Decontamination Using a Desiccant with Air Powder Abrasion Followed by Biphasic Calcium Sulfate Grafting: A New Treatment for Peri-Implantitis

Abstract

Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis.

A Topical Desiccant Agent in Association with Manual Debridement in the Initial Treatment of Peri-Implant Mucositis: A Clinical and Microbiological Pilot Study

“…New antiseptic agents have recently been introduced to improve the supra and sub-gingival debridement efficacy. Among them, a new topical desiccant agent with antiseptic properties has been proposed as an adjunct to mechanical debridement in the non-surgical treatment of chronic periodontitis [19,20,21,22] and the surgical regenerative treatment of peri-implantitis [23]. This desiccant product consists of a liquid solution, which contains a concentrated blend of sulfonic and sulfuric acids compounds.…”

Successful Management of Peri-Implantitis around Short and Ultrashort Single-Crown Implants: A Case Series with a 3-Year Follow-Up

“…Despite these findings, there is no evidence about the application of this product on the contaminated implant surface during an open flap decontamination procedure, with the exception of a case report involving two implant in a single patient treated with clinical success [14].…”

“…These acids have a strong affinity to bind to the water present in the biofilm matrix, denaturing the attachment proteins used by bacteria to adhere to the implant surface and allowing more efficient subsequent removal of biofilm microbes and biofilm eradication [13]. To our knowledge, only one case report study using a topical desiccant as an adjunct to air powder abrasives has been published to date [14].…”

Periimplantäre Entzündungen und Implantatprophylaxe

“…In einem Übersichtsartikel lassen sich Angaben zur Gabe von 2 g Amoxicillin direkt vor Implantation wieder finden, um das Risiko einer bakteriellen Kontamination bereits zu Beginn zu minimieren [15]. [18].…”