Diederik Hentenaar

53 Erythritol air-polishing in non-surgical peri-implantits treatment A brief summary of clinical and research implications Non-surgical peri-implantitis treatment using either air-polishing or piezoelectric ultrasonic scaling seems to result in a reduction in clinical inflammatory outcomes up to the 3 month follow-up, however without effectively arresting disease progression in the majority of cases. Therefore, our findings underline the limited effect of a single non-surgical intervention in the treatment of peri-implantitis. Interestingly, in patients which show a positive outcome at 3 months after therapy, stable peri-implant health could be expected up to 12 months after therapy. A priori identification of potentially successful patients characteristics (i.e., specific clinical, implant and patient characteristics) need to be further assessed in future studies. Although the overall effect for non-surgical therapies seems limited, a non-surgical treatment phase per se seems imperative in the overall treatment approach since a small number of patients may benefit from a non-surgical treatment in such a way that no further surgical treatment is required. Additionally, the clinician can evaluate patient motivation and use this phase to educate patients about the disease process and modifying factors. INTRODUCTION Over the past decades a variety of interventions, alone or in combination, have been investigated for the non-surgical treatment of peri-implantitis including, mechanical (e.g., carbon fiber/titanium curettes, glycine air-polishing, ultrasonic therapy), chemical (i.e., local or systemic antibiotics, chlorhexidine irrigation) and light-mediated therapies (e.g., Er:YAG laser or photodynamic therapy) (Renvert, Roos-Jansåker, Claffey, 2008; Renvert, Lindahl, Roos Jansåker, Persson, 2011; Bassetti et al. 2014; Schwarz et al. 2015, Renvert 2015, Mettreux et al. 2016). Despite these various treatment strategies, the most effective treatment option for treating peri-implantitis lesions in a non-surgical way remains unclear (Faggion, Listl, Frühauf, Chang, Tu, 2014; Renvert et al. 2019, Wang et al. 2019). However, among the previously investigated interventions the use of air-polishing is considered a promising treatment method (Schwarz, Becker, Renvert, 2015, Schwarz 2016). A myriad of in-vitro studies on air-polishing have appeared in the recent literature showing positive results on implant surface cleaning efficacy and surface damage (Tastepe et al. 2012, louropoulou 2014, Moharrami 2018). Clinically, air-polishing has been scarcely investigated in the treatment of peri-implantitis (Renvert et al. 2011, John et al. 2015). Previous studies reported small sample sizes, different peri-implantitis case 3