Decontamination Methods of Implant Surfaces in the Surgical Treatment of Peri-implant Disease

Yıl 2013, Cilt: 7 Sayı: 2, 1517 - 1526, 01.07.2013

Berceste Güler Ahu Uraz Mehmet Yalım

Öz

The main purpose of the treatment of peri-implant diseases is the removal of the biofilm layer and, theoretically, ensuring an appropriate implant surface for osseointegration. The implant surface decontamination methods are divided into four groups: Mechanical methods, chemical methods, laser applications and photodynamic therapy. Contemporarily, titanium rotating brush and erythritol or glisin based air-abrasive powder systems are used for implant surface decontamination. The literature suggests that mechanical treatment methods aren’t effective by themselves and should be supported with chemical solutions. No chemical solution is superior to any other and there is no conclusive information on the application protocols and processes. Positive results have been generated regarding laser application and photodynamic therapy; however, long-term controlled clinical trials are required. The aim of this review is to make a comprehensive assessment of implant surface decontamination, the most important phase for the treatment of peri-implant diseases

Anahtar Kelimeler

Peri-implantitis, decontamination, dental implants

Peri-implant Hastalıkların Cerrahi Tedavisinde İmplant Yüzeylerine Uygulanan Dekontaminasyon Yöntemleri

Öz

Peri-implant hastalıkların tedavisinde asıl amaç biyofilmin ortadan kaldırılması ve teorik olarak reosseointegrasyon için uygun implant yüzeyi sağlanmasıdır. İmplant yüzey dekontaminasyon yöntemleri mekanik yöntemler, kimyasal yöntemler, lazer uygulamaları ve fotodinamik terapi olarak dört ana başlıkta incelenmektedir. İmplant yüzey dekontaminasyonu için güncel olarak titanyum döner fırçalar ve glisin veya eritritol içerikli hava toz sistemleri de kullanılabilmektedir. Literatürde mekanik tedavi yöntemlerinin tek başına etkin olmadığı, bu sebeple kimyasal solüsyonlarla beraber kullanımı önerilmektedir. Uygulanan kimyasal solüsyonların herhangi birinin diğerine üstünlüğü kanıtlanmamıştır ve uygulama süreleri ve protokolleri ile ilgili kesin bir bilgi bulunmamaktadır. Lazer ve fotodinamik uygulamalar ile ilgili olumlu sonuçlar ortaya koyulmuştur ancak uzun dönemli kontrollü klinik çalışmalara ihtiyaç duyulmaktadır. Bu derlemenin amacı peri-implant hastalıkların tedavisinde başarılı sonuçlar alabilmek için gerekli en önemli aşama olan implant yüzey dekontaminasyonu ile ilgili genel bir değerlendirme oluşturmaktır

