The effectiveness of the information-motivation model and domestic brushing with a hypochlorite-based formula on peri-implant mucositis: A randomized clinical study

Abstract

Objective: Management of mucositis is essential for the long-term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non-surgical periodontal therapy (NSPT) for patients with peri-implant mucositis.

Materials and methods: Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite-based formula brushing solution (test) after diagnosis of peri-implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient-related outcomes were recorded during a 90-day follow-up period.

Results: Forty patients completed the three-month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh-day evaluation (T₁ ) in the gingival index (0-3) and FMBS (%). Favorable outcomes were maintained during the entire follow-up period.

Conclusion: The present study showed that the modified NSPT paired with the domestic use of nitradine-based formula helps resolve peri-implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases.

Clinical relevance: The gold standard for nonsurgical maintenance is full-mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross-infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.

Keywords: PerioTabs®; chlorhexidine; full-mouth disinfection; nitradine.

Figure 1

Gingival index (0–3) the GI drops down in both groups. After the domiciliary treatment (T1), the PerioTabs®‐group shows a significantly greater reduction in mean value relative to that of chlorhexidine

Figure 2

The full‐mouth bleeding scores (%) drop down in both groups, especially in T2 after the professional oral hygiene session. After the domiciliary treatment (T1), the PerioTabs® group shows a significant reduction in mean value relative to that of the chlorhexidine group

Figure 3

The modified plaque index (mPI, value between 0–3) drops down in both groups, especially in T2 after the professional oral hygiene session. In both groups the plaque grows after the same weeks in T3 and T4. No statistically significant differences are highlighted between the groups, with a p‐value <0.05, except for T2

Figure 4

A patient in the PerioTabs® group that has four implants with peri‐implant mucositis, at each time‐point—A: T0, before dental check‐up; b: T0, during probing with a plastic tool; c: T1, clinical aspect of the mucosa around the dental implants after 1 week of domiciliary PerioTabs® therapy, during the full‐mouth NSPT; d: T2, during the check‐up 3 days after the FMD; e: T3, during the check‐up; f: T4, during the check‐up