The Treatment of Peri-Implant Diseases: A New Approach Using HYBENX® as a Decontaminant for Implant Surface and Oral Tissues

Abstract

Background: Peri-implantitis is a pathological condition characterized by an inflammatory process involving soft and hard tissues surrounding dental implants. The management of peri-implant disease has several protocols, among which is the chemical method HYBENX®. The aim of this study is to demonstrate the efficacy of HYBENX® in the treatment of peri-implantitis and to compare HYBENX® with other chemical agents used in the surgical treatment of peri-implantitis. Methods: The present study included a population of ten subjects with severe peri-implantitis. The procedure used in the study involves the application of HYBENX® after open-flap debridement. Each patient has been followed for 12 months after a single application of the decontaminant agent. Clinical and radiographical parameters were recorded at baseline, 3 months, and 12 months after treatment completion. Results: At baseline, a mean pocket probing depth (PPD) of 7.3 ± 0.5 mm and a mean clinical attachment level (CAL) of 8.8 ± 0.8 mm was recorded. An average residual PPD of 4.2 ± 0.5 mm and a mean CAL of 5.2 ± 0.8 mm were observed after 1 year. Additionally, the average of bone gain was about 3.4 mm, with a mean marginal bone level (MBL) change from 5.8 mm (baseline) to 2.4 mm (12 months). In total, 90% of the treated implants reached the success rate after the 1-year follow-up. Only in one case out of ten treated implants was resolution of the disease not achieved. Conclusion: Clinical improvements highlight that the procedure of open-flap debridement (OFD) + HYBENX® may be considered an effective technique in the treatment of peri-implantitis. From the results obtained, it can be concluded that the use of HYBENX® in the surgical treatment of peri-implantitis is promising. Overall, this protocol demands further studies to better understand the role and potential benefits of HYBENX® in the treatment of peri-implantitis.

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants—A Narrative Review

“…The management of peri-implantitis comprises conservative (non-surgical) and surgical techniques. There are lots of strategies for peri-implantitis treatment, including detoxifying the implant surfaces, including mechanical methods, chemicals, laser and photodynamic therapies, but the results of some of them are contradictory and uncertain over the long term [ 29 , 30 , 109 ]. Some studies in the literature reveal a better osseointegration process in implants when treated with photobiomodulation and ozone therapy compared with control groups [ 110 ].…”

“…Current studies suggest more clinical benefits in the local use of antibiotics than the local use of chlorhexidine [ 30 ]. For the local application of the antibiotic, we can use tetracycline fibers, doxycycline, minocycline or metronidazole [ 74 , 75 , 76 ].…”

“…This substance also reduces the frequency of detection of Prevotella intermedia/nigrescens, Fusobacterium sp., Bacteroides forsythus , and Campylobacter rectus [ 77 ]. The study on patients with peri-implantitis, where the 50 mg/mL dose of tetracycline was applied for 5 min after implantoplasty or air powder and followed by an autogenous bone graft or xenograft and membrane, resulted in the arrest of the disease and radiographic bone fill of the peri-implant defects [ 29 , 30 ]. Doxycycline is a broad-spectrum antibiotic and has antimicrobial activity against the subgingival biofilm.…”

“…HYBENX is based on a desiccation shock debridement technology (DSD), which consists of using a new class of a non-antibiotic cleanser to eradicate pathogens and the residual molecular matrix from infected tissue surfaces. Its selectivity allows for the reduction in bleeding in the treatment area, pain and tissue inflammation [ 30 , 87 ].…”

“…The weighted mean prevalence of these conditions is clinically very important and may even be as high as 47% for subject-based peri-implant mucositis [ 29 ]. The high incidence of peri-implant pathologies forces clinicians to search for novel treatments, including the site decontamination of dental implants and dental implant sites [ 30 , 31 ].…”