Table 1.
Publication | Design | Population | Case definition | Period | Test | Control | Mean (SD) outcome | Supportive therapy/comments |
---|---|---|---|---|---|---|---|---|
Alternative measures for biofilm removal | ||||||||
Ji et al. (2014) | RCT, parallel |
24 patients Test: 12; mean age: 46.2 years; 50% female Control: 12; mean age: 41.3 years: 67% female 8 patients – diagnosed with periodontitis 33 implants (test: 17, control: 16) Molar/premolar sites 1 implant system (ITI Straumann, Standard Implant, SLA surface) |
PD ≥ 4 mm, BOP + no radiographic bone loss compared with baseline (i.e immediately after prosthesis insertion) |
3 months |
OHI + mechanical debridement (ultrasonic scaler with carbon fiber tips) + air abrasive device, glycine powder (sites with PD ≥ 4 mm) |
OHI + mechanical debridement (ultrasonic scaler with carbon fiber tips) |
Subject level BI Test baseline: 1.4 (0.57); 3 months: 1.1 (0.58); p = 0.150 Implant level (at sites PD ≥ 4 mm): baseline: 1.7 (0.93); 3 months: 1.1 (0.98); p = 0.002 Control subject level: Baseline:1.5 (0.65); 3 months: 1.0 (0.85); p = 0.058 Implant level (at sites PD ≥ 4 mm): baseline: 1.7 (1.0); 3 months: 0.9 (1.1); 3-months; p < 0.001 Between-group comparison: subject level: p = 0.764; implant level: p = 0.361 PD Test baseline: 3.6 (0.47) mm; 3 months: 3.2 (0.48); p = 0.017 Implant level (at sites PD ≥ 4 mm): baseline: 4.6 (0.50); 3 months: 3.7 (0.95); p < 0.001 Control subject level: Baseline: 3.5 (0.50); 3 months: 3.1 (0.38); p = 0.012 Implant level (at sites PD ≥ 4 mm): baseline: 4.5 (0.55); 3 months: 3.1 (0.38); 3-months; p = 0.012 Between-group comparison: subject level: p = 0.587; implant level: p = 0.831 |
During follow-up visits, oral hygiene instructions were reinforced (at 1- and 3-months) Adjunctive air abrasive device with glycine powder appeared to have a limited beneficial effect as compared with mechanical debridement alone |
De Siena et al. (2014) | CCT, parallel |
30 patients (15 per group) Test: 9 female; 6 male; mean age: 64.8 (12.5) years; mean cigarettes per day: 5.5 (2.6); Control: 9 female, 6 male; mean age: 63.3(9.3) years; mean cigarettes per day: 4.3(2.3); None of the patients were diagnosed with periodontitis |
BOP or spontaneous bleeding with local swelling + PD ≤ 3.5 mm + bone loss ≤ 3.0 mm |
6 months |
OHI + mechanical debridement Teflon curettes, polishing + air abrasive devic with, glycine powder |
OHI + mechanical debridement Teflon curettes, polishing |
Implant level BI Test: 13 patients did not present bleeding at 6 months; Control: 9 patients did not present bleeding at 6 months PD Test baseline: 3.0 (0.4) mm; 6 months: 2.4 (0.5) mm; p < 0.05; Control baseline: 2.9 (0.4) mm; 6 months: 3.0 (0.6) mm; p > 0.05 |
OHI were provided at baseline and repeated in each follow-up visit 3 and 6 months after intervention Test group showed a significant reduction in PD values |
Riben-Grundstrim et al. (2015) |
RCT, parallel |
37 patients Test:17; mean age: 64.4 (range: 25–85) years; Control:18; mean age: 64.3 (range: 25–86) years; 5 patients – current smokers (test: 1; control: 4) 37 implants 3 implant systems (Astra Tech, Nobel Biocare, Straumann) |
PD ≥ 4 mm, BOP + with or without SUPP + bone loss ≤ 2 mm from implant shoulder |
12 months |
OHI + air abrasive device with glycine powder Repeated treatment at 3 and 6 months |
OHI + mechanical debridement (ultrasonic scaler with plastic coated tips) Repeated treatment at 3 and 6 months |
