Randomized clinical trial of the effects of azithromycin use in the treatment of peri‐implantitis

Background

The aim of this clinical trial was to establish a proof of concept that the adjunctive use of systemic azithromycin (AZM) in conjunction with mechanical debridement has an increased benefit in reducing soft tissue inflammation in the treatment of peri‐implantitis.

Methods

In a randomized, double‐blind, clinical trial, the treatment group (nine patients) received AZM as well as mechanical debridement in a single course of treatment, whereas the control group (eight patients) received a placebo and mechanical debridement. The primary outcome variables studied were bleeding on probing, suppuration, pocket probing depth and gingival recession. The secondary variables studied were gingival index, plaque index, microbiological and interleukin‐1β status. The observation period was 6 months.

Results

Over the 6 months’ observation period, the treatment patients showed a consistently greater reduction of gingival inflammation and an improvement in soft tissue healing than the control patients.

Conclusions

The adjunctive use of a single course of systemic azithromycin can assist in the control of peri‐implant mucositis in the treatment of peri‐implantitis.     

Comparison of two full‐mouth approaches in the treatment of peri‐implant mucositis: a pilot study

Objectives: The aim of the present study was to test the hypothesis that an additional full‐mouth disinfection results in a greater clinical and microbiological improvement compared with sole mechanical debridement within one session in patients with peri‐implant mucositis and treated chronic periodontitis. Material and methods: The study included 13 partially edentulous patients (mean age 51.5 years) with treated chronic periodontitis and 36 dental implants with mucositis (bleeding on probing and/or a gingival index ≥1 at least at one site at baseline, absence of peri‐implant bone loss during the last 2 years before baseline). After randomized assignment to a test and a control group, patients received a one‐stage full‐mouth scaling with or without chlorhexidine. Clinical and microbiological examination was performed at baseline, after 1, 2, 4 and 8 months. Additional microbial samples were taken 24 h after treatment. Microbiological analysis was performed by real‐time polymerase chain reaction. Results: Both treatment modalities resulted in significant reductions of probing depth at implant sites after 8 months, with no significant group differences. The bacteria at implants and teeth could be reduced in every group 24 h after treatment; however, this reduction was not significant after 8 months. Conclusions: Both treatment modalities led to an improvement of the clinical parameters and a temporary reduction of the microflora at implants with mucositis, but without significant inter‐group differences after 8 months. To cite this article:
Thöne‐Mühling M, Swierkot K, Nonnenmacher C, Mutters R, Flores‐de‐Jacoby L, Mengel R. Comparison of two full‐mouth approaches in the treatment of peri‐implant mucositis: a pilot study.
Clin. Oral Impl. Res. 21 , 2010; 504–512.
doi: 10.1111/j.1600‐0501.2009.01861.x