Efficacy of mechanical debridement with adjunctive probiotic therapy in the treatment of peri-implant mucositis in cigarette-smokers and never-smokers

Clin Implant Dent Relat Res. 2019 Aug;21(4):734-740. doi: 10.1111/cid.12795. Epub 2019 May 16.

Abstract

Background: Efficacy of mechanical debridement (MD) with adjunctive probiotic therapy (PT) in the treatment of peri-implant mucositis (PiM) in cigarette-smoking and never-smoking subjects remains uninvestigated.

Purpose: The aim was to assess the efficacy of MD with adjunctive PT in the treatment of PiM in cigarette-smoking and never-smoking individuals.

Materials and methods: Patients with (group I) and without PiM (group II) were included. Demographic data was collected using a questionnaire. Treatment-wise, patients in groups I and II were subdivided into: (a) Patients that underwent MD with adjunct PT (using Lactobacillus reuteri); and (b) MD alone. In all groups, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were measured at baseline and compared after 3- and 6-months. Baseline peri-implant crestal bone levels were also measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post-hoc adjustment tests. P values under .05 were deemed significant.

Results: Eighty individuals (group I: 40 cigarette-smokers and group II: 40 never-smokers) with PiM participated in this study. At all-time intervals, no significant difference in PD, PI, and BOP were observed in all patients in group I. At 3-months' follow-up, the differences in BOP (P < .05), and PI (P < .05) were significantly higher in group II that underwent MD + PT than MD alone. At 6-months' follow-up, there was no difference in the changes in BOP and PI among subjects that underwent MD with and without adjunct PT.

Conclusion: On a short-term basis, MD with adjunct PT is more effectual in the treatment of PiM than MD alone in never-smokers. Cigarette-smoking compromises peri-implant soft tissue healing following MD with or without adjunct PT.

Keywords: Lactobacillus reuteri; bleeding on probing; cigarette smoking; dental implant; inflammation; probiotics.

MeSH terms

  • Debridement
  • Humans
  • Mucositis*
  • Peri-Implantitis*
  • Probiotics*
  • Smokers