Treatment of Peri-implant Mucositis and Supportive Peri-implant Therapy

Despite the potential benefits of an air-polishing device with erythritol powder, clinical trials using the device as a monotherapy for treating patients with peri-implant mucositis remained limited. Therefore, the primary aim of the present study is to compare clinical outcomes of the non-surgical treatment of peri-implant mucositis and subsequent supportive peri-implant therapy (SPIT) using an erythritol air-polishing device or conventional mechanical debridement. The secondary aim is to compare the resolution of inflammation after non-surgical treatment of peri-implant mucositis and to monitor levels of peri-implant tissues inflammation during supportive peri-implant therapy by using the level of selected pro-inflammatory cytokines.

Up to 60 participants with dental implants will be recruited from patients seeking and/or receiving dental care at the University of Michigan Graduate Periodontics department, until 34 peri-mucositis participants and 17 healthy participants are achieved.

Inclusion criteria

• Age 18 to 85 years.
• Healthy systemic conditions (American Society of Anesthesiologists classification (ASA) I or II: systemically healthy or suffer from mild to moderate, but well controlled systemic diseases).
• Must have at least one osseointegrated dental implant with the following conditions (Berglundh et al. 2018a).

• At least 12 months since the prosthesis was placed.
• Absence of bone loss beyond crestal bone level changes from initial bone remodeling.
• For implant mucositis subjects: Presence of bleeding and/or suppuration on gentle probing around implant at least 2 sites. Visual inspection demonstrating the presence of peri-implant signs of inflammation.
• For healthy implant subjects: Absence of bleeding and/or suppuration on gentle probing around implant.
• Have a current (less than 6 months old) x-ray of the affected site
• All participants must be enrolled in a 3 to 6 months maintenance recall program including teeth/implants prophylaxis and supportive periodontal therapy.

Exclusion criteria

• Poorly controlled diabetes mellitus (HbA1c >6.5).
• Uncontrolled systemic disease or condition known to alter bone metabolism. (e.g. osteoporosis, osteopenia, hyperparathyroidism, Paget's disease)
• Current smokers or vapers.
• Pregnancy or could be pregnant (self-reported), or plan to be pregnant in the next 6 months.
• Long-term (3 months) intake of anti-inflammatory medications (e.g. non-steroidal anti-inflammatory drugs (NSAIDs)) known to affect periodontal status within one month previous to participation in the study.
• Taking corticosteroids.
• Long-term antibiotic use (> one weeks) within three months previous to participation in the study.
• No history of supragingival scaling or non-surgical therapy at the affected implant site in the last 1 month.
• Taking anticoagulant medications.
• Subjects who require prophylactic antibiotics.