Anahtar Kelimeler

Peri-implantitis, dekontaminasyon, diş implantları

Kaynakça

• Lang NP, Berglundh T, Heitz-Mayfield LJ, Pjetursson BE, Salvi GE, Sanz M. Consensus statements and recommended clinical procedures regarding implant survival and complications. Int J Oral Maxillofac Implants. 2004;19 Suppl:150-4.
• Lindhe J, Meyle J, on behalf of Group D of the European Workshop on Periodontology. Peri- implant diseases: Consensus report of the sixth european workshop on periodontology. J Clin Periodontol. 2008;35(8 Suppl):282-5.
• Fürst MM, Salvi GE, Lang NP, Persson GR. Bacterial colonization immediately after installation on oral titanium implants. Clin Oral Implants Res. 2007;18:501-8.
• Mettraux GR, Sculean A, Bürgin WB, Salvi GE. Two-year clinical outcomes following non- surgical mechanical therapy of peri-implantitis with adjunctive diode laser application. Clin Oral Implants Res. 2016;27:845-9.
• Renvert S, Samuelsson E, Lindahl C, Persson GR. Mechanical non-surgical treatment of peri-implantitis: A double-blind randomized longitudinal clinical study. I: Clinical results. J Clin Periodontol. 2009;36:604-9.
• Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J. Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodontol. 2008;35:80-7.
• Schwarz F, Sahm N, Iglhaut G, Becker J. Impact of the method of surface debridement and decontamination on the clinical outcome following combined surgical therapy of peri- implantitis: A randomized controlled clinical study. J Clin Periodontol. 2011;38:276-84.
• Klinge B, Flemming T, Cosyn J, De Bruyn H, Eisner BM, Hultin M, Isidor F, Lang NP, Lund B, Meyle J, Mombelli A, Navarro JM, Pjetursson B, Renvert S, Schliephake H. The patient undergoing implant therapy. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res. 2015;26 Suppl 11:64-7.
• Mengel R, Buns CE, Mengel C, Flores-de-Jacoby L. An in vitro study of the treatment of implant surfaces with different instruments. Int J Oral Maxillofac Implants. 1998;13:91-6.
• Heitz-Mayfield LJ, Salvi GE, Botticelli D, Mombelli A, Faddy M, Lang NP, on behalf of the Implant Complication Research Group. Anti- infective treatment of peri-implant mucositis: A randomised controlled clinical trial. Clin Oral Implants Res. 2011;22:237-41.
• Máximo MB, de Mendonça AC, Renata Santos V, Figueiredo LC, Feres M, Duarte PM. Short-term clinical and microbiological evaluations of peri- implant diseases before and after mechanical anti-infective therapies. Clin Oral Implants Res. 2009;20:99-108.
• Thöne-Mühling M, Swierkot K, Nonnenmacher C, Mutters R, Flores-de-Jacoby L, Mengel R. Comparison of two full-mouth approaches in the treatment of peri-implant mucositis: A pilot study. Clin Oral Implants Res. 2010;21:504-12.
• Mann M, Parmar D, Walmsley AD, Lea SC. Effect of plastic-covered ultrasonic scalers on titanium implant surfaces. Clin Oral Implants Res. 2012;23:76-82.
• Lyngstadaas SP, Ellingsen JE, Wohlfahrt JC, inventors; Numat AS, assignee. Medical cleaning tool. Norway patent US 20100163073 A1. 2010 Jul 1.
• Wohlfahrt JC, Lyngstadaas SP. Mechanical debridement of a peri-implant osseous defect with a novel titanium brush and reconstruction with porous titanium granules: A case report with reentry surgery. Clinic Adv Periodontics. 2012;2:136-40.
• John G, Becker J, Schwarz F. Modified implant surface with slower and less initial biofilm formation. Clin Implant Dent Relat Res. 2015;17:461-8.
• Drago L, Del Fabbro M, Bortolin M, Vassena C, De Vecchi E, Taschieri S. Biofilm removal and antimicrobial activity of two different air-polishing powders: An in-vitro study. J Periodontol. 2014;85:363-9.
• Ronay V, Merlini A, Attin T, Schmidlin PR, Sahrmann P. In vitro cleaning potential of three implant debridement methods. Simulation of the non-surgical approach. Clin Oral Impl Res. 2016 Jan 22. doi: 10.1111/clr.12773.