Subject level BOP Test baseline: 43.9 (7.3)%; 12 months: 12.1 (3.8)%; p < 0.05 Control baseline: 53.7 (7.9)%; 12 months: 18.6 (6.4)%; p < 0.05 No significant difference between the groups Number of diseased sites (PD ≥ 4 mm with BOP/ SUPP) Test baseline: 38%; 12 months: 8% Control baseline: 52%; 12 months: 17% |
Supragingival maintenance care was provided at months 9 and 12 Both treatment approaches were effective in treating peri-implant mucositis |
Wohlfahrt et al. (2018) | RCT, split-mouth desing |
11 patients Age: NR Periodontal/smoking status: NR 24 implants (test: 12, control: 12) 3 implant brands (Astra, Nobel Mark III, Straumann) |
BOP + at least on esite PD ≥ 4 mm + no perceptible bone loss | 6 months | Chitosan brush (BioClean Labrida) with oscillating hand piece for 3 min + saline irrigation | Mechanical debridement (titanium curettes) for 3 min + saline irrigation |
Implant level mBOP Test baseline: 1.54 (0.78), 6 months: 0.70 (0.70); Control baseline: 1.35 (0.85); 6 months: 0.74 (0.80); no significant difference between groups PD Test baseline: 4.27 (1.36) mm; 6 months: 4.09 (1.68) mm Control baseline: 4.29 (1.50) mm; 6 months: 3.95 (1.27) mm; no significant difference between groups |
Reduced signs of inflammation were seen in both groups |
Adjunctive diode laser/aPDT therapy | ||||||||
Javed et al. (2017) |
RCT, parallel |
54 male patients Test: 28 patients, mean age: 50.6 (0.8) years Control: 26 patients, mean age: 52.5 (0.5) years Nr of implants—NR All patients smokers |
PD ≥ 4 mm at least at 30% sites | 3 months | Mechanical debridement (plastic curettes) + aPDT (photosensitizer: phenothiazine chloride (HELBO)) application for 2 min + light exposure (diode laser 660 nm 10 s.) | Mechanical debridement (plastic curettes) |
Subject level BOP Test baseline: 10.2 (1.2)%, 3 months: 8.8 (0.2)%, p < 0.001; Control baseline: 8.6 (0.8)%, 3 months: 6.9 (0.2)%, p < 0.001. Between group comparison: p > 0.001. No significant difference between the groups PD Test baseline: 7.4 (0.3) mm, 3 months: 1.5 (0.3) mm, p < 0.001; Control baseline: 6.6 (NR) mm, 3 months: 3.8 (0.4) mm, p < 0.001. Between-group comparison: p < 0.001 |
In smokers, aPDT was more effective in the treatment of peri-implant mucositis compared to mechanical debridement alone |
Al Rifaiy et al. (2018) | RCT |
38 male patients Test: 20 patients; mean age: 33.6(3.8) years; 28 implants Control: 18 patients; mean age: 35.4(2.1) years; 27 implants All patients reported on vaping e-cigarettes |
BOP + no bone loss > 2 mm (7th EWON) | 3 months | OHI + mechanical debridement + aPDT(photosensitizer: 0.005% Methylene blue) application for 10 s. + diode laser irradiation (670 nm) at 150 milliwatts for 1 min | OHI + mechanical debridement |
Subject level BOP Test baseline: 14.6 (3.1)%, 3 months: 11.7 (0.5)%; p < 0.001; Control baseline: 9.2 (1.0)%, 3 months: 7.9 (0.2)%; p < 0.001. No significant difference between the groups PD Test baseline: 4.3 (0.8) mm; 3 months: 2.1 (0.3) mm; p < 0.001; Control baseline:, 4.5 (0.9) mm; 3 months: 2.2 (0.5) mm; p < 0.001; Significantly higher reduction in the test group (p < 0.001) |
aPDT was more effective compared to mechanical debridement alone |
Aimetti et al. (2019) | RCT, parallel |
220 patients Test: 110 patients; mean age: 58.1(10.1) years; 78 female; light smokers: 14 patients; history of periodontitis: 54 patients Control: 110 patients; mean age: 56.8 (10.2) years; 71 female; light smokers: 20 patients; history of periodontitis: 45 patients 220 implants: 110 test, 110 control |
