Diederik Hentenaar^1,*; Yvonne de Waal²; Roy Stewart³; Arie Jan Van Winkelhoff⁴; Henny Meijer⁵; Gerry Raghoebar⁶

¹Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen; ²Center for Dentistry and Oral Hygiene; ³Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen; ⁴Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen; ⁵Department of Oral and Maxillofacial Surgery & Center for Dentistry and Oral Hygiene; ⁶Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, Netherlands

Background: Implant surface decontamination and/or debridement is considered a critical component for the successful surgical treatment of peri-implantitis (Sanz, Chapple, Working Group 4 of the VIII European Workshop on Periodontology, 2012). To date, no clinical, radiographical and microbiological data favors any cleansing approach (Khoury, et al., 2019). Clinical investigations are needed to determine the superiority of a decontamination and/or debridement method (Koo, et al., 2019).

Aim/Hypothesis: To compare erythritol air polishing with implant surface cleansing using saline during the surgical resective treatment of peri-implantitis.

Material and Methods: During a resective surgical intervention, the implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline-soaked cotton gauzes (control group n = 31 patients/ 40 implants). The primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow-up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full mouth scores (PFMS) and levels of 8 classical periodontal pathogens. Patients were assessed at 3, 6, 9 and 12 months follow-up. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann-Whitney U test.

Results: No differences between the test and control group were found for the primary outcome BoP over 12 months of follow-up, nor for the secondary parameters Plq, PPD and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1-year follow-up, a successful treatment outcome (PPD < 5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%).

Conclusion and Clinical implications: Erythritol air polishing as implant surface cleansing method seemed as effective as saline during resective surgical treatment of peri-implantitis in terms of clinical, radiographical and microbiological parameters. Both therapies resulted in low treatment success.

Disclosure of Interest: None Declared

Keywords: clinical studies/trials, dental implants, peri-implantitis

迪德里克·亨特纳尔^1,* ; 伊冯娜·德瓦尔² ; 罗伊斯图尔特³ ; 阿里扬范温克尔霍夫⁴ ; 亨尼迈耶⁵ ; 格里拉格赫巴尔⁶

¹格罗宁根大学口腔颌面外科系，格罗宁根大学医学中心；²牙科和口腔卫生中心；³格罗宁根大学医学中心健康科学、社区和职业医学系；⁴格罗宁根大学牙科和口腔卫生中心，格罗宁根大学医学中心；⁵口腔颌面外科及牙科口腔卫生中心；⁶荷兰格罗宁根格罗宁根大学医学中心口腔颌面外科

背景：种植体表面去污和/或清创被认为是成功手术治疗种植体周围炎的关键组成部分（Sanz, Chapple，第八届欧洲牙周病研讨会第 4 工作组，2012 年）。迄今为止，没有任何临床、放射学和微生物学数据支持任何清洁方法（Khoury 等人，2019 年）。需要进行临床调查来确定去污和/或清创方法的优越性（Koo 等人，2019 年）。

目的/假设：比较赤藓糖醇空气抛光与使用生理盐水清洁种植体表面在种植体周围炎手术切除治疗中的效果。

材料和方法：在切除手术干预期间，种植体表面随机使用空气抛光（测试组n = 26 名患者/53 个种植体）或盐水浸泡的棉纱布（对照组n= 31 名患者/40 个种植体）。主要结果是探查时平均出血 (BoP) 从基线到 12 个月随访的变化。次要结果是探诊平均化脓 (SoP)、菌斑评分 (Plq)、探诊袋深度 (PPD)、边缘骨丢失 (MBL)、牙周全口评分 (PFMS) 和 8 种经典牙周病原体水平的变化。在 3、6、9 和 12 个月的随访中对患者进行评估。使用多级回归分析来分析临床和放射学参数。使用 Mann-Whitney U 检验分析微生物结果。

结果：在 12 个月的随访期间，在主要结果 BoP 以及次要参数 Plq、PPD 和 MBL 方面，未发现测试组和对照组之间存在差异。在两组之间，发现 SoP 水平存在显着差异（p = 0.035）。未发现对微生物水平的显着影响。试验组共丢失 6 个种植体，对照组丢失 10 个种植体。在 1 年的随访中，总共 18 颗种植体 (19.2%) 获得了成功的治疗结果（PPD < 5 mm，6 个位点中最多有 1 个为 BoP，无化脓且无进展性骨质流失 >0.5 mm）。

结论和临床意义：就临床、放射学和微生物学参数而言，赤藓糖醇空气抛光作为种植体表面清洁方法在种植体周围炎的切除手术治疗中似乎与盐水一样有效。两种疗法均导致治疗成功率低。

利益披露：无申报

关键词：临床研究/试验，牙种植体，种植体周围炎