• Hägi TT, Hofmänner P, Eick S, Donnet M, Salvi GE, Sculean A, Ramseier CA. The effects of erythritol air-polishing powder on microbiologic and clinical outcomes during supportive periodontal therapy: Six-month results of a randomized controlled clinical trial. Quintessence Int. 2015;46:31-41.
• Kreisler M, Kohnen W, Christoffers AB, Götz H, Jansen B, Duschner H, d‘Hoedt B. In vitro evaluation of the biocompatibility of contaminated implant surfaces treated with an Er: YAG laser and an air powder system. Clin Oral Implants Res. 2005;16:36-43.
• Schwarz F, Sahm N, Becker J. Combined surgical therapy of advanced peri-implantitis lesions with concomitant soft tissue volume augmentation. A case series. Clin Oral Implants Res. 2014;25:132- 6.
• Augthun M, Tinschert J, Huber A. In vitro studies on the effect of cleaning methods on different implant surfaces. J Periodontol. 1998;69:857- 64.
• Romeo E, Lops D, Chiapasco M, Ghisolfi M, Vogel G. Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part II: Radiographic outcome. Clin Oral Implants Res. 2007;18:179- 87.
• Sharon E, Shapira L, Wilensky A, Abu-Hatoum R, Smidt A. Efficiency and thermal changes during implantoplasty in relation to bur type. Clin Implant Dent Relat Res. 2013;15:292-6.
• Teughels W, Van Assche N, Sliepen I, Quirynen M. Effect of material characteristics and/or surface topography on biofilm development. Clin Oral Implants Res. 2006;17 Suppl 2:68-81.
• Jepsen S, Berglundh T, Genco R, Aass AM, Demirel K, Derks J, Figuero E, Giovannoli JL, Goldstein M, Lambert F, Ortiz-Vigon A, Polyzois I, Salvi GE, Schwarz F, Serino G, Thomasi C, Zitzmann NU. Primary prevention of peri- implantitis: Managing peri-implant mucositis. J Clin Periodontol. 2015;42 Suppl 16:152-7.
• Guimarães LF, Fidalgo TK, Menezes GC, Primo LG, Costa e Silva-Filho F. Effects of citric acid on cultured human osteoblastic cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:665-9.
• Gosau M, Hahnel S, Schwarz F, Gerlach T, Reichert TE, Bürgers R. Effect of six different peri-implantitis disinfection methods on in vivo human oral biofilm. Clin Oral Implants Res. 2010;21:866-72.
• You TM, Choi BH, Li J, Jung JH, Lee HJ, Lee SH, Jeong SM. The effect of platelet-rich plasma on bone healing around implants placed in bone defects treated with Bio-Oss: A pilot study in the dog tibia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:8-12.
• You TM, Choi BH, Zhu SJ, Jung JH, Lee SH, Huh JY, Li J. Treatment of experimental peri-implantitis using autogenous bone grafts and platelet- enriched fibrin glue in dogs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:34-7.
• deWaal YC, Raghoebar GM, Huddleston Slater JJ, Meijer HJ, Winkel EG, van Winkelhoff AJ. Implant decontamination during surgical peri- implantitis treatment: A randomized, double- blind, placebo-controlled trial. J Clin Periodontol. 2013;40:186-95. Erratum in: J Clin Periodontol. 2014;41:94.
• Verdugo F, Sáez-Rosón A, Uribarri A, Martínez- Conde R, Cabezas-Olcoz J, Moragues MD, Pontón J. Bone microbial decontamination agents in osseous grafting: An in vitro study with fresh human explants. J Periodontol. 2011;82:863- 71.
• Giannelli M, Chellini F, Margheri M, Tonelli P, Tani A. Effect of chlorhexidine digluconate on different cell types: A molecular and ultrastructural investigation. Toxicol In Vitro. 2008;22:308-17.
• Blomlöf J, Blomlöf L, Lindskog S. Effect of different concentrations of EDTA on smear removal and collagen exposure in periodontitis-affected root surfaces. J Clin Periodontol. 1997;24:534-7.
• Wohlfahrt JC, Lyngstadaas SP, Rİnold HJ, Saxegaard E, Ellingsen JE, Karlsson S, Aass AM. Porous titanium granules in the surgical treatment of peri-implant osseous defects: A randomized clinical trial. Int J Oral Maxillofac Implants. 2012;27:401-10.
• Gustumhaugen E, Lönn-Stensrud J, Scheie AA, Lyngstadaas SP, Ekfeldt A, Taxt-Lamolle S. Effect of chemical and mechanical debridement techniques on bacterial re-growth on rough titanium surfaces: An in vitro study. Clin Oral Implants Res. 2014;25:707-13.