Treatment of Peri-Implant Mucositis with Standard of Care and Bioptron Hyperlight Therapy: A Randomized Clinical Trial

Gianna Maria Nardi, Marta Mazur, Giulio Papa, Massimo Petruzzi, Felice Roberto Grassi, Roberta Grassi, Gianna Maria Nardi, Marta Mazur, Giulio Papa, Massimo Petruzzi, Felice Roberto Grassi, Roberta Grassi

Abstract

The aim of this study was to evaluate in a cohort of patients with peri-implant mucositis: (a) the efficacy of professional mechanical debridement therapy assisted using Bioptron Hyperlight Therapy on the reduction in periodontal indexes and (b) the reduction in total oxidative salivary stress. Forty subjects with a diagnosis of peri-implant mucositis were enrolled and randomly assigned to the Study Group (mechanical debridement therapy assisted using Bioptron Hyperlight Therapy) or Control Group (mechanical debridement therapy alone). The study duration was 6 months. Data on plaque index (PI), bleeding on probing (BoP), probing pocket depth (PPD), and pain relief on Visual Analogue Scale (VAS) were recorded at T0, T1 (14 days), T2 (1 month), and T3 (6 months). Group differences were assessed using Student's t-test and Pearson's Chi-squared test of homogeneity. PI and PPD decreased in the Study Group at the [T0; T1] time interval and during the overall time of observation significantly more than in the Control Group; BoP and pain on VAS decreased significantly faster in the Study Group than in the Control Group. Differences in Salivary Antioxidant Test (SAT) changes were not significant at any time interval. Patients' gender and smoking habit were not correlated with the clinical outcomes. Clinical parameters related to peri-implant mucositis significantly improved in the Study Group, which demonstrated the clinical efficacy of the Bioptron Hyperlight Therapy as an adjunct to standard of care for the treatment of peri-implant mucositis. The RCT was registered at the US National Institutes of Health #NCT05307445.

Keywords: Bioptron; SAT; clinical trial; dental hygiene; dental implants; non-surgical periodontal therapy; oxidative stress; peri-implant mucositis; photobiomodulation; salivary test.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Distribution of changes in plaque index (percentage points).
Figure 3
Figure 3
Distribution of changes in PPD.
Figure 4
Figure 4
Distribution of changes in SAT.

