Download or read book Non-surgical Treatment Protocol of Peri-implantitis with Topical Doxycycline and Air-polishing with Erythritol Powder. A Case Series written by Carrara Clara and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aim: The treatment of peri-implantitis has been challenging in the past years.u2028Non-surgical procedures are considered to be fundamental in the treatment of peri-implant diseases, in order to reduce the inflammatory parameters. However, there is limited evidence on its efficacy in the complete resolution of peri-implantitis and a surgical access may be needed. The aim of this case series was to evaluate the clinical results of a non-surgical treatment protocol that includes supra-mucosal and sub-mucosal decontamination with erythritol powder air polishing, topical doxycycline and chlorhexidine.Materials and methods: A total of 22 implants in 7 patients affected by peri-implantitis were included in the study.u2028Peri-implantitis was defined as probing depth (PD) of at least 5 mm, bleeding on probing and a radiographic bone loss of at least 2 mm. All implants were treated with the following non-surgical protocol. T0: supra-mucosal mechanical debridement with rubber plugs and topical application of chlorhexidine 1% gel, that was repeated by the patients twice a day for 7 days. T1 (7 days after T0): sub-mucosal debridement with teflon curettes and air-polishing with erythritol powder (Air-Flow Powder Plus, eMS, Nyon). T2 (2 days after T1): sub-mucosal application of topical 14% doxycycline gel (Ligosan, Heraeus Kulzer, Hanau) around the infected implant. T3 (2 weeks after T2): second application of topical doxycycline. T4 (6 weeks after T3): re-evaluation. PD, recession, bleeding index (BI), plaque index (PI) and suppuration were recorded at T0, T1, T4. Peri-apical radiographs were taken at T0 and T4. Results: All the included implants had external connection (Nobel Speedy Groovy, Nobel Biocare, Zurich) with a moderately rough surface. In all the treated implants it was possible to remove the prosthesis in order to perform each phase of the treatment.u2028No implant failure were recorded.Considering the totality of the sites, the implants have an average PD of 4.95 mm (SD2.06) at t0, 4.72 mm (SD 2.21) at t1 and 3.57 mm (SD 1.07) at t4. Considering only the sites with PD at t0 greater than 4 mm, an average PD value of 6.10 mm was recorded at t0, 5.72 mm at t1 and 3.52 mm at t4 (Graph 1).The number of implants with suppuration were 13 at t0 and 2 at t4 (Graph 3).u2028In both cases there is a significant difference between the values of PD at t0 and t4 and between t1 and t4 (p0.05). The decrease in BI among t0, t1 and t4 (Graph 2) and the decrease suppuration (Graph 3) between t0-t4 and t1-t4 were statistically significant (p0.05). No significant radiographic bone loss was found in any implant at t4 compared to t0. Conclusion: Within the limitations of the present study, the proposed protocol showed good short-term efficacy, in both reduction of PD and BI, greater than what described in the literature by other non-surgical treatment methods.u2028Further studies with a larger sample and medium and long term results are needed to be able to evaluate its efficacy, better understand possible risk factors and predict the therapy outcome.