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Hentenaar DFM, De Waal YCM, Strooker H, et al. Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT. Int J Implant Dent. 2017;3(1):33doi: 10.1186/s40729-017-0091-5.
Hentenaar, D. F. M., De Waal, Y. C. M., Strooker, H., Meijer, H. J. A., Van Winkelhoff, A. J., & Raghoebar, G. M. (2017). Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT. International journal of implant dentistry, 3(1), 33. https://doi.org/10.1186/s40729-017-0091-5
Hentenaar, Diederik F M, et al. "Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT." International journal of implant dentistry vol. 3,1 (2017): 33. doi: https://doi.org/10.1186/s40729-017-0091-5
Hentenaar DFM, De Waal YCM, Strooker H, Meijer HJA, Van Winkelhoff AJ, Raghoebar GM. Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT. Int J Implant Dent. 2017 Dec;3(1):33. doi: 10.1186/s40729-017-0091-5. Epub 2017 Jul 17. PMID: 28718012; PMCID: PMC5514004.
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Int J Implant Dent. 2017 Dec;3(1):33. doi: 10.1186/s40729-017-0091-5. Epub 2017 Jul 17.

Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT.

International journal of implant dentistry

Diederik F M Hentenaar, Yvonne C M De Waal, Hans Strooker, Henny J A Meijer, Arie-Jan Van Winkelhoff, Gerry M Raghoebar

Affiliations

  1. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
  2. Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  3. Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  4. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands. [email protected].

PMID: 28718012 PMCID: PMC5514004 DOI: 10.1186/s40729-017-0091-5

Abstract

BACKGROUND: Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of the implant surface during surgical peri-implantitis treatment.

METHODS: Peri-implantitis lesions were treated with resective surgical treatment aimed at peri-implant granulation tissue removal, bone recontouring, and pocket elimination. Fifty-three implant surfaces in 28 patients were mechanically cleaned and treated with either 35% phosphoric etching gel (test group) or sterile saline (control group). Microbiological samples were obtained during surgery; clinical parameters were recorded at baseline and at 3 months after treatment. Data were analyzed using multi-variable linear regression analysis and multilevel statistics.

RESULTS: Significant immediate reductions in total anaerobic bacterial counts on the implant surface were found in both groups. Immediate reduction was greater when phosphoric acid was used. The difference in log-transformed mean anaerobic counts between both procedures was not statistical significant (p = 0.108), but there were significantly less culture-positive implants after the decontamination procedure in the phosphoric acid group (p = 0.042). At 3 months post-surgery, 75% of the implants in the control group and 63.3% of the implants in the test group showed disease resolution. However, no significant differences in clinical and microbiological outcomes between both groups were found.

CONCLUSIONS: The application of 35% phosphoric acid after mechanical debridement is superior to mechanical debridement combined with sterile saline rinsing for decontamination of the implant surface during surgical peri-implantitis treatment. However, phosphoric acid as implant surface decontaminant does not seem to enhance clinical outcomes on a 3-month follow-up.

TRIAL REGISTRATION: Netherlands National Trial Register, NTR5185 (www.trialregister.nl).

Keywords: Decontamination; Dental implants; Microbiology; Peri-implantitis; Surgery

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