An innovative therapy for peri-implantitis based on radio frequency electric current: Numerical simulation results and clinical evidence

Abstract

Peri-implantitis is a severe inflammatory pathology that affects soit and hard tissues surrounding dental implants. Nowadays, only prevention is effective to contrast peri-implantitis, but, in recent years, there is the clinical evidence of the efficiency of a therapy based on the application of radio frequency electric current, reporting that 81% of the cases (66 implants, 46 patients) were successfully treated. The aim of this paper is to present the therapy mechanism, exploring the distribution of the electric currents in normal and pathologic tissues. A 3D numerical FEM model of tooth root with a dental implant screwed in the alveolar bone has been realized and the therapy has been simulated in COMSOL Multiphysics® environment. Results show that the electric current is focused in the inflamed zone around the implant, due to the fact that its conductivity is higher than the healthy tissue one. Moreover, by means of a movable return electrode, the electric current and field lines can be guided in the most inflamed area, limiting the interference on healthy tissues and improving the therapy in the area of interest. In conclusion, it can be stated that this innovative therapy would make a personalized therapy for peri-implantitis possible, also through impedance measurements, allowing the clinician to evaluate the tissue inflammation state.

Development of a Novel Medical Device for Mucositis and Peri-Implantitis Treatment

“…Depending on the measured bioimpedance values and, thus, on the severity of the pathology, the therapeutic signal can be properly set to tune the treatment to the pathological conditions of the peri-implant tissues. The therapy consists of the application of a radio frequency (i.e., 312.5 kHz) alternating current burst, with a standard time duration of 120 ms and a peak power value of 6 W, passing through the tissues between the electrodes [32].…”

“…It is worthy to underline the fact that the EM signal acts just on the principal hallmarks of peri-implantitis: soft tissue inflammation, peri-implant bone loss, and bacterial growth. Hence, EM signal can be evaluated as a possible therapy for peri-implantitis disease; in the literature, there is a clinical study (started in 2002) exploring this possibility [32] and the same hypothesis was reported in Reference [19]. Therefore, it appears that the development of a novel therapeutic device based on EM radiation would be very promising for peri-implantitis treatment and would also have a great impact on the electromedical device market.…”

“…For all the reasons reported above, a research project aimed to design an electromedical device took place between 2013 and 2016, ending in the realization of a first prototype of the device, including both a diagnostic and a therapeutic part [46]. The efficacy of the electromagnetic treatment provided was already proven by the authors, reporting a success rate of 81% (on a total of 81 dental implants-30 molars, 23 premolars, nine canines, and 10 incisors) [32]. The clinical evidence of the treatment, together with results from numerical simulations, as well as an accurate consideration of electromagnetic compatibility (EMC) susceptibility aspects, guided the whole design process.…”

Electroactive Biomaterials for Facilitating Bone Defect Repair under Pathological Conditions

“…To date, a number of studies have demonstrated the beneficial effects of direct electrical stimulation on alveolar bone regeneration without the use of electroactive biomaterials. [ 217 , 218 , 219 ] Kaynak et al. [ 217 ] showed the application of a capacitively coupled electrical field (CCEF) could enhance alveolar bone defect repair in a beagle dog model.…”

“…Cosoli et al. [ 219 ] reported the application of a radio frequency current could mitigate inflammation (peri‐implantitis) around dental implants. Lastly, Kim et al.…”