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Adjunctive Systemic and Local Antimicrobial Therapy in the Surgical Treatment of Peri-implantitis: A Randomized Controlled Clinical Trial

Journal article
Authors Olivier Carcuac
Jan Derks
Georgios Charalampakis
Ingemar Abrahamsson
Jan Wennström
Tord Berglundh
Published in Journal of Dental Research
Volume 95
Issue 1
Pages 50-57
ISSN 0022-0345
Publication year 2016
Published at Institute of Odontology
Pages 50-57
Language en
Links dx.doi.org/10.1177/0022034515601961
Keywords dental implant, amoxicillin, implant surface decontamination, radiographs, logistic regression, consensus report, follow-up, bone loss, diseases, lesions, dogs, Dentistry, Oral Surgery & Medicine
Subject categories Periodontology

Abstract

The aim of the present randomized controlled clinical trial was to investigate the adjunctive effect of systemic antibiotics and the local use of chlorhexidine for implant surface decontamination in the surgical treatment of peri-implantitis. One hundred patients with severe peri-implantitis were recruited. Surgical therapy was performed with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated at 1 y. A binary logistic regression analysis was used to identify factors influencing the probability of treatment success, that is, probing pocket depth <= 5 mm, absence of bleeding/suppuration on probing, and no additional bone loss. Treatment success was obtained in 45% of all implants but was higher in implants with a nonmodified surface (79%) than those with a modified surface (34%). The local use of chlorhexidine had no overall effect on treatment outcomes. While adjunctive systemic antibiotics had no impact on treatment success at implants with a nonmodified surface, a positive effect on treatment success was observed at implants with a modified surface. The likelihood for treatment success using adjunctive systemic antibiotics in patients with implants with a modified surface, however, was low. As the effect of adjunctive systemic antibiotics depended on implant surface characteristics, recommendations for their use in the surgical treatment of peri-implantitis should be based on careful assessments of the targeted implant (ClinicalTrials.gov NCT01857804).

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