Effectiveness of Mechanical Debridement Combined With Adjunctive Therapies for Nonsurgical Treatment of Periimplantitis

Almeida, Juliano Milanezi de; Matheus, Henrique Rinaldi; Gusman, David Jonathan Rodrigues; Faleiros, Paula Lazilha; Araújo, Nathália Januário de; Novaes, Vivian Cristina Noronha

doi:10.1097/id.0000000000000469

Cited by 19 publications

(14 citation statements)

References 18 publications

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“…After full‐text evaluation, 11 articles did not meet our inclusion criteria and were excluded (Table ) . Finally, a total of 23 SRs formed the basis for this study …”

Section: Resultsmentioning

confidence: 99%

“…The reasons for this result were a lack of protocol papers, which predefined inclusion criteria, and the publication language restriction. In the domain related to synthesis (domain 4), nine SRs were judged as unclear . There was only one SR without meta‐analysis which interpreted and discussed the results of ROB and heterogeneity assessments properly .…”

Section: Resultsmentioning

confidence: 99%

“…In 10 included SRs, the effects of both non-surgical and surgical treatments were elucidated. [32][33][34][35][36][37][38][39][40][41] Six SRs included only non-surgical treatment, [42][43][44][45][46][47] and seven focused on surgical treatment. [48][49][50][51][52][53][54] 74% of included SRs were published between 2014 and 2016.…”

Section: General Study Characteristicsmentioning

confidence: 99%

“…In the domain related to synthesis (domain 4), nine SRs were judged as unclear. 34,37,40,42,43,[45][46][47][48] There was only one SR without meta-analysis which interpreted and discussed the results of ROB and heterogeneity assessments properly. 52 Besides this SR, it was difficult to assess appropriateness of synthesis in SRs of NRSIs.…”

Section: Robis Assessmentmentioning

confidence: 99%

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Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Hasuike

Ueno²,

Nagashima

et al. 2019

J of Periodontal Research

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Background and Objectives The purpose of the present study was to evaluate the methodological quality and risk of bias in systematic reviews (SRs) on the effectiveness of peri‐implantitis treatments. Material and Methods We searched four electronic databases: MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and EMBASE. Previous SRs focusing on peri‐implantitis treatment published between 2010 and 2017 were identified. After literature screening, eligible SRs were qualitatively assessed using two validated instruments: Assessing the Methodological Quality of Systematic Reviews (AMSTAR2) and Risk Of Bias In Systematic reviews (ROBIS). The characteristics and findings of SRs are also reported. Results A total of 23 SRs formed the basis of this study. Of the 23, six included randomized controlled trials (RCTs) only. Overall, the AMSTAR2 assessment revealed three studies with high and six studies with low methodological quality, and all the other SRs were judged as having critically low methodological quality. ROBIS revealed only one Cochrane review with a low risk of bias and the others with a high risk of bias. In particular, the assessment of non‐randomized studies (NRSIs), appropriateness of ROB assessment, and meta‐analysis did not satisfy the criteria in AMSTAR2 assessment. Furthermore, there were a few SRs that interpreted and discussed the results of risk of bias (ROB) and heterogeneity assessment, together with the impact of treatment. Conclusions Due to the lack of head‐to‐head comparisons conducted in RCTs, review authors need to use other sources of evidence, such as clinical control trials (CCTs), cohort studies (CS), clinical research (CR), and animal studies. The end result is the presentation of low‐quality evidence, with high ROB. Several SRs conducted network meta‐analysis as an alternative to head‐to‐head conventional meta‐analysis of RCTs. We suggest that the best methods to generate, access, and assess evidence in situations where RCT evidence is lacking should be discussed on an urgent basis.

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“…After full‐text evaluation, 11 articles did not meet our inclusion criteria and were excluded (Table ) . Finally, a total of 23 SRs formed the basis for this study …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: General Study Characteristicsmentioning

confidence: 99%

Section: Robis Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Hasuike

Ueno²,

Nagashima

et al. 2019

J of Periodontal Research

View full text Add to dashboard Cite

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“…17,18 AA system was even reported to be superior in cleaning and preserving the implant surfaces compared to curettes or ultrasonic scalers. 19,20 Several systematic reviews are available in the scientific literature about the AA method, 19,[21][22][23][24] but most of these studies generally concentrated on mechanical debridement treatments rather than on AA specifically. Furthermore, these reviews mainly focused on a particular outcome, not providing a comprehensive view, or only reported clinical results without correlating them with the parameters of AA systems (eg, device settings and powders) or the features of titanium surfaces (eg, roughness and compositions), so not providing a deep understanding of the mechanisms of AA systems which can lead to the further improvements.…”

mentioning

confidence: 99%

Effects of air abrasive decontamination on titanium surfaces: A systematic review of in vitro studies

Moharrami¹,

Perrotti

Iaculli

et al. 2019

Clin Implant Dent Rel Res

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Background Air abrasion (AA) is one of the decontamination methods that have demonstrated promising results in treating peri‐implant diseases. Purpose This systematic review aimed at evaluating the in vitro effect of AA on surface change, cleaning efficacy, and biocompatibility of titanium surfaces and at comparing it with other decontamination methods. Materials and Methods A comprehensive search was conducted up to April 2018 using PubMed, Scopus, and Google Scholar databases to identify studies on the decontamination effect of AA. All types of titanium surfaces, abrasive powders, contaminated surfaces, and measuring methods were included. Results Overall, 1502 articles were identified. After screening the titles and abstracts, and carefully reading the full‐texts, 48 articles published between 1989 and 2018 were selected. AA was considered almost safe, particularly for the nonmodified surfaces. Nevertheless, harder powders such as sodium bicarbonate tended to damage the surface more than glycine. AA resulted in surface change similar to plastic curettes and Er: YAG lasers. Regarding the cleaning efficacy, there was no significant difference between glycine and sodium bicarbonate, but different mixtures of calcium phosphate, hydroxyapatite, and erythritol were superior to glycine. AA was superior or equal to all other decontamination methods in cleaning. Regarding biocompatibility, AA was more successful in preserving biocompatibility for noncontaminated surfaces compared with contaminated surfaces and when used with erythritol and osteoinductive powders. Conclusions AA can efficiently remove contamination without serious damage to the surface. The main drawback of the AA method seems to be its limitation in restoring the biocompatibility of the surface.

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Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study

et al. 2021

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Objective Treatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography. Materials and methods Saliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey’s multiple comparison test. Results In the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups. Conclusions Decontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures. Clinical relevance CAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.

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Effectiveness of Mechanical Debridement Combined With Adjunctive Therapies for Nonsurgical Treatment of Periimplantitis

Abstract: Despite the improvement in the periimplant indices, there is no sufficient evidence to score the best results or even to choose the best association for nonsurgical treatment of periimplantitis; hence, more trials are necessary to answer this question.

Cited by 19 publications

References 18 publications

Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Effects of air abrasive decontamination on titanium surfaces: A systematic review of in vitro studies

Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study

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