Valutazione dell’efficacia di una terapia antibiotica locale nella perimplantite

Objectives

To assess the effect of non-surgical perimplant treatment using a local antibiotic and to compare them with a standard treatment of non-surgical root planing of the perimplant, evaluating clinical, microbiological, and radiological parameters in a randomized controlled trial.

Materials and methods

Forty implants with perimplantitis diagnosed with clinical and radiological exams meeting predefined criteria of inclusion and exclusion were included in the study. The presence of inflammation and gingival redness, suppuration and/or bleeding on probing, pathological depth probing, circumferential bone reabsorption evidenced with perioapical rx. Patients were allocated to a test group and a control group.

The study protocol involved baseline clinical parameters (PD, BOP, Suppuration, Plaque index, Morphology of perimplant soft tissues, radiography, microbiological test), root planing of the defect to break up the biofilm, flushing with saline solution and topical application of an antibiotic (Implacid) in the test group. It also involved the registration of parameters, follow-up Rx, and microbiological test at three months. End of the study.

Results

After three months, the patients in the test group treated with a topical antibiotic in addition to the standard non-surgical treatment for perimplantitis showed a more dramatic improvement of perimplant tissues than the patients in the control group who underwent only the usual non-surgical treatment.

This trend was statistically significant as far as bleeding on probing and bacterial load in the perimplant pocket were concerned, whereas for PPD and superficial bacterial plaque such difference was not statistically significant, although after three months the average improvement was more prominent in the test group than in the control group.

Conclusions

The use of a topical antibiotic in patients with perimplantitis is a clinical procedure widely recognized by the scientific community. Implacid showed to be a valid agent and to be able to significantly improve the perimplant tissue inflammation and the bacterial load in marginal tissues. However, a further evaluation of clinical and microbiological parameters would be advisable at six and 12 months to support these preliminary results.