Effect of a Maintenance Protocol After Surgical Treatment of Peri-implantitis
2022年10月5日 更新者：Universidad Complutense de Madrid
Effect of a Maintenance Protocol Based on the Surgical Treatment of Peri-implantitis and Implant Surface Decontamination With Glycine Powder Air-polishing
This study was designed as a 12-month, two arms, randomized clinical trial to evaluate the efficacy of a supportive treatment protocol (SPIT).
Thirty patients were randomized, six months after access-flap surgery, in two different SPIT groups.
After ultrasonic debridement, the affected implant surfaces of the test group were treated with glycine powder air-polishing, while implants in the control group a rubber cup and polishing paste was used.
Maintenance visits were carried every 3 months and clinical, radiological, microbiological and biochemical variables were registered at baseline (6 months after surgery) and after a follow-up period of 12 months (18 months after surgery).
研究概览
详细说明
Study design:
This study was designed as a 12-month, two arms, RCT to evaluate the efficacy of a SPIC protocol. Thirty patients were randomized, six months after access-flap surgery, in two different SPIT groups. After ultrasonic debridement, the affected implant surfaces of the test group were treated with glycine powder air-polishing, while implants in the control group a rubber cup and polishing paste was used. Maintenance visits were carried every 3 months and clinical, radiological, microbiological and biochemical variables were registered at baseline (6 months after surgery) and after a follow-up period of 12 months (18 months after surgery).
Interventions:
At the 6-month evaluation after the surgery, the baseline data for the present study were obtained and patients were randomised using a computerized block randomization protocol to one of the following SPIC protocols. In the test group, implant surfaces were treated with glycine powder air-polishing after ultrasonic instrumentation; the specific nozzle was activated subgingivally and circumferentially around the implant for 1 minute. In the control group, implants were cleaned with a rubber cup and polishing paste after ultrasonic instrumentation. This SPIC visits were carried out at 6 (baseline visit), 9, 12, 15 and 18 months after surgery.
研究类型
介入性
注册 (实际的)
30
阶段
- 不适用
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Presence of at least one implant with peri-implantitis, defined as: radiographic evidence of bone loss >2 mm, inflammation of the peri-implant mucosa as defined by positive BoP and/or suppuration, and at least one site with PD ≥ 5 mm.
- Based on the radiographic examination, the affected implant should not have a vertical peri-implant defect. Positive selection was based on the presence of pe-ri-implant lesions wider than 4 mm, with an angle greater than 35 º.
- In patients with a history of periodontitis, periodontal therapy should have been provided at least 6 months prior to the initiation of the study.
Exclusion Criteria:
- Presence of relevant medical conditions and/or systemic medications that would contraindicate the surgical procedure or modify the tissue response after therapy.
- Patients requiring antibiotic prophylaxis.
- Heavy smokers (> 10 cigarettes/day).
- Pregnant or lactating women
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：Glycine - Test
Polishing treatment with glycine powder air-polishing after ultrasonic plaque debridement.
|
Every 3 months, ultrasonic instrumentation was carried out with an specific implant tip coated with Polyether Ether Ketone (PEEK), activated subgingivally and circumferentially around the implant.
Then, the implants were treated with glycine powder air-polishing.
|
|
有源比较器：Rubber cup - Control
Polishing treatment with a rubber cup and polishing paste after ultrasonic debridement
|
Every 3 months, ultrasonic instrumentation was carried out with an specific implant tip coated with Polyether Ether Ketone (PEEK), activated subgingivally and circumferentially around the implant.
Then, the implants were treated with rubber cup and a polishing paste.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Probing Pocket Depth
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Changes in Probing Pocket Depth measured in milimeters with a manual periodontal probe
|
Baseline, 6 and 18 months after the surgical procedure
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Distance of Gingival Recession
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Recession distance of the mucosal margin relative to the restoration margin (REC) at the implant (6 sites/implant) measured in milimeters with a manual periodontal probe
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Bleeding on Probing index
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Rate of Presence / absence Bleeding on Probing at the implant (6 sites/implant)
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Plaque Index
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Rate of Presence / absence of Plaque at the implant (6 sites/implant)
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Suppuration Index
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Rate of Presence / absence of suppuration at the implant (6 sites/implant)
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Radiographic bone loss distance measured from the prosthetic connection platform to the bottom of the intraosseous defect
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Intraoral standardised radiographs of the site of interest measured in digital intraoral radiographs using an image-processing software
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Concentration of the selected cytokines measured in pg/ml (IL1B; Il-6; IL-8; Tumoral Necrosis Factor Alpha)
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Samples taken from the gingival crevicular fluid (GCF) were taken from each included implant from the deepest PD site with positive BoP, at baseline and at the final evaluation, always prior to microbiological sampling.