References

    1. Renvert S., Persson G.R., Pirih F.Q., Camargo P.M. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J. Periodontol. 2018;89:S304–S312. doi: 10.1002/JPER.17-0588.
    1. Rosen P., Clem D., Cochran D., Froum S., McAllister B., Renvert S., Wang H.L. Peri-implant mucositis and peri-implantitis: A current understanding of their diagnoses and clinical implications. J. Periodontol. 2013;84:436–443.
    1. Heitz-Mayfield L.J.A., Salvi G.E. Peri-implant mucositis. J. Clin. Periodontol. 2018;45:S237–S245. doi: 10.1111/jcpe.12953.
    1. Berglundh T., Armitage G., Araujo M.G., Avila-Ortiz G., Blanco J., Camargo P.M., Chen S., Cochran D., Derks J., Figuero E., et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J. Clin. Periodontol. 2018;45:S286–S291. doi: 10.1111/jcpe.12957.
    1. Figuero E., Graziani F., Sanz I., Herrera D., Sanz M. Management of peri-implant mucositis and peri-implantitis. Periodontol 2000. 2014;66:255–273. doi: 10.1111/prd.12049.
    1. Butera A., Pascadopoli M., Pellegrini M., Gallo S., Zampetti P., Cuggia G., Scribante A. Domiciliary Use of Chlorhexidine vs. Postbiotic Gels in Patients with Peri-Implant Mucositis: A Split-Mouth Randomized Clinical Trial. Appl. Sci. 2022;12:2800. doi: 10.3390/app12062800.
    1. Mongardini C., Pilloni A., Farina R., Di Tanna G., Zeza B. Adjunctive efficacy of probiotics in the treatment of experimental peri-implant mucositis with mechanical and photodynamic therapy: A randomized, cross-over clinical trial. J. Clin. Periodontol. 2017;44:410–417. doi: 10.1111/jcpe.12689.
    1. Alhumaidan A.A., AlAli Y., Ahmed S., Vohra F., Abduljabbar T. Effect of photobiomodulation after non-surgical mechanical debridement on cortisol levels in the peri-implant sulcular fluid among patients with peri-implant mucositis. Photodermatol. Photoimmunol. Photomed. 2022. epub ahead of print.
    1. BIOPTRON. [(accessed on 14 January 2022)]. Available online: .
    1. Nardi G.M., Grassi R., Grassi F.R., Aragona S.E., Rapone B., Della Vella F., Sabatini S. Use of photobio-modulation induced by polarized polychromatic non-coherent light in the management of adult chronic periodontitis. J. Biol. Regul. Homeost. Agents. 2019;1:293–297.
    1. Aragona S.E., Grassi F.R., Nardi G.M., Lotti J., Mereghetti G., Canavesi E., Equizi E., Puccio A.M., Lotti T. Photobiomodu- lation with polarized light in the treatment of cutaneous and mucosal ulcerative lesions. J. Biol. Regul. Homeost. Agents. 2017;2:213–218.
    1. Nardi G.M., Guerra F., Ndokaj A., Corridore D., Straker M.A., Sportelli P., Di Giorgio R., Grassi F.R., Grassi R., Ottolenghi L. Phototherapy and Tailored Brushing Method. Personalized Oral Care in Patients with Facial and Dental Trauma. A Report of a Case. Healthcare. 2021;9:561. doi: 10.3390/healthcare9050561.
    1. Alqahtani F., Alqhtani N., Celur S.L., Divakar D.D., Al-Kheraif A.A., Alkhtani F. Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial. J. Oral Implantol. 2020;46:526–531. doi: 10.1563/aaid-joi-D-19-00367.
    1. De Siena F., Corbella S., Taschieri S., Del Fabbro M., Francetti L. Adjunctive glycine powder air-polishing for the treatment of peri-implant mucositis: An observational clinical trial. Int. J. Dent. Hyg. 2015;13:170–176. doi: 10.1111/idh.12114.
    1. Chow S., Shao J., Wang H. Sample Size Calculations in Clinical Research. 2nd ed. Chapman & Hall/CRC Biostatistics Series; Boca Raton, FL, USA: 2008.
    1. Nardi G.M., Sabatini S., Guerra F., Tatullo M., Ottolenghi L. Tailored Brushing Method (TBM): An Innovative Simple Protocol to Improve the Oral Care. J. Biomed. 2016;1:26–31. doi: 10.7150/jbm.16953.
    1. Nardi G.M., Fais S., Casu C., Mazur M., Di Giorgio R., Grassi R., Grassi F.R., Orrù G. Mouthwash Based on Ozonated Olive Oil in Caries Prevention: A Preliminary In-Vitro Study. Int. J. Environ. Res. Public Health. 2020;17:9106. doi: 10.3390/ijerph17239106.
    1. Nardi G.M., Cesarano F., Papa G., Chiavistelli L., Ardan R., Jedlinski M., Mazur M., Grassi R., Grassi F.R. Evaluation of Salivary Matrix Metalloproteinase (MMP-8) in Periodontal Patients Undergoing Non-Surgical Periodontal Therapy and Mouthwash Based on Ozonated Olive Oil: A Randomized Clinical Trial. Int. J. Environ. Res. Public Health. 2020;17:6619. doi: 10.3390/ijerph17186619.
    1. Pontoriero R., Tonelli M.P., Carnevale G., Mombelli A., Nyman S.R., Lang N.P. Experimentally induced peri-implant mucositis. A clinical study in humans. Clin. Oral Implants Res. 1994;5:254–259. doi: 10.1034/j.1600-0501.1994.050409.x.