PD ≥ 4 mm + BOP ± SUPP + no radiographic bone loss beyond bone remodeling or (in the absence of baseline radiographic data) < 2 mm | 3 months | OHI + diode laser application (980-nm, 2.5 W 30 s. + irrigation with 3% H2O2 10 s.(repeated 3 times) + debridement manual and ultrasonic (titanium-coated Gracey or carbon fiber curretes) + biostimulation 60 s. at 0.7 W | OHI + debridement manual and ultrasonic (titanium-coated Gracey or carbon fiber curretes) |
Subject level BOP Test baseline: 48.3 (26.9)%, 3 months: 23.3 (23.5), p < 0.05 Control baseline: 46.2 (25.6)%, 3 months: 26.8 (23.0)%, p < 0.05. Between-group comparison: p > 0.05 PD Test baseline: 3.5 (0.7) mm, 3 months: 2.9 (0.6), p < 0.05 Control baseline: 3.4 (0.9) mm, 3 months: 3.0 (0.7) mm, p < 0.05. Between-group comparison: p > 0.05 |
Reinforcement of OHI 1- and 3-months after the treatment and professional implant cleaning and polishing The adjunctive use of diode laser did not yield any statistical significant clinical benefit as compared to mechanical treatment alone |
Mariani et al. 2020 [follow-up study of Aimetti et al. (2019)] |
73 patients Tests: 28; mean age: 59.2 (9.3) years; female: 24; history of periodontitis: 12 patients Control: 35; mean age: 62.1(6.8) years; female: 23; history of periodontitis: 13 patients |
12 months |
Subject level Test baseline: 63.6 (24.2)%, 12 months: 25.8 (24.1); p < 0.001 Control baseline: 59.5 (25.0)%, 12 months: 27.6 (25.5)%, p < 0.001 Between-group comparison: p > 0.05 PD Test baseline: 3.6 (0.7) mm, 12 months: 3.1 (0.7), p < 0.001 Control baseline: 3.8 (0.6) mm, 12 months: 3.3 (0.6) mm, p < 0.001. Between-group comparison: p > 0.05 |
During recalls (3, 6, 12 months after treatment) OHI reinforcement and professional implant cleaning and polishing The adjunctive use of diode laser showed no statistically significant additional beneficial effect in treatment of peri-implant mucositis |
||||
Deeb et al. (2020) | RCT, parallel, 3 arm |
45 male patients Test 1: 15 patients; mean age: 52.6(0.9) years; Test 2: 15 patients; mean age: 53.8(0.7) years; Control: 15 patients All patients smokers Nr of implants – NR |
BOP + no signs of bone loss | 3 months |
Test 1 OHI + mechanical debridement with titanium curettes and polishing with rubber cups and paste + aPDT (photosensitizer: Phenothiazine chloride (HELBO) application for 2 min, light exposure (diode laser 660 nm 10 s.) + CHX 0.12% mouthrinse twice daily 2 weeks Test 2 debridement with titanium curettes and polishing with rubber cups and paste + aPDT (aPDT (photosensitizer: Phenothiazine chloride (HELBO) application for 2 min, light exposure (diode laser 660 nm 10 s.) + CHX 0.12% mouthrinse twice daily 2 weeks + Azithromycin 500 mg (1st day), 150 mg (following 2–4 days) |
OHI + mechanical debridement with titanium curettes and polishing with rubber cups and paste + CHX 0.12% mouthrinse twice daily 2 weeks |
Subject level BOP Test 1 baseline: 12.3 (4.8)%, 3 months: 8.0 (3.7)%; p < 0.001 Test 2 baseline: 15.7 (3.9)%, 3 months: 10.1 (3.1)%; p < 0.001 Control baseline: 13.6 (4.0)%, 3 months: 11.8 (4.0); p < 0.001. Between-group comparison: p > 0.05 PD Test 1 baseline: 4.8 (1.0) mm, 3 months: 3.9 (0.9) mm; p < 0.001 Test 2 baseline: 4.6 (1.1) mm, 3 months: 3.9 (1.0) mm; p < 0.001 Control baseline: 4.5 (0.8) mm, 3 months: 4.1 (1.0); p < 0.001. Between-group comparison: p > 0.05 |
