Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes

Clin Oral Implants Res. 2007 Jun;18(3):281-5. doi: 10.1111/j.1600-0501.2007.01377.x. Epub 2007 Mar 12.

Abstract

Aim: To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis.

Material and methods: In 25 partially edentulous subjects, 31 implants diagnosed with peri-implantitis were treated. Three weeks after oral hygiene instruction, mechanical debridement and local antiseptic cleansing using 0.2% chlorhexidine gel, baseline (Day 0) parameters were recorded. Minocycline microspheres (Arestin) were locally delivered to each implant site with bone loss and a probing pocket depth (PPD) >or=5 mm. Rescue therapy with Arestin was allowed at Days 180 and 270 at any site exhibiting an increase in PPD>or=2 mm from the previous visit. The following clinical parameters were recorded at four sites/implant at Day 0, 10, 30, 60, 90, 180, 270 and 360: PPD, clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PlI).

Results: Six implants in six subjects were either rescued or exited because of persisting active peri-implantitis. Successful implants showed a statistically significant reduction in both PPD and percentage of sites with BOP between baseline and Day 360 (P<0.05). At mesial implant sites, the mean PPD reduction amounted to 1.6 mm (95% CI: 0.9-2.2 mm, P<0.001) and was accompanied by a statistically significant reduction of the BOP value (P<0.001). Binary regression analysis showed that the clinical parameters and smoking history could not discriminate between successfully treated and rescued or exited implants at any observation time point.

Conclusion: Non-surgical mechanical treatment of peri-implantitis lesions with adjunctive local delivery of microencapsulated minocycline led to positive effects on clinical parameters up to 12 months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / drug therapy*
  • Alveolar Bone Loss / etiology
  • Anti-Bacterial Agents / therapeutic use*
  • Dental Implants / adverse effects*
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / drug therapy
  • Mandibular Diseases / etiology
  • Maxillary Diseases / diagnostic imaging
  • Maxillary Diseases / drug therapy
  • Maxillary Diseases / etiology
  • Middle Aged
  • Minocycline / therapeutic use*
  • Radiography

Substances

  • Anti-Bacterial Agents
  • Dental Implants
  • Minocycline