Comparison of the effect of local delivery of metronidazole with mechanical debridement in treatment of peri-implantitis

Abstract

Introduction: Peri-implantitis is an infectious disease that affects the tissues around dental implants and presents with clinical signs of inflammation and irreversible loss of supporting bone. Since metronidazole is an antibiotic that has been used effectively in the treatment of periodontitis and is particularly effective on bacteria, this study aimed to compare the effect of slow-release metronidazole with mechanical debridement in the treatment of peri-implantitis. Materials and Methods: In this single-blind randomized clinical trial, 36 patients (18 patients in each group) with peri-implantitis were treated with topical slow release metronidazole. Patients aged 20 years and older with peri-implantitis and at least one implant with PD> 6 mm, also with BOP positive and radiographic bone loss, were included in the study. Four clinical findings, including mPI (modified plaque index), PD (probing pocket depth), mBI (modified bleeding index), and CAL (clinical attachment level), were measured at baseline and three and 6-month follow-up. Results: The study's results using the Student's t-Test showed that the study variables (PD reduction in the intervention group after 3 and 6 months by 1.77 0. 54 mm and 4.00 1. 28 mm, respectively, and in the control group by 1.94 0.41 mm and 3.33 0.84 mm, respectively; The rate of mPI reduction in the intervention group was 1.05 0. 63 and 1.88 0.67, respectively, and in the control group was 0.83 0. 70 and 1.16 0.78, respectively; The rate of mBI reduction in the intervention group was 0.38 0.15 and 0.52 0.15, respectively, and in the control group was 0.24 0.14 and 0.39 0.16, respectively (have significant differences after 3 and 6 months. In all samples in the two groups, the mean of CAL before and after treatment was constant and there was no statistically significant difference (p>0.05). The paired-Sample t-test also showed that the results obtained in the two groups were not statistically significant, although the results were better in the intervention group (slow-release metronidazole topical antibiotic). Conclusion: The results showed that the use of topical slow-release metronidazole could be an adjunctive therapy in improving and enhancing the effects of mechanical debridement in the treatment of pre-implantitis.