Diederik Hentenaar

83 Erythritol air-polishing in surgical peri-implantitis treatment Participants Eligibility criteria Between December 2016 and January 2019, 62 patients were screened for eligibility by one and the same researcher (D.H.). The last follow-up visit took place in February 2020. Eligible participants had at least one dental implant with persisting signs of inflammation 3 months after the preceding non-surgical intervention (probing pocket depth (PPD ≥ 5mm with concomitant bleeding and/or suppuration on probing (BoP/SoP) and progressive loss of marginal bone (MBL) ≥ 2mm, when compared to the baseline radiograph (after placement of the definitive restoration) (de Waal, et al., 2013). All the patients’ eligible implants were included for clinical, radiographical and microbiological assessment. A patient was excluded when there was a history of local head and neck radiotherapy, pregnancy and/or lactation, uncontrolled diabetes mellitus (HbA1c > 7% or > 53 mmol/mol), use of antibiotics within 2 months before the baseline assessment, known allergy to chlorhexidine, long-term use of anti-inflammatory drugs, incapability of performing basal oral hygiene measures, implants with bone loss exceeding 2/3 of the length of the implant, implant mobility, chronic bronchitis and/or asthma. Periodontal full mouth plaque and bleeding levels were required to be ≤ 20%. Before participation, oral and written information about the study was provided. All patients signed a written informed consent prior to enrolment. Setting and location All patients were consecutively recruited from the patient population of the Center of Dentistry and Oral Hygiene and the Department of Oral and Maxillofacial Surgery of the University Medical Center Groningen in the Netherlands. This single-center study was performed at the Department of Oral and Maxillofacial Surgery of the University Medical Center Groningen. Surgical intervention Prior to the surgical intervention, all patients underwent a non-surgical treatment in which they received extensive oral hygiene instructions, periodontal cleaning and a single mechanical peri-implant supra- and submucosal debridement with either air- polishing or piezoelectric ultrasonic scaling. Screw retained implant suprastructures were removed before surgery if reasonably possible. Surgery was performed by two experienced implant clinicians within the group of authors (G.R., Y.d.W.). The surgical resective procedure was performed under local anesthesia. After the incision, one or more millimetres under the level of the marginal gingiva in order to remove the inflamed soft tissue collar and create pocket reduction, a full-thickness flap was elevated at the buccal and lingual aspect of the affected implants. Subsequently, granulation tissue was removed using handinstruments (Hu Friedy ® , Chicago, IL, USA). Calculus, if 4