Non-surgical treatment of mild to moderate peri-implantitis with an oscillating chitosan brush or a titanium curette-12-month follow-up of a multicenter randomized clinical trial.

OBJECTIVES: To study clinical and radiographic outcomes after non-surgical treatment of peri-implantitis using either an oscillating chitosan brush (OCB) or titanium curette (TC) and to observe changes in clinical signs of inflammation after repeated treatment. METHODS: Thirty-nine patients with dental implants (n = 39) presented with radiographic bone level (RBL) of 2-4 mm, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly assigned to mechanical debridement with OCB (test) or TC (control). Treatment was performed at baseline and repeated at 3, 6, and 9 months in cases with > 1 implant site with BI ≥ 1 and PPD≥4 mm. Blinded examiners recorded PPD, BI, pus, and plaque. The radiographic bone level change between baseline and 12 months was calculated. A multistate model was used to calculate transitions of BI. RESULTS: Thirty-one patients completed the study. Both groups exhibited a significant reduction in PPD, BI, and pus at 12 months compared to baseline. Radiographic analysis showed stable mean RBL in both groups at 12 months. There was no statistically significant difference in any of the parameters between the groups. CONCLUSIONS: Within the limitations of this 12-month multicenter randomized clinical trial, non-surgical treatment of peri-implantitis with OCB or TC showed no statistically significant differences between the groups. Clinical improvements and, in some cases, disease resolution, was observed in both groups. However, persistent inflammation was a common finding which further puts emphasis on the need for further treatment.

Non-surgical treatment of mild to moderate peri-implantitis using an oscillating chitosan brush or a titanium curette-A randomized multicentre controlled clinical trial.

OBJECTIVES: This prospective, parallel-group, examiner-blinded, multicentre, randomized, controlled clinical trial aimed to assess the efficacy of an oscillating chitosan brush (OCB) versus titanium curettes (TC) on clinical parameters in the non-surgical treatment of peri-implantitis. MATERIAL AND METHODS: In five dental specialist clinics, 39 patients with one implant with mild to moderate peri-implantitis, defined as 2-4 mm radiographic reduced bone level, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly allocated to test and control groups, receiving OCB or TC debridement, respectively. Treatment was performed at baseline and three months. PPD, BI, and Plaque index (PI) were measured at six sites per implant and recorded by five blinded examiners at baseline, one, three, and six month(s). Pus was recorded as present/not present. Changes in PPD and BI were compared between groups and analysed using multilevel partial ordinal and linear regression. RESULTS: Thirty-eight patients completed the study. Both groups showed significant reductions in PPD and BI at six months compared with baseline (p < .05). There was no statistically significant difference in PPD and BI changes between the groups. Eradication of peri-implant disease as defined was observed in 9.5% of cases in the OCB group and 5.9% in the TC group. CONCLUSIONS: Within the limitations of this six-month multicentre clinical trial, non-surgical treatment of peri-implantitis with OCB and TC showed no difference between the interventions. Eradication of disease was not predictable for any of the groups.

The Value of Visa-Score and Colour Flow Imaging in the Follow-Up of Non-Athletes Operated for Jumpers Knee.

The objective of this study was to assess if the Victorian Institute of Sport Assessment (VISA) questionnaire was suitable in the evaluation of patients from a mixed population with normal levels of sports activity, and if neovascularization of the patellar tendon demonstrated by color flow imaging (CFI) was more frequent in patients with lasting symptoms after surgical treatment for jumpers knee (JK). This study was conducted at St. Olavs Hospital, University Hospital of Trondheim, Norway, and included 21 men and 18 women who were operated for JK. Symptoms were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and VISA questionnaires. Clinical and ultrasonographic examinations of the knees, including CFI, were done at a mean follow-up duration of 82 (range, 16-136) months after surgery. Patients with positive CFI also had significantly lower KOOS scores, whereas the total VISA-P (Victorian Institute of Sport Assessment - Patella) score showed no association. Patients with a positive clinical examination had significantly more frequent positive CFI findings than did patients with negative examinations. The operated patellar tendon was significantly thicker and had more frequent hypoechoic signal in the proximal part than the contralateral unoperated tendon. The post-operative VISA-P score seems less valuable in the evaluation of patients from a mixed population with normal levels of sports activity. CFI may be a valuable diagnostic tool in the evaluation of patients operated for JK.