Title : Regenerative therapy for the treatment of peri-implantitis in patients with type 2 diabetes mellitus
Abstract:
Introduction:The high prevalence of peri-implantitis reflects the lack of effectiveness of treatment methods, which makes the search for new therapeutic approaches relevant.The use of hyaluronic acid in the treatment of peri-implantitis is expedient, which determined the purpose of the study.To evaluate the outcome of regenerative therapy of peri-implantitis in patients with type 2 diabetesmellitus. Study included 53 patients with type 2 diabetes mellitus diagnosed peri-implantis.38 implants with early peri-implantitis, 23 implants with moderate peri-implantitis. The diagnostic parameters used for assessing peri-implantitis include clinical indices, Probing Pocket Depth (PPD), Bleeding On Probing (BOP), peri-implant radiography, data at the re-examination were retrospectively compared to baseline data. Patients underwent treatment with HbA1c levels <7.2% or less than 154 mg/dL.Treatment including systemic antibiotics (amoxicillin 500mg and metronidazole 200mg) with duration of 7-10 days. Granulation tissue was carefully removed in the bone defect with titanium instruments. The implant surface is decontaminated with successive topical applications of citric acid, 0.12% chlorhexidine, sterile physiological saline and adjunctive magneto-laser therapy with a wavelength of 810nm power density of 100mW during 30 seconds. After degranulatin and antiseptic preparation Bio-Oss had mixed with hyaluronic acid (Gengigel) and the periimplant bone defect was filled. A membrane Bio-Gide was placed over the filled defect.Local applications Elzylol dental gel. A statistical significant reduction in both PPD and BOP were seen at all-timepoints as compared with the baseline clinical measurements. Stable clinical measurements PPD and BOP were demonstrated after 1 year the initial treatment, remaining stable during the following three years. Based on the clinical experience developed by us Algorithm for the treatment of peri-implantitis at different stages. Surgical regenerative treatment combined with systemic antibiotics, on pocket elimination, detoxification of the implants’ surface,bone grafting with grafts materials and hyaluronic acid Gengigel, magnetolaser therapy was an effective therapy for treatment of peri-implantitis.
Keywords:Peri-Implantitis; Implants; Regenerative Therapy; Magneto-Laser Therapy; Hyaluronic Acid
