33
HERRERA ET AL .
Background
R5.14. In patients treated for peri-implantitis is there a specific regime for professional mechanical plaque removal (PMPR) that reduces risk of disease recurrence?
See background text in R5.16, common for recommendations R5.11 – 16.
R5.16. In patients treated for peri-implantitis does the professional administration* of adjunctive local antimicrobial agents as part of a supportive peri- implant care (SPIC) programme reduce the risk of disease recurrence?
PICOS question addressed by an SR
R5.14: Expert consensus-based statement We do not know which specific PMPR regime is most effective in reducing the risk of recurrent peri-implantitis. However, based upon the periodontal literature and indirect evidence, the following approaches for dental implant biofilm removal can be used alone or in combination : • Titanium or stainless steel area-specific curettes • Ultrasonic/sonic instruments • Rubber cup or brushes • Air-polishing devices with glycine powder or erythritol alone or in combination . Supporting literature (Stiesch et al., 2023) Quality of evidence No studies were identified to compare different PMPR regimes Grade of recommendation GradeO — $ Statement, additional research needed Strength of consensus Strong consensus (0% of the group abstained due to potential CoI)
Question addressed by an SR
R5.16: Expert-based consensus recommendation We suggest not to use professional application a of adjunctive local antimicrobial agents in SPIC to reduce the risk of recurrent peri- implantitis . Supporting literature (Stiesch et al., 2023) Quality of evidence No studies were identified to specifically evaluate local antimicrobial agent use in secondary prevention of peri- implantitis Grade of recommendation GradeB — # Strength of consensus Strong consensus (3.8% of the group abstained due to potential CoI) a Professional administration is by the oral healthcare professional within the dental office.
Background
See background text in R5.16, common for recommendations R5.11 – 16.
Background
Intervention
R5.15. In patients treated for peri-implantitis, is there a specific oral hygiene method that reduces risk of disease recurrence?
SPIC provided after completion of active peri-implantitis therapy (i.e., any intervention during a supportive care visit). These interven- tions include: • reinforcement of systemic risk factor control (e.g., metabolic, inflam- matory and hormonal diseases, medications, tobacco use and stress); • management of remaining local risk factors (site-related factors, e.g., keratinized tissue width), implant- and prosthesis-related factors; • reinforcement of self-performed mechanical plaque control regimes (with or without antiseptic agents). • PMPR: removal of supra- and sub-mucosal biofilm by hand or mechani- cal instruments; removal of supra- and sub-mucosal hard deposits (calculus) by hand or mechanical instruments.
PICOS question addressed by an SR
R5.15: Expert-based consensus statement (1), Evidence-based recommendation (2) 1. We do not know which specific OH method is most effective in reducing the risk of recurrent peri-implantitis. However, based upon the periodontal literature, indirect evidence and expert opinion, we recommend individually tailored to the patient and prosthesis care including at least : • twice daily brushing of dental implants and teeth using either manual or re-chargeable power brushes ; • once daily use of interproximal brushes of an appropriate size ; 2. We recommend OH methods be demonstrated by the patient to the oral healthcare professional and periodically reinforced . Supporting literature (Stiesch et al., 2023) Quality of evidence No studies were identified to compare different OHmethods Grade of recommendation GradeO — $ Statement, additional research needed (1); Grade A — "" (2) Strength of consensus Unanimous consensus (10.9% of the group abstained due to potential CoI)
Available evidence
Number and design of included studies A total of 15 studies were included in this SR (Stiesch et al., 2023). The studies included were of prospective ( n = 10) and retrospective
Made with FlippingBook Annual report