Anti-infective treatment of peri-implant mucositis: a randomised controlled clinical trial

AIM: To compare the effectiveness of two anti-infective protocols for the treatment of peri-implant mucositis. MATERIALS AND METHODS: Twenty-nine patients with one implant diagnosed with peri-implant mucositis (bleeding on probing BOP with no loss of supporting bone) were randomly assigned to a control or test group. Following an assessment of baseline parameters (probing depth, BOP, suppuration, presence of plaque), all patients received non-surgical mechanical debridement at the implant sites and were instructed to brush around the implant twice daily using a gel provided for a period of 4 weeks. The test group (15 patients) received a chlorhexidine gel (0.5%), and the control group (14 patients) received a placebo gel. The study was performed double blind. After 4 weeks, patients were instructed to discontinue using the gel and to continue with routine oral hygiene at the implant sites. Baseline parameters were repeated at 1 and 3 months. RESULTS: At 1 month, there was a statistically significant reduction in the mean number of sites with BOP and mean probing depth measurements at implants in both groups. There were also some statistically significant changes in these parameters from 1 to 3 months. However, there were no statistically significant differences between test and control groups. One month following treatment, 76% of implants had a reduction in BOP. Complete resolution of BOP at 3 months was achieved in 38% of the treated implants. The presence of a submucosal restoration margin resulted in significantly lower reductions in probing depth following treatment. CONCLUSIONS: Non-surgical debridement and oral hygiene were effective in reducing peri-implant mucositis, but did not always result in complete resolution of inflammation. Adjunctive chlorhexidine gel application did not enhance the results compared with mechanical cleansing alone. Implants with supramucosal restoration margins showed greater therapeutic improvement compared with those with submucosal restoration margins.