title: Water jet with adjunct chlorhexidine gel for nonsurgical treatment of peri-implantitis.
abstract: BACKGROUND
  Peri-implant disease following successful integration of an endosseous implant is the result of an imbalance between bacterial load and host defense, which may affect not only the peri-implant mucosa but also involve the supporting bone.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the adjunctive effect of a dental water jet rinse mixed with chlorhexidine gel to the nonsurgical treatment for peri-implantitis.
  
  
  METHODS
  A prospective randomized interventional cohort study was conducted. Forty consecutive patients presenting with peri-implantitis were recruited and randomly assigned into two treatment groups. Initially all patients received scaling/surface debridement and oral hygiene instruction. Patients in the study group received a water jet device containing chlorhexidine gel (Silonite®) for home use twice daily while the control group performed the recommended oral hygiene measures with no water jet usage. Three months following baseline visit, patients were reevaluated clinically and radiographically.
  
  
  RESULTS
  In total, 39 patients completed the study and were available for final examination. Three months following baseline visit the test group exhibited greater mean probing depth reduction (0.75 mm vs 0.27 mm; P = .029) as well as greater reduction in the number of sites presenting with bleeding on probing (2.26 vs 0.45 sites; P = .011). No significant change in bone level was observed at 3 months (mean bone gain was 0.18 mm).
  
  
  CONCLUSIONS
  Water jet mixed with chlorhexidine gel might supplement the response to nonsurgical treatment for peri-implantitis lesions. Further, larger-cohort studies are warranted.
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
authors.forename: Shai
authors.initials: S
authors.lastname: Frankenthal
authors.forename: Livia
authors.initials: L
authors.lastname: Joseph
authors.forename: Doron
authors.initials: D
authors.lastname: Rozitsky
authors.forename: Guy
authors.initials: G
authors.lastname: Levi
authors.forename: Eli E
authors.initials: EE
authors.lastname: Machtei
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014867:Water
chemical_list: D000891:Anti-Infective Agents, Local; D005782:Gels; D014867:Water; D002710:Chlorhexidine