Recubrimiento radicular de recesiones gingivales con matriz dérmica acelular / Root coverage of gingival recession with acellular dermal matrix

La recesión gingival es considerada como una deformidad o condición mucogingival, la Academia Americana de Periodontología, define a la recesión gingival como el desplazamiento del margen del tejido blando apical a la unión cemento-esmalte con la exposición de la superficie radicular. El tratamiento de las recesiones gingivales es un motivo de consulta común debido a razones estéticas, hipersensibilidad dentinaria, molestias durante el cepillado e incluso temor a la pérdida dentaria. Es una situación clínica común, 60% de la población humana tiene algún tipo de recesión gingival. Al realizar el examen clínico a paciente masculino de 55 años, se observó una recesión gingival tipo 1 (RT1) sin pérdida de inserción interproximal de la clasificación de Cairo. Se realizó el colgajo posicionado coronalmente (CPC) utilizando una matriz dérmica acelular (MDA) de origen humano OrACELL®. Se obtuvo resultado favorable en el recubrimiento de recesiones gingivales múltiples; considerándolos como una buena alternativa frente a los injertos gingivales autógenos. Concluyendo que, el uso de la matriz dérmica acelular para el tratamiento de la recesión gingival tipo 1 es una adecuada opción para el recubrimiento radicular. Se recomiendan más estudios a largo plazo para ver la estabilidad de los resultados obtenidos con la MDA (AU)

Gingival recession, considered a deformity or mucogingival condition, the American Academy of Periodontology, defines gingival recession as the exposure of the root surface resulting from migration of the gingival margin apical to the cementoenamel junction (CEJ). The treatment of gingival recessions is a common reason for consultation due to aesthetic reasons, dentin hypersensitivity, discomfort during brushing and even fear of tooth loss. It is a common clinical situation, 60% of the human population has some kind of gingival recession. Clinical examination of a 55-year-old male patient showed a type 1 gingival recession (RT1) without loss of interproximal insertion of the Cairo classification. Coronally advanced flap (CAF) was performed using an acellular dermal matrix (ADM) of human origin OrACELL®. Favorable results were obtained in the coating of multiple gingival recessions; considering them as a good alternative to autogenous gingival grafts. Concluding that, the use of the acellular dermal matrix for the treatment of gingival recession type 1, is a suitable option for root lining. Further long-term studies are recommended to see the elasticity of MDA outcomes (AU)

Prevalencia e indicadores de riesgo de recesiones gingivales en adolescentes de Valdivia en el año 2018 / Prevalence and risk indicators of gingival recessions in school senior students in the city of Valdivia in 2018

OBJETIVO: Determinar la prevalencia de recesiones gingivales e identificar indicadores de riesgo, en estudiantes de cuarto medio de la ciudad de Valdivia en el año 2018. MATERIAL Y MÉTODOS: Estudio de corte transversal. Se midió la prevalencia, distribución y tipo de recesión gingival según clasificación de Miller en estudiantes de cuarto medio de establecimientos públicos y subvencionados de la ciudad de Valdivia, seleccionados mediante muestreo aleatorio estratificado. Dos examinadores calibrados realizaron un examen clínico utilizando una sonda periodontal carolina del norte y un cuestionario escrito individual a cada estudiante para evaluar indicadores de riesgo. Los datos fueron tabulados y el análisis estadístico se realizó usando el programa estadístico SPSS 18 (IBM® SPSS® software). RESULTADOS: Se examinaron 310 estudiantes. La prevalencia encontrada fue de 68,4%. La Clase I de Miller se presentó en un 97,7%. La arcada mandibular con un 64,8% presentó mayor prevalencia de recesiones gingivales y los premolares inferiores fueron los dientes más afectados con un 47,7%. CONCLUSIÓN: Existe una alta prevalencia de recesiones gingivales en la población estudiada. Los estudiantes de establecimientos públicos presentan significativamente mayor prevalencia de recesiones gingivales y menor frecuencia de cepillado.

