Discussion
suppuration, PCF, bone loss, peri-implant mucosal inflammation, pain, PD, peri-implantitis
SUPPURATION, BONE LOSS, DISEASE, MINOR, SECONDARY, PLAQUE
The objective of this 12-month, examiner-masked, randomized, controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system offers adjunctive clinical effects to conventional non-surgical treatment of peri-implantitis, and secondly, to evaluate patient-centred outcomes using VAS. In short, the observations herein indicate that both treatment approaches support clinical improvements. For both groups, a significant reduction in PD was observed from baseline to 6 months, but at 12 months only for the control group. CBLs showed no change over time for either group. BoP was significantly reduced from baseline to 12 months for both treatments. Following instrumentation, less discomfort and pain was reported from the control group and significantly less by males.At implant sites with peri-implantitis, PD is correlated with bone loss and therefore serves as a relevant surrogate for disease severity [Both test and control sites showed significant reduction in PD from baseline to 6 months, but at 12 months only for control sites with significant between-group differences. To date, no studies have reported on erythritol air-polishing as an adjunctive therapy to conventional non-surgical treatment of peri-implantitis in a cohort of maintenance patients. A recent RCT, comparing erythritol air-polishing as monotherapy with piezoelectric ultrasonic scaling in non-surgical treatment of peri-implantitis, reported no significant intergroup treatment differences for clinical peri-implant parameters as PD, suppuration on probing, and plaque score at a 3-month observation [At baseline the proportions of sites with PDs ≥ 6 was within both groups above 40%. Over time a significant reduction was observed at 6 months followed by a slight relapse at 12 months particularly in the test group (from 35 to 38%). These findings together with rather high BoP at 12 months (test 37% and control 32%) underline the limitations of non-surgical interventions and that neither treatment approach effectively resolve peri-implantitis. Our observations are thus in support of retrospective [In the present study, both interventions induced a significant reduction in the inflammatory surrogates. Improvement in secondary outcomes BoP and PCF have been reported previously comparing air-abrasives devices and conventional mechanical debridement [Non-surgical dental implant biofilm disruption appears insufficient intervention in patients with less than optimal oral hygiene [Previous reports showing enhanced effects of air-abrasive treatment have been limited to teeth [For both groups, minor pain/discomfort (VAS2) was reported, with significantly less pain/discomfort experienced in control group at baseline, 3, 6, and 9 months. The difference vanished at 12 months, as after 6 months the VAS scores for the test group decreased whereas continued to increase in the control. In the test group the percentage of implants diagnosed with SUP at baseline was 32.3, whereas the corresponding percentage in the control group was 16.7. Thus, a higher proportion of SUP at baseline in the test group, possibly reflecting a higher degree of peri-implant mucosal inflammation, may partly explain the increased pain/discomfort reported up to 9 months in this group. A previous RCT also reported on pain/discomfort following air polishing and ultrasonic scaling [