non-surgical electrolytic cleaning peri-implantitis

Conditions: Peri-Implantitis

Summary: electrolytic cleaning is a promising treatment for dental implant decontamination, but this mode of therapy has not yet been clinically tested as an adjunct to the non-surgical treatment of periimplantitis. a prospective clinical and radiographic case series study will be performed to evaluate the clinical performance of the adjunctive use of electrolytic cleaning as an adjunct to a non-surgical therapy protocol that includes curettage of the peri-implant soft tissue. this is study is a proof of principle study, thus, a case series study is selected to start with. if the results of this case series study are favourable, a future study with a clinical trial design is then planned to do.

electrolytic cleaning is a promising treatment for dental implant decontamination, but this mode of therapy has not yet been clinically tested as an adjunct to the non-surgical treatment of periimplantitis. electrolytic cleaning is a promising treatment for dental implant decontamination, but this mode of therapy has not yet been clinically tested as an adjunct to the non-surgical treatment of periimplantitis.this is study is a proof of principle study, thus, a case series study is selected to start with. as this is a pilot study to test for the first time the electrolytic cleaning under non-surgical therapy, the sample size has been estimated in a minimum of 25 patients. if the results of this case series study are favourable, a future study with a clinical trial design is then planned to do. therapeutic success is defined as as a composite index (sanz \& chapple 2012 criteria of disease resolution) that includes: (1) probing pocket depth \< 5 mm, (2) no bleeding on probing/suppuration and (3) no additional bone loss, at 6 and 12 months). secondary objectives are: changes in the clinical outcomes measurements.changes in the radiological outcomes measurements. changes in the patient-reported outcomes (proms). evaluation of the outcomes related to the prosthetic restoration. this study will be carried out in the following centers: * postgraduate periodontal clinic at the faculty of odontology-universidad complutense of madrid (spain) * ceosa-madrid private dental centre after the non-surgical therapy, patients will be recalled for control visits, with supra- gingival removal of biofilm with air polishing without anaesthesia at: * 3 months. * 6 months. * 12 months. after non-surgical therapy, patients will be included in a strict peri-implant maintenance therapy program to avoid re-contamination of the affected implants. removal of biofilm with air polishing without anaesthesia and oral hygiene instruction reinforcement will be performed at: 3 months, 6 months, 9 months and 12 months.

Eligibility criteria:
inclusion criteria: * male or female age \> 18 years. * presence of at least 1 implant with the diagnose of peri-implantitis (berglundh et al. 2018; renvert et al. 2018) * peri-implant bone loss \< 2/3 * history of treated periodontal diseases (caton 2018). * screw retained prosthesis that can be easily unscrewed. * prosthesis that allows access to biofilm control by the patient, or which can be modified accordingly. * absence of implant mobility exclusion criteria: systemic exclusion criteria * pregnant or lactating women non-surgical electrolytic cleaning confidential * patients chronically treated (i.e., two weeks or more) with any medication known to affect periodontal/peri-implant status (i.e., antibiotics intake within 3 months prior to the initiation) * medical conditions requiring prolonged use of steroids and/or with medications that could interfere with bone metabolism. * history of leukocyte dysfunction and deficiencies. * history of neoplastic disease requiring the use of radiation or chemotherapy. * patients with chronic renal failure requiring dialysis. * patients with metabolic bone disorders such as osteoporosis treated with antiresoptive medications. * history of uncontrolled endocrine disorders: hypothyroidism or diabetes. * physical handicaps that would interfere with the ability to perform adequate oral hygiene or patients unable to use daily interproximal cleaning. * alcoholism or drug abuse. * history of immunodeficiency syndromes. * tobacco consumption (smoking more than 10 cigarettes per day) * conditions or circumstances, which in the opinion of the investigator, would avoid the completion of study participation, or interfere with analysis of study results, such as history of non-compliance or unreliability, or do have any additional medical condition that contraindicates non-surgical treatment local exclusion criteria * mucosal diseases such as erosive lichen planus in the area to be treated. * history of local irradiation therapy. * implants with peri-implant bone loss beyond 2/3 of the implant length

Keywords: peri-implantitis electrolytic cleaning implant decontamination non-surgical treatment