The Initial Treatment of Peri-implant Disease
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In 1952 Per-Ingvar Brånemark discovered the potential of titanium’s ability to bond to bone. In 1977 he introduced the concept of the titanium dental implant. Since Dr. Brånemark’s discovery the titanium dental implant has revolutionized dentistry, providing treatment options from single tooth to full arch replacement. Implants provide a service to our patients that have the potential to be life changing both functionally and aesthetically. Unfortunately, this progress is lost when dental implants fail, causing emotional and financial distress to the patient. One of the complications that can lead to implant failure is peri-implant disease. Thus far the literature has shown that non-surgical treatment significantly reduces BOP at peri-implant disease sites. Although, complete disease resolution is not commonly observed following therapy. In light of the possible peri-implant disease etiologies of bacterial plaque and foreign material, a peri-implant sulcular debridement via sulcular curettage appears prudent and has been rarely studied. Therefore, the purpose of this study was to investigate the effects of sulcular debridement and chlorhexidine irrigation at peri-implant disease sites. All implants included in the study were either diagnosed as having peri-implant mucositis or peri-implantitis. Implants will be randomly assigned to two different groups. Group 1 implants initially received debridement of the peri-implant sulcus. While Group 2 implants received sulcular irrigation with 0.12% chlorhexidine gluconate. Four weeks following initial treatment patients from both groups were re-evaluated and measurements were recorded (PD, BOP, Suppuration, GI). Group 1 patients received sulcular irrigation with 0.12% chlorhexidine gluconate, while Group 2 patients received debridement of the peri-implant sulcus. Four weeks following administration of crossover treatment patients were re-evaluated and measurements were recorded (PD, BOP, Suppuration, GI). 8 weeks following administration of crossover treatment measurements were recorded (PD, BOP, Suppuration, GI). When comparing the treatment of sulcular debridement to chlorhexidine irrigation (0.08mm, 0%), sulcular debridement (0.73mm, 22%) had greater reductions in PD and BOP, although neither group seemed to make clinically significant reductions. Following the completion of both treatments at 3 months peri-implant mucositis PD improved by 0.58mm, while peri-implantitis PD improved by 0.64mm. Peri-implant mucositis and peri-implantitis BOP reduced by 56% and 12.5%, respectively. .
Mentesana, Carl Michael (2018). The Initial Treatment of Peri-implant Disease. Master's thesis, Texas A & M University. Available electronically from