Adjunctive aPDT to mechanical debridement was as efficacious as adjunctive antibiotic therapy Additional benefits in reducing BOP scores were observed for adjunctive aPDT among the smokers |
Adjunctive local antiseptic/systemic antibiotic therapy | ||||||||
Porras et al. (2002) |
RCT, parallel |
16 patients Mean age: 58.9 (8.4) years (range: 34–76) Smokers excluded Periodontal status – NR 28 implants Test: 16 Control: 12 3 implant types (plasma-sprayed Ti/ cp Ti (HA-coated Ti) |
Supra- and subgingival plaque + PD ≤ 5 mm BOP + “incipient” radiographic lesion |
3 months |
OHI + mechanical cleansing (plastic scaler, rubber cups, polishing paste) + local irrigation CHX (0.12%) and topical CHX gel application + 0.12% CHX mouthrinse twice for 10 days |
OHI + mechanical cleansing (plastic scaler, rubber cups, polishing paste) |
Implant level mSBI and BOP (%) scores: no sign. differences between groups at 1 and 3 months PD values Test: baseline: 3.27 (0.81); 3 months: 2.71 (0.70)mm Control: baseline: 3.48 (0.61); 3 months: 2.55 (0.72) mm Changes in mean PD between test and control groups at 3 months were statistically significant (p = 0.035) |
The addition of CHX to mechanical debridement did not enhance the outcomes as compared to mechanical debridement alone |
Thöne-Mühling et al. (2010) |
RCT, parallel |
11 patients with treated chronic periodontitis Mean age: 51.5 years (range: 37–67) Smokers included 36 implants Tests: 22 Control: 14 2 implant types (MK ii; Nobel Biocare and Osseotite 3i Implant innov.) |
BOP + and/or gingival index (GI) ≥ 1 absence of radiographic bone loss during the last 2 years |
8 months |
OHI + mechanical cleansing (plastic scaler and polyetheretherketone-coated ultrasonic instruments) + topical CHX gel application once + full mouth disinfection (deep scaling in one session + CHX disinfection of tongue and tonsils) + 0.2% CHX mouthrinse 2 × /day and tonsil spraying 1 × /day for 14 days |
OHI + mechanical cleansing (plastic scaler and polyetheretherketone-coated ultrasonic instruments) + full mouth scaling in one session |
Implant level BOP Test baseline: 0.22 (0.11); 8 months: 0.16 (0.09) % Control baseline: 0.17 (0.19); 8 months: 0.17 (0.11) % PD Test baseline: 3.49 (0.78); 8 months: 2.84 (0.64) mm Control baseline: 3.4 (0.62) mm; 8 months: 2.82 (0.59) mm PD reduced significantly after 8 months compared to baseline (test: p = 0.033; control: p = 0.004). No significant difference between the groups ML (recession) Test baseline: 0.21 (0.25) mm; 8 months: 0.35 (0.65) mm; Control baseline: 0.33 (0.42) mm; 8 months: 0.33 (0.44) mm |
Both treatments lead to an improvements of the clinical parameters, but without significant differences between the groups after 8 months |
Hallström et al. (2012) |
RCT, parallel |
45 patients, 45 implants: 22 test, 23 control Mean age: test 54.6 (18.2) years; control 54.6 (19.8) years |
PD ≥ 4 mm BOP + and/or SUPP + radiographic bone loss ≤ 2 mm |
6 months |
OHI + mechanical cleansing (titanium curettes + rubber cups + polishing paste) + Azithromycin® 500 mg day 1 and 250 mg days 2–4 |
OHI + mechanical cleansing (titanium curettes + rubber cups + polishing paste) |
Subject level BOP Test baseline: 82.6 (24.4)%, 6 months: 27.3 (18.8)% Control baseline: 80.0 (25.0)%, 6 months: 47.5 (32.3)%; Between group comparison: p > 0.05 Mean PD Test baseline: 4.4 (1.0) mm, 6 months: 3.5 (1.1) mm Control baseline: 4.1 (0.9) mm; 6 months: 4.1 (1.2) mm; Between-group comparison: p < 0.16 Odds ratio of a positive treatment outcome (PD ≤ 4.0 mm and BOP ≤ 1) was 4.5:1 (test vs. control) |
