,20,23,24,26,[31][32][33][34][35][36]41]. The process of identi cation of the included studies from the initial yield is described in Fig.1.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Fig.3, compared with MD alone, MD with chlorhexidine have a limited bene cial effect at 3 months following treatment. An included article reported the adjunctive effect of chloramine and found that chloramine could not improve the clinical outcomes of peri-implant diseases [31]. The effects of probiotic Lactobacillus reuteri in combination with MD were evaluated in implants with peri-implantitis, and no clinical differences between probiotic and placebo treatments were observed over time [35,36] (Fig.4).…”

Section: Discussionmentioning

confidence: 99%

“…Summarizing the risk of bias for each study, only six studies were considered at low risk of bias [17,20,23,33,34,36], seven were at unclear risk [10,14,16,19,31,35,41], and ve studies were considered at high risk of bias [9,13,24,26,32]. Results of the quality assessment of RCTs are listed in Table 2, following the recommendations [44].…”

Section: Quality Assessmentmentioning

confidence: 99%

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Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Xiao

Qin

2020

Preprint

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Background Peri-implant diseases are mainly caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE, Cochrane Library and Science Direct. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of peri-implant diseases with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before June 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of eighteen RCTs met the inclusion criteria, of which 13 articles were included in the meta-analysis. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; photodynamic therapy; local antibiotics; systemic antibiotics; probiotics. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone in the treatment of peri-implant diseases at 3 months follow-up ( P = 0.84), so is MD with probiotics and MD alone ( P = 0.96), and so is systemic antibiotics and MD alone ( P = 0.47). Conclusion. MD adjunct with PDT is an effective treatment for peri-implant mucositis. However, there is still no effective non-surgical treatment for peri-implantitis.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

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Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Xiao

Qin

2020

Preprint

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“…3, compared to MD alone, MD with chlorhexidine has a limited beneficial effect at 3 months post-treatment. An included article reported the adjunctive effect of chloramine and found that it could not improve the clinical outcomes of periimplant diseases [31]. The effects of probiotic Lactobacillus reuteri in combination with MD were evaluated in implants with peri-implantitis, and no clinical differences between probiotic and placebo treatments were observed over time [35,36] (Fig.…”

Section: Discussionmentioning

confidence: 99%

Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Xiao

Qin

2020

Preprint

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Background Peri-implant diseases are caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement (MD) with different adjunctive therapies has been applied in the treatment of peri-implant diseases. This systematic review aimed to deduce the optimal adjunctive therapy. Methods Two independent authors screened the literature using MEDLINE and Cochrane Library. Only clinical randomized controlled trials (RCTs) about adjunctive therapies for non-surgical treatment of peri-implant diseases were included in this review. Studies selected were published before February 2020. The clinical outcomes were compared in this meta-analysis. Results: A total of 31 RCTs met the inclusion criteria. The following adjunctive interventions were compared in the included studies: modification of the prosthesis; air abrasive; Er:YAG laser; diode laser; photodynamic therapy; local antibiotics; system antibiotics; probiotics; and enamel matrix derivative. Follow-up ranged from 3 months to 1 year. A statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). However, such a difference was not detected between MD with chlorhexidine and MD alone at 3 months follow-up ( P = 0.61), between MD with probiotics and MD alone ( P = 0.47), and between systemic antibiotics and MD alone ( P = 0.96). Conclusion Currently, the optimal non-surgical intervention is not known. Also, among the interventions with similar efficiency, that with fewer side effects, easy to use, and cost-effective is yet to be identified. Thus, well-designed RCTs with prolonged follow-ups to assess the accurate effectiveness of therapies are imperative.

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“…23,[53][54][55] Aspects commonly assessed are pain, probing depth, mobility, bleeding index and radiographic evaluation of bone loss. 23,[54][55][56][57] Signs of peri-implant disease include bleeding or suppuration after probing, swelling, periimplant pockets greater than 4 mm, bone loss or saucer-shaped radiolucency around the implant, implant mobility and pain. 58 The diagnosis of peri-implant mucositis is generally associated with the presence of exudate release, swelling and/or bleeding on probing but without loss of bone.…”

Section: Diagnosis Of Peri-implantitismentioning

confidence: 99%

Peri-Implantitis: A Review of the Disease and Report of a Case Treated with Allograft to Achieve Bone Regeneration

Rashid¹,

Sheikh²,

Vohra³

et al. 2015

Dent Open J

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Dental implants offer excellent tooth replacement options however; peri-implantitis can limit their clinical success by causing failure. Peri-implantitis is an inflammatory process around dental implants resulting in bone loss in association with bleeding and suppuration. Dental plaque is at the center of its etiology, and in addition, systemic diseases, smoking, and parafunctional habits are also implicated. The pathogenic species associated with peri-implantitis include, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia. The goal in the management of peri-implantitis is the complete resolution of peri-implant infection with function. Therapies using various biomaterials to deliver antibiotics have been used in the treatment of peri-implantitis e.g. fibers, gels, and beads. The use of guided tissue regeneration barrier membranes loaded with antimicrobials has shown success in re-osseointegrating the infected implants in animal models. Several uncertainties still remain regarding the management of peri-implantitis. The purpose of this article is to present a background of peri-implantitis along with a case of peri-implantitis successfully treated for bone regeneration.

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Treatment of peri‐implantitis: clinical outcome of chloramine as an adjunctive to non‐surgical therapy, a randomized clinical trial

Abstract: In the present randomized clinical trial of peri-implantitis therapy; non-surgical mechanical debridement with adjunctive use of a chloramine is equally effective in the reduction of mucosal inflammation as conventional non-surgical mechanical debridement up to 3 months.

Cited by 35 publications

References 28 publications

Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

Peri-Implantitis: A Review of the Disease and Report of a Case Treated with Allograft to Achieve Bone Regeneration

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