Non‐surgical treatment of mild to moderate peri‐implantitis using an oscillating chitosan brush or a titanium curette—A randomized multicentre controlled clinical trial

Abstract

Objectives: This prospective, parallel-group, examiner-blinded, multicentre, randomized, controlled clinical trial aimed to assess the efficacy of an oscillating chitosan brush (OCB) versus titanium curettes (TC) on clinical parameters in the non-surgical treatment of peri-implantitis. Material and Methods:In five dental specialist clinics, 39 patients with one implant with mild to moderate peri-implantitis, defined as 2-4 mm radiographic reduced bone level, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly allocated to test and control groups, receiving OCB or TC debridement, respectively.Treatment was performed at baseline and three months. PPD, BI, and Plaque index (PI) were measured at six sites per implant and recorded by five blinded examiners at baseline, one, three, and six month(s). Pus was recorded as present/not present.Changes in PPD and BI were compared between groups and analysed using multilevel partial ordinal and linear regression.Results: Thirty-eight patients completed the study. Both groups showed significant reductions in PPD and BI at six months compared with baseline (p < .05). There was no statistically significant difference in PPD and BI changes between the groups.Eradication of peri-implant disease as defined was observed in 9.5% of cases in the OCB group and 5.9% in the TC group.Conclusions: Within the limitations of this six-month multicentre clinical trial, nonsurgical treatment of peri-implantitis with OCB and TC showed no difference between the interventions. Eradication of disease was not predictable for any of the groups.

Non‐surgical treatment of mild to moderate peri‐implantitis with an oscillating chitosan brush or a titanium curette—12‐month follow‐up of a multicenter randomized clinical trial

“…It is demonstrated that disease resolution is unpredictable after non‐surgical peri‐implantitis treatment; thus, novel methods should be developed and tested (Roccuzzo et al, 2020). Non‐surgical treatment of mucositis and peri‐implantitis with OCB compared to TC has been evaluated in clinical studies with equal efficacy for both treatment modalities (Khan et al, 2022; Koldsland & Aass, 2020; Wohlfahrt et al, 2017) The presence of pus was resolved in 19.1% of the implants in the OCB group and with no reduction in the TC group when the treatments were compared in an RCT with a 6‐month follow‐up (2022). Further reduction in the presence of pus following repeated treatments over 12 months was observed in the present study (2022).…”

“…A calibration meeting was held to discuss the study protocol prior to the study start. The detailed clinical protocol and study design have been published (Khan et al, 2022).…”

“…Complementary inclusion and exclusion criteria were published in a previous publication (Khan et al, 2022).…”

“…The affected implant's short‐ and long‐term re‐evaluation is indicated due to constant changes in plaque and inflammation (Polyzois, 2019). Outcomes of a recent multicenter randomized controlled clinical trial (RCT) demonstrated reductions in inflammatory parameters but rarely disease resolution when treatment was performed non‐surgically with an oscillating chitosan brush (OCB) or titanium curettes (TC; Khan et al, 2022). Similar findings with a reduction in bleeding sites but no reduction in PPD and stable RBL were observed when implants were non‐surgically treated with carbon fiber curettes or a Vector® system (Karring et al, 2005).…”

“…Thus, a different threshold for periimplantitis should have been used since baseline radiographic data were lacking, namely 3 mm bone loss and 6 mm PPD.The required sample size to achieve 80% study power was calculated to be 17 patients in each group. At baseline, 21 patients were included in the test group and 17 in the control group(Khan et al, 2022). At 12 months, the test group consisted of 18 patients and the control group 13 patients.…”