Samples were taken using the filter paper technique.
After isolation of the area with cotton rolls and gentle cleaning with air and a gauze to remove supragingival biofilm deposits and potential saliva contamination, a paper strip of standard length and height was inserted into the peri-implant pocket, until mild resistance was felt and left in place for 30 seconds.
The soaked volume of GCF was measured using the Periotron 8000® device.
Subsequently, the paper strips were inserted in micro-centrifuge plastic tubes and immediately stored at -80°C until further processing.
Analyses were carried out using a Luminex System (Luminex® 200, Luminex Corporation, Austin, TX, USA) to determine volume of the following biomarkers: IL-1β, IL-6, IL-8 and TNF-α.
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Presence of putative periodontal pathogens
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Sample from the deepest site in the evaluated implant using two consecutive sterile paper-points kept in place for 10 seconds and then transferred into a screw-capped vial, containing 1.5 mL of reduced transport fluid (RTF).
Samples were transferred to the microbiological laboratory within 2 hours and homogenized by vortexing for 30 seconds and serially diluted in phosphate buffer saline (PBS).
Then, 0.1 mL of each dilution was plated manually on the specific medium Dentaid-1, for the detection of Aggregatibacter actinomycetemcomitans, and incubated for 3 days in air with 5% CO2 at 37ºC.
Samples were also plated into a non-selective blood agar plate, supplemented with haemine (5 mg/l), menadione (1 mg/l) and 5% sterile horse blood, with 7-14 days of anaerobic incubation.
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Frequency of detection of putative periodontal pathogens
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Sample from the deepest site in the evaluated implant using two consecutive sterile paper-points kept in place for 10 seconds and then transferred into a screw-capped vial, containing 1.5 mL of reduced transport fluid (RTF).
Samples were transferred to the microbiological laboratory within 2 hours and homogenized by vortexing for 30 seconds and serially diluted in phosphate buffer saline (PBS).
Then, 0.1 mL of each dilution was plated manually on the specific medium Dentaid-1, for the detection of Aggregatibacter actinomycetemcomitans, and incubated for 3 days in air with 5% CO2 at 37ºC.
Samples were also plated into a non-selective blood agar plate, supplemented with haemine (5 mg/l), menadione (1 mg/l) and 5% sterile horse blood, with 7-14 days of anaerobic incubation.
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Proportions of putative periodontal pathogens
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Sample from the deepest site in the evaluated implant using two consecutive sterile paper-points kept in place for 10 seconds and then transferred into a screw-capped vial, containing 1.5 mL of reduced transport fluid (RTF).
Samples were transferred to the microbiological laboratory within 2 hours and homogenized by vortexing for 30 seconds and serially diluted in phosphate buffer saline (PBS).
Then, 0.1 mL of each dilution was plated manually on the specific medium Dentaid-1, for the detection of Aggregatibacter actinomycetemcomitans, and incubated for 3 days in air with 5% CO2 at 37ºC.
Samples were also plated into a non-selective blood agar plate, supplemented with haemine (5 mg/l), menadione (1 mg/l) and 5% sterile horse blood, with 7-14 days of anaerobic incubation.
|
Baseline, 6 and 18 months after the surgical procedure
|
|
Counts of putative periodontal pathogens
大体时间：Baseline, 6 and 18 months after the surgical procedure
|
Sample from the deepest site in the evaluated implant using two consecutive sterile paper-points kept in place for 10 seconds and then transferred into a screw-capped vial, containing 1.5 mL of reduced transport fluid (RTF).
Samples were transferred to the microbiological laboratory within 2 hours and homogenized by vortexing for 30 seconds and serially diluted in phosphate buffer saline (PBS).
Then, 0.1 mL of each dilution was plated manually on the specific medium Dentaid-1, for the detection of Aggregatibacter actinomycetemcomitans, and incubated for 3 days in air with 5% CO2 at 37ºC.
Samples were also plated into a non-selective blood agar plate, supplemented with haemine (5 mg/l), menadione (1 mg/l) and 5% sterile horse blood, with 7-14 days of anaerobic incubation.
|
Baseline, 6 and 18 months after the surgical procedure
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2013年1月1日
初级完成 (实际的)
2021年8月1日
研究完成 (实际的)
2021年8月1日
研究注册日期
首次提交
2022年9月26日
首先提交符合 QC 标准的
2022年10月5日
首次发布 (实际的)
2022年10月10日
研究记录更新
最后更新发布 (实际的)
2022年10月10日
上次提交的符合 QC 标准的更新
2022年10月5日
最后验证
2022年9月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
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