Eficácia da implantoplastia adjuvante no tratamento cirúrgico da peri-implantite

Abstract

Surgical therapy has been identified as the most appropriate strategy for the treatment of peri-implantitis. One of these techniques is implantoplasty, whose proposal is to modify the surface of the implant by removing exposed threads, making it less adherent to the biofilm. The study aimed to evaluate the effect of implantoplasty in the treatment of peri-implantitis, by comparing two intervention groups: one with and the other without implantoplasty. Thus, it is a prospective, controlled, randomized and blinded clinical trial. 13 participants with 33 implants were randomly allocated into two groups: surgical access + mechanical debridement (control-I group) and surgical access + mechanical debridement + implantoplasty (test-II group). The primary outcomes were assessed at baseline and at 3 months: Plaque Index -PI, Gingival Bleeding Index -GBI, Probing Depth -PD, Bleeding on Probing -BoP, and Keratinized Mucosal Band -MK. Quality of life was evaluated by the Oral Health Impact Profile -OHIP14 and oxidative stress markers by salivary samples. The results showed that 69.2% were women, with an average age of 60.6 years. Of the 32 implants, 16 received therapy I and 16 received therapy II. Of all rehabilitations, 53.8% were total and 30.8% were partial, with the rest being single. The Mann-Whitney test showed that the values of PI and GBI in group II were higher than in group I at 3 months, but they were not significant (p=0,193; p=0,419). The BoP was higher in I group (50%) than in II group (41.6%) at 3 months, however, without significance (p=0,759). At 3 months, all parameters - except BoP in II group - decreased in value, being significant for PI in I group (p=0,038), GBI in I and II groups (p=0,011 and p=0,015) and PD in II group (p=0,041). Split-Plot ANOVA showed no interaction between time and treatment. The OHIP14 showed that at baseline there was a predominance of “Physical pain”, “Psychological discomfort” and “Physical disability”, while at 3 months there was an improvement in the evaluated items. Salivary analysis showed that there was a reduction in the levels of oxidative stress markers after treatment, being significant for superoxide dismutase (Z=-2,701; p=0,007). Conclusion: there is insufficient evidence that the addition of implantoplasty improves clinical parameters in the surgical treatment of peri-implantitis at 3 months, in relation to mechanical debridement alone.