Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Simplified nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride

  • Heo, SunJin (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Kim, Hyun-Joo (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Joo, Ji-Young (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Lee, Juyoun (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Kim, Sung-Jo (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Choi, Jeomil (Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute)
  • Received : 2018.07.30
  • Accepted : 2018.10.20
  • Published : 2018.10.30
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Abstract

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

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References

  1. Mombelli A, Lang NP. The diagnosis and treatment of peri-implantitis. Periodontol 2000 1998;17:63-76. https://doi.org/10.1111/j.1600-0757.1998.tb00124.x
  2. Heitz-Mayfield LJ, Lang NP. Comparative biology of chronic and aggressive periodontitis vs. periimplantitis. Periodontol 2000 2010;53:167-81. https://doi.org/10.1111/j.1600-0757.2010.00348.x
  3. Hultin M, Gustafsson A, Hallstrom H, Johansson LA, Ekfeldt A, Klinge B. Microbiological findings and host response in patients with peri-implantitis. Clin Oral Implants Res 2002;13:349-58. https://doi.org/10.1034/j.1600-0501.2002.130402.x
  4. Karring ES, Stavropoulos A, Ellegaard B, Karring T. Treatment of peri-implantitis by the Vector system. Clin Oral Implants Res 2005;16:288-93. https://doi.org/10.1111/j.1600-0501.2005.01141.x
  5. Renvert S, Samuelsson E, Lindahl C, Persson GR. Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I: clinical results. J Clin Periodontol 2009;36:604-9. https://doi.org/10.1111/j.1600-051X.2009.01421.x
  6. van Steenberghe D, Bercy P, Kohl J, De Boever J, Adriaens P, Vanderfaeillie A, et al. Subgingival minocycline hydrochloride ointment in moderate to severe chronic adult periodontitis: a randomized, double-blind, vehicle-controlled, multicenter study. J Periodontol 1993;64:637-44. https://doi.org/10.1902/jop.1993.64.7.637
  7. Mombelli A, Feloutzis A, Bragger U, Lang NP. Treatment of peri-implantitis by local delivery of tetracycline. Clinical, microbiological and radiological results. Clin Oral Implants Res 2001;12:287-94. https://doi.org/10.1034/j.1600-0501.2001.012004287.x
  8. Buchter A, Meyer U, Kruse-Losler B, Joos U, Kleinheinz J. Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial. Br J Oral Maxillofac Surg 2004;42:439-44. https://doi.org/10.1016/j.bjoms.2004.06.005
  9. Salvi GE, Persson GR, Heitz-Mayfield LJ, Frei M, Lang NP. Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes. Clin Oral Implants Res 2007;18:281-5. https://doi.org/10.1111/j.1600-0501.2007.01377.x
  10. Persson GR, Salvi GE, Heitz-Mayfield LJ, Lang NP. Antimicrobial therapy using a local drug delivery system (Arestin) in the treatment of peri-implantitis. I: Microbiological outcomes. Clin Oral Implants Res 2006;17:386-93. https://doi.org/10.1111/j.1600-0501.2006.01269.x
  11. Lang NP, Wilson TG, Corbet EF. Biological complications with dental implants: their prevention, diagnosis and treatment. Clin Oral Implants Res 2000;11 Suppl 1:146-55. https://doi.org/10.1034/j.1600-0501.2000.011S1146.x
  12. Linares A, Cortellini P, Lang NP, Suvan J, Tonetti MS; European Research Group on Periodontology (ErgoPerio). Guided tissue regeneration/deproteinized bovine bone mineral or papilla preservation flaps alone for treatment of intrabony defects. II: radiographic predictors and outcomes. J Clin Periodontol 2006;33:351-8. https://doi.org/10.1111/j.1600-051X.2006.00911.x
  13. Behneke A, Behneke N, d'Hoedt B, Wagner W. Hard and soft tissue reactions to ITI screw implants: 3-year longitudinal results of a prospective study. Int J Oral Maxillofac Implants 1997;12:749-57.
  14. Bragger U, Burgin WB, Hammerle CH, Lang NP. Associations between clinical parameters assessed around implants and teeth. Clin Oral Implants Res 1997;8:412-21. https://doi.org/10.1034/j.1600-0501.1997.080508.x
  15. Zarb GA, Symington JM. Osseointegrated dental implants: preliminary report on a replication study. J Prosthet Dent 1983;50:271-6. https://doi.org/10.1016/0022-3913(83)90029-X
  16. Stavropoulos A, Wikesjo UM. Influence of defect dimensions on periodontal wound healing/regeneration in intrabony defects following implantation of a bovine bone biomaterial and provisions for guided tissue regeneration: an experimental study in the dog. J Clin Periodontol 2010;37:534-43. https://doi.org/10.1111/j.1600-051X.2010.01566.x
  17. Cortellini P, Carnevale G, Sanz M, Tonetti MS. Treatment of deep and shallow intrabony defects. A multicenter randomized controlled clinical trial. J Clin Periodontol 1998;25:981-7. https://doi.org/10.1111/j.1600-051X.1998.tb02402.x
  18. Heitz-Mayfield LJ, Salvi GE, Botticelli D, Mombelli A, Faddy M, Lang NP, et al. Anti-infective treatment of peri-implant mucositis: a randomised controlled clinical trial. Clin Oral Implants Res 2011;22:237-41. https://doi.org/10.1111/j.1600-0501.2010.02078.x
  19. Maximo MB, de Mendonca AC, Renata Santos V, Figueiredo LC, Feres M, Duarte PM. Short-term clinical and microbiological evaluations of peri-implant diseases before and after mechanical anti-infective therapies. Clin Oral Implants Res 2009;20:99-108. https://doi.org/10.1111/j.1600-0501.2008.01618.x
  20. Lindhe J, Meyle J; Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35:282-5. https://doi.org/10.1111/j.1600-051X.2008.01283.x
  21. Renvert S, Roos-Jansaker AM, Claffey N. Non-surgical treatment of peri-implant mucositis and periimplantitis: a literature review. J Clin Periodontol 2008;35 Suppl:305-15.
  22. Persson GR, Samuelsson E, Lindahl C, Renvert S. Mechanical non-surgical treatment of peri-implantitis: a single-blinded randomized longitudinal clinical study. II. Microbiological results. J Clin Periodontol 2010;37:563-73. https://doi.org/10.1111/j.1600-051X.2010.01561.x
  23. Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantology 2012;5 Suppl:S21-41.
  24. Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res 2011;22:1214-20. https://doi.org/10.1111/j.1600-0501.2010.02098.x

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