Clinical, microbiological and biochemical impact of a supportive care protocol with an air polishing device, after surgical treatment of peri-implantitis: Randomized clinical trial.

OBJECTIVES: The aim of the present study was to evaluate the efficacy of a supportive peri-implant care (SPIC) protocol after surgical therapy of peri-implantitis, combining ultrasonic mechanical debridement and glycine powder air-polishing.

MATERIAL AND METHODS: Thirty subjects diagnosed with peri-implantitis and treated by means of access flap were randomized six months later into two different SPIC groups: the test group combined a piezoelectric ultrasonic instrumentation with a specific implant PEEK tip and glycine powder air-polishing while control group received the same ultrasonic instrumentation together with a rubber cup and a polishing paste. Patients were followed for 12 months, with intermediate SPIC visits every 3 months. Clinical, radiological, microbiological and biochemical outcome variables were registered and calculated.

RESULTS: After 12 months of SPIC, probing depths (PD) showed a mean reduction of 0.33±0.11 mm, with significant differences (p<0.001) between the test (-0.84±0.43 mm) and the control group (+0.18±0.73 mm). Healthy peri-implant tissues defined by PD<5 mm, absence of BoP (or in only one site around the implant), and no additional bone loss (<0.5 mm), were observed at the final visit in 83% of the implants (87% in the test group and 80% in the control group, p=0.255). No adverse events were reported by the subjects participating in the study.

CONCLUSIONS: The SPIC protocol including mechanical ultrasonic debridement and glycine powder air-polishing demonstrated significantly better efficacy in terms of PD reductions. A strict SPIC protocol can maintain for one year, or even improve, the results obtained after surgical treatment of peri-implantitis.