No short-term differences were found between study groups |
Menez et al. (2016) |
RCT, parallel |
37 patients: 6 male, 31 female. Age range: 33–75 years, mean age: 57.4 years Only non-smokers included Test: 61 implants; control: 58 implants |
BOP + PD ≥ 5 mm + no radiographic evidence of bone loss beyond the first two threads of the implants | 6 months | OHI + subgingival debridement with plastic curets + CHX (0.12%) mouthrinse used for brushing the dorsum of the tongue for 1 min. + rinsing for 10 s. + subgingival irrigation for 10 min. + CHX mouthrinse (0.12%) every 12 h, 30 min. 14 days | OHI + subgingival debridement with plastic curets + placebo mouthrinse used for brushing the dorsum of the tongue for 1 min. + rinsing for 10 s. + subgingival irrigation for 10 min. + placebo mouthrinse every 12 h, 30 min. 14 days |
Implant level BOP Test baseline: 75.82 (33.98)%, 6 months: 45.76 (34.85)%, p < 0.001 Control baseline: 67.54 (34.38)%, 6 months: 41.08 (41.0)%; p < 0.001 Between-group comparison: p = 0.21 PD Test baseline: 2.85 (0.60) mm; 6 months: 2.49 (0.60) mm; p < 0.001; Control baseline: 2.72 (0.68) mm; 6 months: 2.49 (0.67) mm, p < 0.001; Between-group comparison: p = 0.32 |
Patients were further motivated with respect to oral hygiene habits during the entire period of the study Use of 0.12% CHX did was not more effective than placebo |
Iorio-Siciliano et al. (2020) | RCT, parallel |
45 patients Smokers included; Patients with gingivitis or treated periodontitis included; 67 implants Test: 22 patients; mean age: 46.5(15.35) years; 22.7% smokers; 40.9% of patients with treated periodontitis; 33 implants Control: 23 patients; mean age: 45.96(9.84) years; 26.1% smokers; 43.5% of patients with treated periodontitis; 34 implants |
≥ 1 site with BOP + absence of radiographic bone loss compared to previous radiograph | 6 months | Amino acid buffered sodium hypochlorite (Perisolv) application + ultrasonic scaler + application of Perisolv repeated 5 times + CHX (0.12%) gel twice daily for 2 weeks | Application of placebo gel + ultrasonic scaler + application of placebo gel repeated 5 times + CHX (0.12%) gel twice daily for 2 weeks |
Implant level BOP-positive implants Test baseline: 33%, 6 months: 18%; p < 0.001 Control baseline: 34%, 6 months: 23%, p < 0.001. Between-group comparison: p = 0.271 PD Test baseline: 3.93 (1.09) mm, 6 months: 3.04 (0.46) mm; p < 0.001; Control baseline: 3.68 (0.85) mm; 6 months: 3.07 (0.58) mm; p < 0.001 Between-group comparison: p = 0.53 |
Clinical parameters were recorded at 1, 3 and 6 months following the treatment Test: 110 patients; mean age: 58.1 ± 10.1 years; 78 female; light smokers; 14; history of periodontitis: 54 patients Changes in PD from baseline to 6 months were not statistically significantly different between groups. Complete resolution was not achieved with either of the therapies |
Adjunctive probiotics | ||||||||
Pena et al. (2019) | RCT, parallel |
50 patients, 50 implants Test: 25 patients; mean age: 55.96(10.81) years; 0% smokers; 64% of patients with a history of treated periodontitis Control: 25 patients; mean age: 61.16(10.62) years; 4% smokers; 68% of patients with a history of treated periodontitis |
