Aim To evaluate the clinical and radiographic outcomes of non-surgical treatment by either submarginal erythritol air-polishing or combined instrumentation for peri-implantitis in severe periodontitis patients. Materials and methods This randomized clinical trial enrolled patients diagnosed with stage III/IV periodontitis and peri-implantitis affecting at least one dental implant. The test group received erythritol air-polishing while the control group received ultrasonic combined with manual instrumentation for peri-implant submarginal debridement. The primary outcome was the mean peri-implant probing depth (PPD) at 3 months. Clinical parameters were assessed at baseline (T0), T1 (6 weeks), and T2 (3 months); radiographic parameters were assessed at T0 and T2. Intergroup differences were analyzed using the Mann-Whitney U or t-test at each timepoint and verified by mixed-effects models. Factors potentially influencing PPD prognosis were assessed using Generalized Estimating Equations (GEE). Results Initially, 40 patients (20 per group) with peri-implantitis were randomly assigned to the trial; 38 patients completed the study. At T2, mean PPD reduced from 6.0 ± 1.8 mm to 4.2 ± 1.6 mm (test group) and 4.7 ± 1.5 mm (control group) with no significant differences between groups. Mean modified sulcus bleeding index(mSBI) decreased in both groups, with a significantly greater reduction in the test group. The treatment efficacy of PPD can be influenced by keratinized mucosa width (KMW), PPD-T0, mSBI-T2, and probing depth reduction of adjacent teeth. Conclusions In patients with severe periodontitis, both non-surgical therapies were effective in improving clinical parameters of peri-implantitis. Erythritol air-polishing exhibited greater improvement in soft tissue inflammation. Adequate peri-implant keratinized mucosa and greater reduction in probing depth of adjacent teeth were identified as favorable prognostic factors for PPD. Clinical trial registration This study had retrospectively registered at Chinese Clinical Trial Registry (ChiCTR2100048446) on July 7, 2021 (<ExternalRef> <RefSource>https://www.chictr.org.cn/showproj.html? proj=129220</RefSource> <RefTarget Address="https://www.chictr.org.cn/showproj.html? proj=129220" TargetType="Other" /> </ExternalRef>).

Non-surgical treatment of peri-implantitis with submarginal erythritol air-polishing in severe periodontitis patients: a randomized controlled trial

期刊论文
出版模式：

开放获取
发表日期：

2026年1月19日

查看全文

Shiai Dai,
Xianghui Feng,
Xuyang Gao,
Dong Shi

摘要

Aim

To evaluate the clinical and radiographic outcomes of non-surgical treatment by either submarginal erythritol air-polishing or combined instrumentation for peri-implantitis in severe periodontitis patients.

Materials and methods

This randomized clinical trial enrolled patients diagnosed with stage III/IV periodontitis and peri-implantitis affecting at least one dental implant. The test group received erythritol air-polishing while the control group received ultrasonic combined with manual instrumentation for peri-implant submarginal debridement. The primary outcome was the mean peri-implant probing depth (PPD) at 3 months. Clinical parameters were assessed at baseline (T0), T1 (6 weeks), and T2 (3 months); radiographic parameters were assessed at T0 and T2. Intergroup differences were analyzed using the Mann-Whitney U or t-test at each timepoint and verified by mixed-effects models. Factors potentially influencing PPD prognosis were assessed using Generalized Estimating Equations (GEE).

Results

Initially, 40 patients (20 per group) with peri-implantitis were randomly assigned to the trial; 38 patients completed the study. At T2, mean PPD reduced from 6.0 ± 1.8 mm to 4.2 ± 1.6 mm (test group) and 4.7 ± 1.5 mm (control group) with no significant differences between groups. Mean modified sulcus bleeding index(mSBI) decreased in both groups, with a significantly greater reduction in the test group. The treatment efficacy of PPD can be influenced by keratinized mucosa width (KMW), PPD-T0, mSBI-T2, and probing depth reduction of adjacent teeth.

Conclusions

In patients with severe periodontitis, both non-surgical therapies were effective in improving clinical parameters of peri-implantitis. Erythritol air-polishing exhibited greater improvement in soft tissue inflammation. Adequate peri-implant keratinized mucosa and greater reduction in probing depth of adjacent teeth were identified as favorable prognostic factors for PPD.

Clinical trial registration

This study had retrospectively registered at Chinese Clinical Trial Registry (ChiCTR2100048446) on July 7, 2021 ( https://www.chictr.org.cn/showproj.html? proj=129220 ).