Effect of glycine powder air‐polishing as an adjunct in the treatment of peri‐implant mucositis: a pilot clinical trial

Abstract

This pilot clinical trial suggests that non-surgical mechanical debridement may effectively control peri-implant mucositis, and adjunctive GPAP treatment seems to have a limited beneficial effect as compared with mechanical debridement alone. However, further clinical trials with a large sample size are needed to confirm this preliminary observation.

Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis

“…All selected publications were subdivided according to differences in the treatment protocol:o Nonsurgical treatment of peri-implant mucositis—alternative or adjunctive measures for biofilm removal (2 RCTs and 1 CCT) (Table 3)Table 3Included studies—nonsurgical treatment of peri-implant mucositis: alternative or adjunctive measures for biofilm removalPublicationDesignPopulationCase definitionPeriodTestControlMean (SD) outcomeJi et al [15]RCT, parallel24 patientsPD ≥4 mm, BOP + no radiographic bone loss compared with baseline (i.e. immediately after prosthesis installation)3 monthsOHI + mechanical debridement (ultrasonic scaler with carbon fibre tips) + air abrasive device, glycine powder (sites with PD ≥4 mm)OHI + mechanical debridement (ultrasonic scaler with carbon fibre tips)Test33 implantsBI: 1.4 (0.57) (BL) to 1.1 (0.58) (3 months, subject level)Molar/premolar sitesBI: 1.7 (0.93) (BL) to 1.1 (0.98) (3 months, implant level)1 implant systemSites without bleeding: 29.3 %PD: 3.6 (0.47) (BL) to 3.2 (0.48) mm (3 months, subject level)ControlBI: 1.5 (0.65) (BL) to 1.0 (0.85) (3 months, subject level)BI: 1.7 (1.0) (BL) to 0.9 (1.1) (3 months, implant level)Sites without bleeding: 42 %PD: 3.5 (0.5) (BL) to 3.1 (0.38) mm (3 months, subject level)De Siena et al [18]CCT, parallel30 patientsBOP or spontaneous bleeding with local swelling6 monthsOHI + mechanical debridement Teflon curettes, polishing) + air abrasive device, glycine powderOHI + mechanical debridement Teflon curettes, polishing)TestNo information on number and types of implantsPD ≤3.5 mmPD: 3.0 (0.4) (BL) to 2.4 (0.5) mm (6 months, subject level)Bone loss ≤ 3.0 mm…”

“…While three studies considered mucosal inflammation in the absence of radiographic bone loss [15–17], four studies also accepted a bone resorption of up to 3 mm for defining peri-implant mucositis [18–21]. Moreover, these studies used several clinical parameters to assess mucosal inflammation, employed various oral hygiene instructions (OHI) and defined different intervals for maintenance care.…”

“…In particular, one RCT and one CCT compared the clinical efficacy of adjunctive air polishing (glycine powder) to OHI and mechanical debridement using either ultrasonic scalers or hand instruments [15, 18]. Both test and control groups were associated with significant improvements in mean BI and PD scores after therapy.…”

“…In particular, this was true for 8 (7 RCTs and 1 CCT) [15–22] and 9 (9 RCTs) [23–26, 28, 29, 31–33] studies reporting on the nonsurgical treatment of peri-implant mucositis and peri-implantitis, as well as 5 RCTs [38, 39, 41, 42, 55] reporting on the surgical treatment of peri-implantitis. In addition, 5 RCTs and 4 CCTs not implementing appropriate control measures (i.e.…”

Novel methods for debridement of dental implant surfaces contaminated by biofilm

“…82 However, other authors have reported that glycine particle jets are no better than routine non-surgical debridement when used in PIM cases, but one has to consider that a small sample size may account for lack of a significant change in clinical parameters such as bleeding, plaque and probing scores, due to lack of statistical power. 83 It is unclear at present whether glycine particle jets are suitable for the resolution of PI or PIM, since complete disease reversal has not been commonly observed after treatment, 82,84 even when an open (surgical) approach was adopted. 85 It also remains unclear whether improved oral hygiene and/or the modification of the implant surface to allow for better cleaning are more important than the application of a subgingival powder, for the desired outcome of the improving gingival health and reducing bleeding scores around implants.…”