BOP ± gingival redness, swelling + no bone loss (7th EWOP) | 135 days (4.5 months) | OHI + mechanical debridement (ultrasound titanium tip) + CHX 0.12% mouthrine twice a day, 2 weeks + after 15 days: probiotic tablets containing two strains of L. reunteri for 1 month | OHI + mechanical debridement (ultrasound titanium tip) + CHX 0.12% mouthrine twice a day, 2 weeks + after 15 days: placebo tablets |
Subject level BOP Test baseline: 100%; 135 days: 64% Control baseline: 100%, 135 days: 60%; Between group comparison: p = 0.771 PD Test baseline: 3.10 (0.74) mm, 135 days: 2.88 (0.62) mm; Control baseline: 3.32 (0.65) mm, 135 days: 2.98 (0.60) mm; Between-group comparison: p = 0.599 |
None of the patients received any other mechanical periodontal treatment during the follow-up Administration of probiotics did not seem to provide an additional clinical benefit. Complete disease resolution was not always achieved |
Galofre et al. (2018) | RCT, parallel |
22 patients with history of periodontitis; 22 implants Test: 11 patienst; mean age: 61.5(10.4) years; 27% female Control: 11 patients; mean age: 60.0(9.5) years; 45% female |
Inflammed mucosa with BOP and/or suppuration and no evidence of radiographic bone loss (8th EWOP) | 3 months | Mechanical debridement (ultrasound with carbon tip and titanium curettes) + 30 probiotic lozenges (once a day, 30 days) (L. reuteri, PerioBalance) | Mechanical debridement (ultrasound with carbon tip and titanium curettes) + 30 placebo lozenges (once a day, 30 days) |
Subject level BOP Test baseline: 0.61 (0.27)%, 3 months: 0.29 (0.09)%, p = 0.01 Control baseline: 0.42 (0.18)%, 3 months: 0.35 (0.22)%, p = 0.377 Between-group comparison of the difference baseline-3 months: p = 0.024 PD Test baseline:3.84 (0.55) mm, 3 months: 3.35 (0.76) mm, p = 0.09 Control baseline: 3.82 (0.64) mm; 3 months: 3.66 (0.62)mm, p = 0.187 Between-group comparison: p = 0.094 |
During the study period patients received neither oral hygiene instructions nor any other mechanical periodontal treatment Administration of probiotics together with mechanical debridement improved clinical parameters at peri-implant mucositis sites |
Adjunctive home care mouthrinse | ||||||||
Pulcini et al. (2019) | RCT, parallel |
46 patients, 54 implants Untreated or recurrent periodontitis patients excluded Test: 24 patients; 27 implants; mean age: 61.3(8.9) years; smokers: 7.4%; 11 female; 6 patients with systemic diseases Control: 22 patients; 27 implants; mean age: 61.0(12.0) years; smokers: 14.8%; 14 female; 4 patients with systemic diseases |
BOP and/or SUPP without progressive radiographic bone loss | 12 months | OHI + mechanical debridement (ultrasound with plastic tip and air-polishing with erythritol) + home care mouthrinse (0.03% CHX + 0.05% cetylpiridinium chloride (CPC)) (twice a day, 30 s.) 12 months | OHI + mechanical debridement (ultrasound with plastic tip and air-polishing with erythritol) + home care placebo mouthrinse (twice a day, 30 s.) 12 months |
Implant level BOP Test baseline: 58.64 (27.49)%, 12 months: 10.42 (13.74)% Control baseline: 46.30 (24.17)%, 12 months: 14.39 (18.04)% Between group comparison: p = 0.402 PD Test baseline: 3.36 (0.78) mm; 12 months: 2.50 (0.43) mm Control baseline:3.38 (0.60) mm; 12 months: 2.57 (0.57) mm Between group comparison: p = 0.650 After 12 months, 58.3% of test implants, and 50% of control implants demonstrated complete disease resolution (i.e., absence of BOP); p > 0.05 |
The use of test mouthrinse demonstrated some adjunctive benefits. Complete disease resolution could not be achieved in every case |
