Erythritol air polishing in the surgical treatment of peri‐implantitis: A randomized controlled trial

Abstract

Objectives: To compare erythritol air polishing with implant surface cleansing using saline during the surgical treatment of peri-implantitis. Material and Methods: During a resective surgical intervention, implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline-soaked cotton gauzes (control group n = 31 patients/ 40 implants). Primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow-up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full-mouth scores (PFMS), and levels of 8 classical periodontal pathogens. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann-Whitney U test.Results: No differences between the test and control group were found for BoP over 12 months of follow-up, nor for the secondary parameters Plq, PPD, and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1-year follow-up, a successful treatment outcome (PPD<5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%).Conclusions: Erythritol air polishing as implant surface cleansing method was not more effective than saline during resective surgical treatment of peri-implantitis in terms of clinical, radiographical, and microbiological parameters. Both therapies resulted in low treatment success.Trial registry: https://www.trial regis ter.nl/ Identifier: NL8621.

Reconstructive surgical therapy of peri‐implantitis: A multicenter randomized controlled clinical trial

“…Successful management of peri-implantitis, as indicated by the reduction in bleeding on probing and/or absence of further bone loss, has also been demonstrated both in observational studies (e.g., Berglundh et al, 2018;Roccuzzo et al, 2017;Schwarz et al, 2017) and in randomized controlled trials (e.g., Carcuac et al, 2016;Carcuac et al, 2017;Hentenaar et al, 2022).…”

“…The primary goal of the treatment of peri‐implantitis is to resolve the inflammatory lesion in peri‐implant tissues, which was shown to be possible in preclinical in vivo experiments (Albouy et al, 2011; Carcuac et al, 2015). Successful management of peri‐implantitis, as indicated by the reduction in bleeding on probing and/or absence of further bone loss, has also been demonstrated both in observational studies (e.g., Berglundh et al, 2018; Roccuzzo et al, 2017; Schwarz et al, 2017) and in randomized controlled trials (e.g., Carcuac et al, 2016; Carcuac et al, 2017; Hentenaar et al, 2022).…”

Surgical interventions for the treatment of peri‐implantitis

“…Resective surgery for the management of peri-implantitis lesions has shown efficiency in resolving clinical signs of inflammation and the arrestment of progressive bone loss. 16,19,[41][42][43] Based on similar combined treatment outcomes, disease progression could be suppressed in 5% to 44.9% of the implants throughout 6 months to 3 years following periods (Table 1). With respect to the tissue changes, resective peri-implantitis therapy, however, has been shown to be followed by a considerable post-operative soft-tissue recession (1.22 mm [CI: 0.71; 1.73]).…”

“…Resective surgery for the management of peri‐implantitis lesions has shown efficiency in resolving clinical signs of inflammation and the arrestment of progressive bone loss 16,19,41–43 . Based on similar combined treatment outcomes, disease progression could be suppressed in 5% to 44.9% of the implants throughout 6 months to 3 years following periods (Table 1).…”

“…Former clinical studies have assessed the efficacy of various methods of implant surface decontamination in conjunction with resective peri‐implantitis therapy upon resolution of peri‐implantitis lesions. Based on comparative studies with follow‐up periods of 3 months to 3 years, the adjunctive use of antimicrobials in conjunction to mechanical implant surface debridement (ie, chlorhexidine with or without cetylpyridinium chloride), the use of phosphoric acid, or application of an air‐abrasive device with erythritol powder failed to improve clinical outcomes compared to mechanical debridement alone 16,18,19,41–43 . Furthermore, as demonstrated by one 3‐year RCT, adjunctive use of systemic antibiotics had an initial beneficial effect on implants with modified surfaces, which, however, was limited to the first year of follow‐up 18,19 …”