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The impact of the biofilm removal protocol on effectiveness of maintenance therapy in patients with dental implants


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The exponential growth of the installed dental implants and the absence of a decrease in the number of long-term inflammatory complications after implantation make the search for effective minimally invasive methods of their prevention an urgent problem. Aim: to assess the effectiveness of supportive periodontal therapy (SPT) in patients with dental implants with the use of the protocol of professional oral hygiene (POH), aimed at control of the biofilm - Guided biofilm therapy (GBT) Material and methods. Сlinical observation of 86 people (from 21 to 43 years) without concomitant periodontal pathology with dental implants within 18 months after prosthetics was сarried out. In the control group (n=28) supportive periodontal therapy (SPT) included regular checkups (every 6 months) with carrying POH, including the removal of hard and soft dental deposits in the traditional sequence (ultrasound, polishing) and recommendations for individual oral hygiene of the mouth. In the main group (n=58) range of professional oral hygiene included the indication of the biofilm by using a two-phase dye with the purpose of motivating the patient to good oral hygiene and for visualization of the amount and assessment of the removal efficiency of the biofilm within the professional oral hygiene, then carried out the removal of the biofilm on the principle of full-mouth-therapy with air-polishing method using the powder of the erythritol with a particle diameter of 14 µm, which includes not only supra - and subgingival region, but also the mucous membrane of the tongue, also are reservoir biofilms. We assessed the following parameters: probing depth of peri-implant space, periodontal and hygiene indices PBI, PMA, Silness-Loe, HYG, estimates of osteointegration using Periotest S and Cone Beam Computed Tomography (CBCT), the time spent on professional oral hygiene and data from the survey of patients. Results. No cases of inflammatory complications were registered in patients of the main group during the follow - up period, 4 cases of periimplant mucositis (14.3%) - in the control group. The time spent on professional oral hygiene in the main group was 33.8% less, the proportion of time spent on the use of ultrasound - 28.4% (p<0.01). In the main group, lower levels of indices were revealed during the whole period of observation: Silness-Loe by 41.8% (p<0.01), HYG by 32.4% (p<0.01), PBI by 18.6% (p<0.05), PMA by 21.5 % (p<0.01) and sensations during professional oral hygiene were assessed by patients as more comfortable in the main group. According to the sensing CBCT and measurements with Periotest S in both groups no abnormalities detected. Conclusion. Compliance with GBT protocol optimizes the process of professional oral hygiene and improves the effectiveness of maintenance periodontal therapy and prevent inflammatory complications in the field of implants, which in turn can guarantee the stability and long-term service orthopedic construction.


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© Copyright 2020 Morressier GmbH.
All rights reserved.