Bunk et al. (2020) |
RCT, parallel, three-arm |
60 patients/60 implants Test 1: 20 patients, 20 implants Test 2: 20 patients, 20 implants Control: 20 Periodontally healthy Smokers excluded |
BOP and/or SUPP + absence of radiographic bone loss compared to previous examination, visual signs of inflammation (modified gingival index ≠ 0) | 3 months |
Test 1 OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste) + home use of oral irrigator (Waterpick) with water once a day, 3 months Test 2 OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste) + home use of oral irrigator (Waterpick) with 0.06% CHX solution once a day, 3 months |
OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste) |
Subject level BOP-positive sites Test 1 baseline: 2.25 (1.02), 3 months: 0.45 (0.69) Test 2 baseline: 2.40 (0.88), 3 months: 0.10 (0.45) Control baseline: 2.35 (0.99), 3 months: 0.85 (1.09) Test 2 group showed significantly lower BOP-positive sites compared to control group (p = 0.004) After 3 months prevalence of peri-implant mucositis was 5% in Test 2, 35% in Test 1, and 50% in the control group |
All patients returned for follow-up and data collection after 4, 8, 12 weeks. Mechanical debridement was not performed at follow-up visits The adjunctive use of oral irrigator with 0.06% CHX in addition to mechanical debridement can reduce the presence of peri-implant mucositis |
Philip et al. (2020) |
RCT, Parallel 3-arm |
Test 1: 31 patients/31 implants; 15 female; mean age: 59 (10.6) years; current smokers: 4; 19 implant in maxilla; 12 in mandible Test 2: 30 patients/30 implants; 14 female; mean age: 62 (9.3) years; current smokers: 2; 19 implant in maxilla; 11 in mandible Control: 28 patients/28 implants; 12 female; mean age: 65 (10.3) years; current smokers: 3; 20 implant in maxilla; 8 in mandible |
BOP and/or suppuration with SUPP progressive radiographic bone loss compared to baseline radiograph | 3 months |
OHI + ultrasonic scaler with plastic tip + homecare mouthrinse: Test 1: Decapinol mouthrinse consisting (0.2%) delmopinol hydrochloride Test 2: CHX (0.2%) |
OHI + ultrasonic scaler with plastic tip + homecare Placebo mouthrinse |
Subject level mBI Baseline test 1: 1.0 (0.49); 3 months: 0.13 (0.23) Baseline test 2: 1.03 (0.44); 3 months: 0.28 (0.30) Baseline control: 1.08 (0.52); 3 months: 0.19 (0.32); statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p = 0.42 BOP Baseline test 1: 45 (25.52); 3 months: 3.22 (10.01) Baseline test 2: 43.88 (22.52); 3 months: 8.88 (12.17) Baseline control: 47.02 (24.45); 3 months: 7.73 (13.96); statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p = 0.14 PD Baseline test 1: 3.18 (0.69) mm; 3 months: 2.65 (0.45) mm Baseline test 2: 3.44 (0.60) mm; 3 months: 2.76 (0.47) mm Baseline control: 3.17 (0.78) mm; 3 months: 2.40 (0.67) mm; statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p > 0.05 Complete disease resolution (i.e., absence of BOP) 3 months: Test 1: 27 (87%) Test 2: 18 (60%) Control: 20 (71%); p = 0.29 |
Supragingival maintenance care was provided at 1 and 3 months Mechanical debridement combined with OHI is effective in treating peri-implant mucositis |
RCT randomized clinical trial, OHI oral hygiene instructions, BOP bleeding on probing, mBOP modified bleeding on probing index, PD probing depth, SUPP suppuration, BI bleeding index, mBI modified bleeding index, aPDT antibacterial photodynamic therapy