AIM: To determine the prevalence of gingival recessions and identify risk indicators in school senior students in the city of Valdivia in 2018. MATERIAL AND METHODS: Descriptive observational study. Prevalence, distribution and type of gingival recession were measured according to Miller classification in school senior students of public and charter establishments in the city of Valdivia, selected by stratified random sampling. A clinical examination was performed by two calibrated examiners using a North Carolina periodontal probe and an individual written questionnaire for each student to assess risk indicators. A descriptive analysis was performed using the statistical program SPSS 18 (IMB® SPSS® software). RESULTS: 310 students were examined. The prevalence found of at least one gingival recession was 68.4%. Miller's Class I was present in 97.7%. The jaw presented a higher prevalence of gingival recessions with 64.8% and the lower premolars were the most affected teeth with 47.7%. CONCLUSION: There is a high prevalence of gingival recessions in the population studied. Students in public establishments have a higher prevalence of recessions and a lower frequency of tooth brushing.

Recesión gingival y su efecto en la hipersensibilidad dentinaria / Gingival recession and its effect on dentin hypersensitivity

La exposición de dentina radicular asociada a una recesión gingival puede producir dolor ante distintos estímulos, situación que puede difi cultar la vida cotidiana de los pacientes que lo padecen, además de presentar complicaciones estéticas que pueden afectar la autoestima. La hipersensibilidad dentinaria tiene una etiología asociada a múltiples factores, siendo el principal factor de riesgo la recesión gingival, situación clínica común que se observa en gran parte de la población. El propósito de esta revisión es reunir distintos conceptos que expliquen la asociación que mantienen estas dos patologías, sus etiologías, el cuadro clínico que presenta la hipersensibilidad dentinaria para poder realizar un diagnóstico diferencial y las distintas opciones de tratamiento para realizar un adecuado manejo de esta condición que incluyen desde recursos terapéuticos que buscan resolver la sintomatología hasta procedimientos quirúrgicos que resultan más invasivos y que se enfocan en tratar el factor predisponente como es la recesión gingival misma (AU)

Dentin exposure level periodontal tissues can cause pain to diff erent stimuli, a situation which can hinder the daily lives of patients who suff er, in addition to having aesthetic complications that can damage self-esteem. Dental hypersensitivity has a multifactorial etiology associated being the main risk factor gingival recession, the common clinical situation observed in much of the population. The purpose of this review is to bring together various concepts that explain the association that maintain these two pathologies, their etiologies, clinical picture presented dentine hypersensitivity to perform a diff erential diagnosis and treatment options for proper management of this condition ranging from therapeutic procedure seeking to resolve the symptoms to surgical procedures that are more invasive and that focus on treating the predisposing factor such as the gingival recession itself (AU)

The Laterally Closed Tunnel for the Treatment of Deep Isolated Mandibular Recessions: Surgical Technique and a Report of 24 Cases.

Predictable coverage of deep isolated mandibular gingival recessions is one of the most challenging endeavors in plastic-esthetic periodontal surgery, and limited data is available in the literature. The aim of this paper is to present the rationale, the step-by-step procedure, and the results obtained in a series of 24 patients treated by means of a novel surgical technique (the laterally closed tunnel [LCT]) specifically designed for deep isolated mandibular recessions. A total of 24 healthy patients (21 women and 3 men, mean age 25.75 ± 7.12 years) exhibiting one single deep mandibular Miller Class I (n = 4), II (n = 10), or III (n = 10) gingival recession ≥ 4 mm were consecutively treated with LCT in conjunction with an enamel matrix derivative (EMD) and palatal subepithelial connective tissue graft (SCTG). The following clinical parameters were assessed at baseline and 12 months postoperatively: probing depth (PD), clinical attachment level (CAL), complete root coverage (CRC), mean root coverage (MRC), recession depth (RD), and keratinized tissue width (KTW). The primary outcome variable was CRC. The postoperative morbidity was low, and no complications, such as bleeding, infections/abscesses, or loss of SCTG, occurred. At 12 months, CRC was obtained in 17 of the 24 defects (70.83%), while in the remaining 7 defects RC amounted to 80% to 90% (in 6 cases) and 79% (in 1 case). Of the 17 defects exhibiting CRC, 12 were central incisors and 5 were canines. With respect to defect type, CRC was found in 3 of the 4 Miller Class I, 8 of the 10 Class II, and in 6 of the 10 Class III defects. Mean RD changed from 5.14 ± 1.26 mm at baseline to 0.2 ± 0.37 mm at 12 months, while MRC amounted to 4.94 ± 1.19 mm, representing 96.11% (P < .0001). Mean KTW increased from 1.41 ± 1.00 mm at baseline to 4.14 ± 1.67 mm (P < .0001) at 12 months, yielding a KTW gain of 2.75 ± 1.52 (P < .0001). No statistically significant changes in mean PD occurred following root coverage surgery (1.8 ± 0.2 mm at baseline and 2.1 ± 0.3 mm at 12 months). The present results suggest that the LCT is a valuable approach for the treatment of deep isolated mandibular Miller Class I, II, and III gingival recessions.

