Effects of an amino acid buffered hypochlorite solution as an adjunctive to air-powder abrasion in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo randomized clinical trial

Gerardo La Monaca; Nicola Pranno; Fabio Mengoni; Gianluca Puggioni; Antonella Polimeni; Susanna Annibali; Maria Paola Cristalli

doi:10.1007/s00784-022-04608-5

Effects of an amino acid buffered hypochlorite solution as an adjunctive to air-powder abrasion in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo randomized clinical trial

Clin Oral Investig. 2023 Feb;27(2):827-835. doi: 10.1007/s00784-022-04608-5. Epub 2022 Jul 8.

Authors

Gerardo La Monaca¹, Nicola Pranno², Fabio Mengoni³, Gianluca Puggioni⁴, Antonella Polimeni¹, Susanna Annibali¹, Maria Paola Cristalli⁵

Affiliations

¹ Department of Oral and Maxillofacial Sciences, University of Rome, 6. Caserta St, 00161, SapienzaRome, Italy.
² Department of Oral and Maxillofacial Sciences, University of Rome, 6. Caserta St, 00161, SapienzaRome, Italy. Nicola.pranno@uniroma1.it.
³ Department of Public Health and Infectious Diseases, University of Rome, SapienzaRome, Italy.
⁴ Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy.
⁵ Department of Biotechnologies and Medical Surgical Sciences, University of Rome, SapienzaRome, Italy.

Abstract

Objectives: To evaluate ex vivo the efficacy of an amino acid buffered hypochlorite solution supplemented to surface debridement with air-powder abrasion in removing bacterial biofilm following open-flap decontamination of implants failed due to peri-implantitis.

Materials and methods: This study was an ex vivo, single-blind, randomized, intra-subject investigation. Study population consisted of 20 subjects with at least three implants failed for peri-implantitis (in function for > 12 months and progressive bone loss exceeding 50%) to be explanted. For each patient, implants were randomly assigned to surface decontamination with sodium bicarbonate air-powder abrasion (test-group 1) or sodium bicarbonate air-powder abrasion supplemented by amino acid buffered hypochlorite solution (test-group 2) or untreated control group. Following open-flap surgery, untreated implants (control group) were explanted. Afterwards, test implants were decontaminated according to allocation and explanted. Microbiological analysis was expressed in colony-forming units (CFU/ml).

Results: A statistically significant difference in the concentrations of CFU/ml was found between implants of test-group 1 (63,018.18 ± 228,599.36) (p = 0.007) and implants of test-group 2 (260.00 ± 375.80) (p < 0.001) compared to untreated implants (control group) (86,846.15 ± 266,689.44). The concentration of CFU/ml on implant surfaces was lower in test-group 2 than in test-group 1, with a statistically significant difference (p < 0.001).

Conclusion: The additional application of amino acid buffered hypochlorite solution seemed to improve the effectiveness of implant surface decontamination with air-powder abrasion following open-flap surgery.

Clinical relevance: Lacking evidence on the most effective method for biofilm removal from contaminated implant surfaces, the present experimental study provides further information for clinicians and researchers.

Keywords: Air-powder abrasion; Biofilms; Chemical decontamination; Dental implant; Microbiota; Peri-implantitis.

Publication types

Randomized Controlled Trial

MeSH terms

Amino Acids
Decontamination / methods
Dental Implants* / microbiology
Humans
Hypochlorous Acid
Peri-Implantitis* / prevention & control
Peri-Implantitis* / surgery
Powders
Single-Blind Method
Sodium Bicarbonate
Surface Properties

Substances

Dental Implants
Powders
Hypochlorous Acid
Amino Acids
Sodium Bicarbonate