J Periodontal Implant Sci.  2018 Oct;48(5):326-333. 10.5051/jpis.2018.48.5.326.

Simplified nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride

• Heo S
• Kim HJ
• Joo JY
• Lee J
• Kim SJ
• Choi J

• KMID: 2424866
• DOI: http://doi.org/10.5051/jpis.2018.48.5.326

Abstract

PURPOSE
The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl).
METHODS
Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl.
RESULTS
We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant.
CONCLUSIONS
We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

Keyword

Anti-bacterial agents; Bone regeneration; Dental implants; Peri-implantitis

MeSH Terms

Anti-Bacterial Agents
Bone Regeneration
Chlorhexidine*
Dental Implants
Hemorrhage
Humans
Minocycline*
Peri-Implantitis*
Shoulder
Anti-Bacterial Agents
Chlorhexidine
Dental Implants
Minocycline

Figure

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  Figure 1 A representative radiographic view at the baseline day (A) and the endpoint (B).

• 

  Figure 2 The distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) was measured at the mesial and distal aspects of each implant: A, implant shoulder; B and B′, the most coronal bone-to-implant contact point; C, apex of the implant fixture; A–B, DIB at the distal aspect; A–B′, DIB at the mesial aspect; and A–C, length of the implant fixture (on radiographic view). Amount of actual marginal bone loss at the mesial and distal aspects (X′ and X) calculated follow as:X′=(A–B′)×fixture length (actual)/(A–C)X=(A–B)×fixture length (actual)/(A–C)

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