title: Implant decontamination during surgical peri-implantitis treatment: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  The objective of this randomized, double-blind, placebo-controlled trial was to study the effect of implant surface decontamination with chlorhexidine (CHX)/cetylpyridinium chloride (CPC) on microbiological and clinical parameters.
  
  
  METHODS
  Thirty patients (79 implants) with peri-implantitis were treated with resective surgical treatment consisting of apically re-positioned flap, bone re-contouring and surface debridement and decontamination. Patients were randomly allocated to decontamination with 0.12% CHX + 0.05% CPC (test-group) or a placebo-solution (without CHX/CPC, placebo-group). Microbiological parameters were recorded during surgery; clinical and radiographical parameters were recorded before (pre-) treatment (baseline), and at 3, 6 and 12 months after treatment.
  
  
  RESULTS
  Nine implants in two patients in the placebo-group were lost due to severe persisting peri-implantitis. Both decontamination procedures resulted in significant reductions of bacterial load on the implant surface, but the test-group showed a significantly greater reduction than the placebo-group (log 4.21 ± 1.89 versus log 2.77 ± 2.12, p = 0.006). Multilevel analysis showed no differences between both groups in the effect of the intervention on bleeding, suppuration, probing pocket depth and radiographical bone loss over time.
  
  
  CONCLUSIONS
  Implant surface decontamination with 0.12% CHX + 0.05% CPC in resective surgical treatment of peri-implantitis leads to a greater immediate suppression of anaerobic bacteria on the implant surface than a placebo-solution, but does not lead to superior clinical results. The long-term microbiological effect remains unknown.
authors.affiliation: Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. y.c.m.de.waal@umcg.nl
authors.forename: Yvonne C M
authors.initials: YC
authors.lastname: de Waal
authors.forename: Gerry M
authors.initials: GM
authors.lastname: Raghoebar
authors.forename: James J R
authors.initials: JJ
authors.lastname: Huddleston Slater
authors.forename: Henny J A
authors.initials: HJ
authors.lastname: Meijer
authors.forename: Edwin G
authors.initials: EG
authors.lastname: Winkel
authors.forename: Arie Jan
authors.initials: AJ
authors.lastname: van Winkelhoff
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery; D000891:Anti-Infective Agents, Local / Q000494:pharmacology* / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D002594:Cetylpyridinium / Q000494:pharmacology* / Q000627:therapeutic use; D002710:Chlorhexidine / Q000494:pharmacology* / Q000627:therapeutic use; D003666:Decontamination / Q000379:methods*; D015921:Dental Implants / Q000382:microbiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D057873:Peri-Implantitis / Q000188:drug therapy* / Q000601:surgery*; D057747:Periodontal Debridement; D010512:Periodontal Index; D011859:Radiography
chemical_list: D000891:Anti-Infective Agents, Local; D015921:Dental Implants; D002594:Cetylpyridinium; D002710:Chlorhexidine