    1. Tonetti M.S., Imboden M., Gerber L., Lang N.P. Compartmentalization of inflammatory cell phenotypes in normal gingiva and peri-implant keratinized mucosa. J. Clin. Periodontol. 1995;22:735–742. doi: 10.1111/j.1600-051X.1995.tb00255.x.
    1. Liljenberg B., Gualini F., Berglundh T., Tonetti M., Lindhe J. Composition of plaque-associated lesions in the gingiva and the peri-implant mucosa in partially edentulous subjects. J. Clin. Periodontol. 1997;24:119–123. doi: 10.1111/j.1600-051X.1997.tb00477.x.
    1. Saghiri M.A., Asatourian F., Godoy G., Sheibani N. The role of angiogenesis in implant dentistry part I: Review of titanium alloys, surface characteristics and treatments. Med. Oral Patol. Oral Y Cirugiἰa Bucal. 2016;21:e514–e525. doi: 10.4317/medoral.21199.
    1. Lucarini G., Zizzi A., Rubini C., Ciolino F., Aspriello S.D. VEGF, Microvessel Density, and CD44 as Inflammation Markers in Peri-implant Healthy Mucosa, Peri-implant Mucositis, and Peri-implantitis: Impact of Age, Smoking, PPD, and Obesity. Inflammation. 2019;42:682–689. doi: 10.1007/s10753-018-0926-0.
    1. Guerra F., Mazur M., Ndokaj A., Corridore D., La Torre G., Polimeni A., Ottolenghi L. Periodontitis and the microbiome: A systematic review and meta-analysis. Minerva Stomatol. 2018;67:250–258. doi: 10.23736/S0026-4970.18.04198-5.
    1. Nardi G.M., Grassi R., Ndokaj A., Antonioni M., Jedlinski M., Rumi G., Grocholewicz K., Dus-Ilnicka I., Grassi F.R., Ottolenghi L., et al. Maternal and Neonatal Oral Microbiome Developmental Patterns and Correlated Factors: A Systematic Review-Does the Apple Fall Close to the Tree? Int. J. Environ. Res. Public Health. 2021;18:5569. doi: 10.3390/ijerph18115569.
    1. Derks J., Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J. Clin. Periodontol. 2015;42:S158–S171. doi: 10.1111/jcpe.12334.
    1. Sanz M., Chapple I.L., Working Group 4 of the VIII European Work-shop on Periodontology Clinical research on peri-implant diseases: Consensus report of Working Group 4. J. Clin. Periodontol. 2012;39:202–206. doi: 10.1111/j.1600-051X.2011.01837.x.
    1. Shibli J.A., Melo L., Ferrari D.S., Figueiredo L.C., Faveri M., Feres M. Composition of supra- and subgingival biofilm of subjects with healthy and diseased implants. Clin. Oral Implants Res. 2008;19:975–982. doi: 10.1111/j.1600-0501.2008.01566.x.
    1. Lindhe J., Meyle J., Group D of European Workshop on Periodontology Peri-implant diseases: Consensus report of the Sixth European Workshop on Periodontology. J. Clin. Periodontol. 2008;35:282–285. doi: 10.1111/j.1600-051X.2008.01283.x.
    1. Tsigarida A.A., Dabdoub S.M., Nagaraja H.N., Kumar P.S. The influence of smoking on the peri-implant microbiome. J. Dent. Res. 2015;94:1202–1217. doi: 10.1177/0022034515590581.
    1. Pokrowiecki R., Mielczarek A., Zaręba T., Tyski S. Oral microbiome and peri-implant diseases: Where are we now? Ther. Clin. Risk Manag. 2017;13:1529–1542. doi: 10.2147/TCRM.S139795.
    1. Crincoli V., Ballini A., Fatone L., Di Bisceglie M.B., Nardi G.M., Grassi F.R. Cytokine genotype distribution in patients with periodontal disease and rheumatoid arthritis or diabetes mellitus. J. Biol. Regul. Homeost. Agents. 2016;30:863–866.
    1. Iordanou P., Baltopoulos G., Giannakopoulou M., Bellou P., Ktenas E. Effect of polarized light in the healing process of pressure ulcers. Int. J. Nurs. Pract. 2002;8:49–55. doi: 10.1046/j.1440-172x.2002.00338.x.
    1. Karu T.I., Pyatibrat L.V., Afanasyeva N.I. A novel mitochondrial signaling pathway activated by visible-to-near infrared radiation. Photochem. Photobiol. 2004;2:366–372. doi: 10.1562/2004-03-25-RA-123.1.
    1. Salmeri F.M., Denaro L., Ruello E., Acri G., Gurgone S., Sansotta C., Testagrossa B. Irradiation with Polychromatic In-coherent Low Energy Radiation of Human Peripheral Blood Mononuclear Cells In Vitro: Effects on Cyto-kine Production. Int. J. Environ. Res. Public Health. 2020;17:1233. doi: 10.3390/ijerph17041233.
    1. Limansky Y., Tamarova Z., Gulyar S. Suppression of pain by exposure of acupuncture points to polarized light. Pain Res. Manag. 2006;11:49–57. doi: 10.1155/2006/784968.
    1. Feehan J., Tripodi N., Fraser S., Mikkelsen K., Thewlis A., Kiatos D., Husaric M., Apostolopoulos V. Polarized light therapy: Shining a light on the mechanism underlying its immunomodulatory effects. J. Biophotonics. 2020;13:e201960177. doi: 10.1002/jbio.201960177.
    1. Petruzzi M., Nardi G.M., Cocco F., Della Vella F., Grassi R., Grassi F.R. Polarized Polychromatic Noncoherent Light (Bioptron Light) as Adjunctive Treatment in Chronic Oral Mucosal Pain: A Pilot Study. Photobiomodul. Photomed. Laser Surg. 2019;37:227–232. doi: 10.1089/photob.2018.4576.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner