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Implant decontamination during surgical peri-implantitis treatment: a randomized, double-blind, placebo-controlled trial

J Clin Periodontol. 2013 Feb;40(2):186-95. doi: 10.1111/jcpe.12034. Epub 2012 Dec 4.

Abstract

Aim: The objective of this randomized, double-blind, placebo-controlled trial was to study the effect of implant surface decontamination with chlorhexidine (CHX)/cetylpyridinium chloride (CPC) on microbiological and clinical parameters.

Material & methods: Thirty patients (79 implants) with peri-implantitis were treated with resective surgical treatment consisting of apically re-positioned flap, bone re-contouring and surface debridement and decontamination. Patients were randomly allocated to decontamination with 0.12% CHX + 0.05% CPC (test-group) or a placebo-solution (without CHX/CPC, placebo-group). Microbiological parameters were recorded during surgery; clinical and radiographical parameters were recorded before (pre-) treatment (baseline), and at 3, 6 and 12 months after treatment.

Results: Nine implants in two patients in the placebo-group were lost due to severe persisting peri-implantitis. Both decontamination procedures resulted in significant reductions of bacterial load on the implant surface, but the test-group showed a significantly greater reduction than the placebo-group (log 4.21 ± 1.89 versus log 2.77 ± 2.12, p = 0.006). Multilevel analysis showed no differences between both groups in the effect of the intervention on bleeding, suppuration, probing pocket depth and radiographical bone loss over time.

Conclusion: Implant surface decontamination with 0.12% CHX + 0.05% CPC in resective surgical treatment of peri-implantitis leads to a greater immediate suppression of anaerobic bacteria on the implant surface than a placebo-solution, but does not lead to superior clinical results. The long-term microbiological effect remains unknown.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / surgery
  • Anti-Infective Agents, Local / pharmacology*
  • Anti-Infective Agents, Local / therapeutic use
  • Bacteria, Anaerobic / drug effects*
  • Cetylpyridinium / pharmacology*
  • Cetylpyridinium / therapeutic use
  • Chlorhexidine / pharmacology*
  • Chlorhexidine / therapeutic use
  • Decontamination / methods*
  • Dental Implants / microbiology*
  • Double-Blind Method
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multilevel Analysis
  • Peri-Implantitis / drug therapy*
  • Peri-Implantitis / surgery*
  • Periodontal Debridement
  • Periodontal Index
  • Radiography

Substances

  • Anti-Infective Agents, Local
  • Dental Implants
  • Cetylpyridinium
  • Chlorhexidine