Treatment of peri-implantitis by local delivery of tetracycline - Clinical, microbiological and radiological results

The purpose of this study was to investigate the clinical, microbiological and radiological effects of peri-implantitis therapy by local delivery of t etracycline. In 25 partially edentulous patients, 30 implants with radiogra phic evidence of circumferential bone loss, and peri-implant probing depths greater than or equal to5 mm were treated with polymeric Abstract: The pur pose of this study was to investigate the clinical, microbiological and rad iological effects of peri-implantitis therapy by local delivery of tetracyc line. In 25 from the study after 180 days because of persisting active peri -implantitis with pus formation. The remaining subjects showed a significan t decrease of mean peri-implant probing depth from 6.0 to 4.1 mm (M1, P <0. 001), which was maintained over 12 tetracycline HCl-containing fibers. Clin ical and microbial parameters were recorded at baseline, and 1, 3, 6, and 1 2 months (M) after treatment. Standardized radiographs were obtained at bas eline, M3, and one year after treatment. Two patients were discontinued fro m the study after 180 days because of persisting active peri-implantitis wi th pus months. In comparison to baseline, the bleeding tendency was signifi cantly reduced after one month, and thereafter (P<0.001). No significant re cession of the mucosal margin was noted. The radiologically determined dist ance from the shoulder of the implant to the bottom of the bony defect decr eased slightly, but not significantly, from 5.2 to 4.9 mm. At M1, M3 and M6 , mean total anaerobic cultivable bacterial counts were significantly lower than at baseline (P<0.001). A significant decrease in frequency of detecti on was noted for Prevotella intermedia/nigrescens, Fusobacterium sp., Bacte roides forsythus, and Campylobacter rectus (P <0.01). Actinobacillus actino mycetemcomitans, Porphyromonas gingivalis, and Eikenella corrodens had very low baseline frequencies that could not be significantly suppressed furthe r. In conclusion, therapy of peri-implantitis by local delivery of tetracyc line had a positive effect on clinical and microbiological parameters.