Clinical justification of the choice of an antiseptic and an air-abrasive mixture combination in the treatment of peri-implantitis

Background. Effective decontamination of the dental implant surface, ensuring the removal of microbial biofilm while preserving the surface structure, is a key challenge in the treatment of peri-implantitis. Objective. The article deals with an evaluation of conservative peri-implantitis treatment clinical efficacy of using combinations of antiseptic solutions and air-abrasive powders. Methods. 48 patients with moderate peri-implantitis were divided into 3 groups of treatment: sodium bicarbonate and 0,01% Miramistin; erythritol and 0,05% Chlorhexidine; and glycine and Octenisept. Implant surface treatment was performed four times over a month, at 7-day intervals. Clinical efficacy was assessed using the following parameters: probing pocket depth (PPD), bleeding index (PBI), suppuration index, plaque index (PLI), gingival index (GI), and radiographic bone resorption. Examinations were conducted at baseline, and at 1 and 2.5 months. Results. All groups showed improvement in clinical and radiographic parameters. The combination of sodium bicarbonate and 0,01% Miramistin demonstrated high efficacy. At 1 month, the suppuration index was statistically significantly lower compared to the other groups, and the degree of bone resorption was also lower compared to the glycine and Octenisept group (p<0,001). By 2.5 months, bone resorption and the suppuration index were statistically significantly lower compared to the erythritol and Chlorhexidine group. The need for subsequent surgical treatment in the first group was 6,25%, which is 2 times lower than in the glycine and Octenisept group (12,5%). Conclusion. The use of an air-water abrasive mixture based on sodium bicarbonate followed by irrigation with 0,01% Miramistin provided the most pronounced reduction in clinical symptoms, stabilization of bone loss, and a decreased need for surgical treatment, which allows it to be recommended for implant surface decontamination in the treatment of peri-implantitis.

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