Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes.
OBJECTIVE
To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis.


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.


CONCLUSIONS
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.
Salvi
Giovanni E
GE
School of Dental Medicine, University of Berne, Berne, Switzerland. giovanni.salvi@zmk.unibe.ch
Persson
G Rutger
GR
Heitz-Mayfield
Lisa J A
LJ
Frei
Marc
M
Lang
Niklaus P
NP
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015921:Dental Implants / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D011859:Radiography
D000900:Anti-Bacterial Agents; D015921:Dental Implants; D008911:Minocycline