Nonsurgical Treatment of Peri-implantitis Using a Chitosan Brush with Adjunctive Chemical Decontaminants— A Retrospective Case Series

Purpose: To evaluate the effect of a simple nonsurgical procedure for the treatment of peri-implantitis.
Materials and Methods: A total of 30 implants across 24 patients diagnosed with moderate to advanced peri-implantitis were treated using a chitosan brush with adjunctive chemicals, ie, 3% hydrogen peroxide and a tetracycline slurry. The treatment was performed a total of three times, with intervals of approximately 3 weeks.
Results: Results showed improvement in both the clinical attachment level (CAL) and bleeding on probing score between the baseline and the re-examinations between 9 months and up to 43 months (mean 26.8 months) after treatment. The mean CAL at baseline was 3.4 mm (range: 1 to 8 mm), while the mean CAL during the final examination was 1.4 mm (range: 0 to 5 mm), demonstrating a mean reduction of CAL of 2 mm (range: 1 to 7 mm; P < .001). Of the analyzed implant sites, 72% demonstrated radiographic signs of osseous defect fill varying between 0.1 and 2.2 mm (mean: 1.0 mm).
Conclusion: The results show that this novel treatment strategy may serve as a nonsurgical alternative to reduce parameters of inflammation around implants with moderate to advanced peri-implantitis.