Surgical peri-implantitis treatment with air-abrasive device

Case series

Abstract

Implant related biological complications include peri-implant mucositis and peri-implantitis. The main clinical symptoms of
peri-implant mucositis is bleeding on gentle probing. In case of peri-implantitis, bleeding on probing and increased probing
depth are leading signs. Treatments of peri-implant inflammation are divided into conservative and surgical therapies.
The prerequisite for both approaches is the proper professional cleaning of supracrestal implant surfaces. According to
the literature, air-abrasive technique is suitable for decontamination of contaminated implant surfaces. Silicate-based
powders that are suitable for cleaning supramucosal parts are not soluble in aqueous medium, so their use is not recommended
submucosally as the small particles cannot be completely eliminated. Using Varios Combi Pro (NSK/Nakanishi
Inc., Shimohinata Kanuma, Japan), water-soluble glycine powder can be applied to the implant surface at an adjustable
pressure through a disposable special plastic nozzle. During use, the amount of water cooling can be adjusted. Glycine
powder air-abrasive technique cleans the surface of implants more efficiently than cleaning with conventional hand curette
without damaging supracrestal implant surfaces. Three patients in this case report underwent clinical and radiological
examinations. The peri-implant status was recorded by recording the following parameters: plaque index (PI), calculus
index (CI), probing pocket depth (PPD), bleeding on probing (BoP), gingival recession (GR), keratinized mucosa width (KW)
and radiological bone loss. Status was also registered at baseline and six months after surgical therapy. Treatment plans
of the patients were set up individually, but each treatment involved surgical preparation and air-abrasive debridement
with glycine powder with Varios Combi Pro (NSK/Nakanishi Inc., Shimohinata Kanuma, Japan). In two cases, in addition
to surgical therapy, free gingival graft (FGG) transplantation was also performed. Peri-implant inflammation was treated
successfully in all three cases.