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Discussion : A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series [1]

Discussion : A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series [1]

author: J C Wohlfahrt, B J Evensen, B Zeza, H Jansson, A Pilloni, A M Roos-Jansker, G L Di Tanna, A M Aass, M Klepp, O C Koldsland | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Identifying peri-implant disease at an early stage and promptly treating the inflammatory condition is crucial to prevent the progression of peri-implant bone loss and ensure long-term implant survival [23,24,25]. After completion of active treatment and when the condition is controlled, supportive peri-implant therapy will reduce the risk of disease re-occurrence [9]. A number of scientific reports on various methods for non-surgical peri-implant therapy have been presented, but limited and short-term effects have been reported [26, 27]. Instruments for the removal of submucosal microbial deposits from implant surfaces should obviously be effective without causing damage to the implant. However, clinical devices specifically designed for this purpose are scarce, and the effectiveness and safety of most such devices have rarely been scientifically validated [28]. In a review paper by Schwarz et al. [29], it was reported that mechanical debridement with, e.g. carbon fibre, titanium or plastic curettes combined with measures of oral hygiene, was effective in the management of peri-implant mucositis and that alternative or adjunctive measures such as lasers, ultrasonic devices or air abrasives with glycine powder may improve the efficacy of the treatment of sites with peri-implantitis. The same group of researchers also performed a systematic review on studies evaluating air-polishing with glycine powder of implants with peri-implantitis and reported that this method may lead to improved reduction in parameters of inflammation as compared to mechanical debridement combined with antiseptic therapy [30]. Chitosan is a completely biocompatible biopolymer which also has been demonstrated to be bacteriostatic and exhibit anti-inflammatory properties [31,32,33]. A recent in vitro experimental study demonstrated that chitosan inhibits the growth of the periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and exerts an anti-inflammatory effect by reducing the levels of prostaglandin E-2 (PGE2) [34]. From these perspectives, chitosan may be considered a potential candidate to be used in a device for implant debridement.

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