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

• Published in: Clinical oral implants research Vol. 34; no. 7; pp. 684 - 697
• Main Authors: Khan, Sadia N., Koldsland, Odd Carsten, Roos‐Jansåker, Ann‐Marie, Wohlfahrt, Johan Caspar, Verket, Anders, Mdala, Ibrahimu, Magnusson, Anna, Salvesen, Eirik, Hjortsjö, Carl
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.07.2023
• Subjects: Bone implants; Chitosan; Chitosan - therapeutic use; clinical trial; Clinical trials; Dental implants; Dental Implants - adverse effects; Dental prosthetics; Follow-Up Studies; Health services; Humans; Inflammation; Patients; peri-implantitis; Peri-Implantitis - diagnostic imaging; Peri-Implantitis - therapy; Statistical analysis; Suppuration - chemically induced; Surgical implants; Titanium; Titanium - therapeutic use; Transplants & implants; Treatment Outcome; clinical trial; titanium; dental implants; peri-implantitis
• ISSN: 0905-7161; 1600-0501; 1600-0501
• DOI: 10.1111/clr.14078

Objectives To study clinical and radiographic outcomes after non‐surgical treatment of peri‐implantitis using either an oscillating chitosan brush (OCB) or titanium curette (TC) and to observe changes in clinical signs of inflammation after repeated treatment. Methods Thirty‐nine patients with dental implants (n = 39) presented with radiographic bone level (RBL) of 2–4 mm, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly assigned to mechanical debridement with OCB (test) or TC (control). Treatment was performed at baseline and repeated at 3, 6, and 9 months in cases with > 1 implant site with BI ≥ 1 and PPD≥4 mm. Blinded examiners recorded PPD, BI, pus, and plaque. The radiographic bone level change between baseline and 12 months was calculated. A multistate model was used to calculate transitions of BI. Results Thirty‐one patients completed the study. Both groups exhibited a significant reduction in PPD, BI, and pus at 12 months compared to baseline. Radiographic analysis showed stable mean RBL in both groups at 12 months. There was no statistically significant difference in any of the parameters between the groups. Conclusions Within the limitations of this 12‐month multicenter randomized clinical trial, non‐surgical treatment of peri‐implantitis with OCB or TC showed no statistically significant differences between the groups. Clinical improvements and, in some cases, disease resolution, was observed in both groups. However, persistent inflammation was a common finding which further puts emphasis on the need for further treatment.