Sub-epithelial connective tissue graft for the management of Miller's class I and class II isolated gingival recession defect: A systematic review of the factors influencing the outcome.

The aim of the present systematic review was to analyze the factors that affect the outcome of subepithelial connective tissue graft (SCTG) for managing Miller's class I and class II isolated gingival recession defect. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews were used. Quality assessments of selected articles were performed. Data on root surface condition, recession type defect, flap thickness, different flap designs, different harvesting techniques, presence/absence of the epithelial collar, graft thickness, flap tension, suturing techniques, and smoking-related outcomes on root coverage were assessed. The SCTG procedure provides the best root coverage outcomes for Miller's class I and class II recession. The critical threshold of flap thickness was found to be 1 mm. Maximum root coverage was achieved by envelope and modified tunnel technique. SCTG with the epithelial collar does not provide additional gains than SCTG without the epithelial collar. The thickness of SCTG for root coverage was found to be 1.5-2 mm. Greater flap tension and smoking adversely affect root coverage outcomes. Analysis of the factors discussed would be of key importance for technique selection, and a combined approach involving factors favoring outcomes of SCTG could be of clinical relevance in recession coverage.

Treatment of single and multiple Miller Class I and III gingival recessions at crown-restored teeth in maxillary esthetic areas.

OBJECTIVE: To clinically evaluate the outcomes following surgical coverage of single and multiple Miller Class I and III gingival recessions at crown-restored teeth in the esthetic area by means of the modified coronally advanced tunnel (MCAT). METHOD AND MATERIALS: Eight systemically healthy patients (5 females) with a total of 23 single or multiple maxillary Miller Class I or III gingival recessions were consecutively treated with MCAT in conjunction with a subepithelial connective tissue graft (SCTG). Out of the 23 recessions, 16 were classified as Miller Class I and seven as Miller Class III. All patients presented at least one facial gingival recession at a crown-restored tooth, located in the maxillary anterior area. In all cases, the facial recession was associated with an impaired esthetic appearance. Clinical measurements were made at baseline (immediately before reconstructive surgery) and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (ie, 100% root coverage). RESULTS: Healing was uneventful in all cases. At 12 months, statistically highly significant (P < .0001) root coverage was obtained in all patients and defects. CRC was obtained in 22 out of the 23 recessions (in 16 Miller Class I and in six out of the seven Miller Class III recessions). In one Miller Class III recession, root coverage measured 89.10%. The treatment yielded a mean root coverage of 92.62% and 3.75 mm, respectively, and was associated with a mean gain of keratinized tissue width of 0.62 ± 1.15 mm (P < .05). CONCLUSION: Within their limits, the present findings indicate that MCAT in conjunction with SCTG represents a valuable option for treating single and multiple gingival recessions at crown-restored teeth in the maxillary esthetic area thus avoiding the replacement of the prosthetic restorations.

A Novel Modification of Semilunar Coronally Advanced Flap for the Treatment of Gingival Recession: Case Series.

This article aims to describe a modification of the semilunar coronally advanced flap. A total of 12 systemically and periodontally healthy patients presenting Miller Class I gingival recession were treated with the modified semilunar coronally advanced flap technique described in this article. After 1 year of follow-up, the mean root coverage was 85.4% ± 24.7%. Significant gingival recession reduction, clinical attachment gain, and reduction in dentin sensitivity was observed 1 year after surgery. This novel semilunar coronally advanced flap technique was demonstrated to be effective for root coverage in Miller Class I gingival recessions.

[Root coverage: Prognostic factors and surgical techniques]. / Le recouvrement radiculaire : facteurs pronostiques et techniques chirurgicales.

Gingival recession is an oral exposure of the root surface due to an apical displacement of the gingival margin below the cemento-enamel junction. The root coverage is indicated for esthetic reasons, to reduce root hypersensitivity and to create or to augment keratinized tissue. Several surgical techniques have been described, the decision depending on anatomical and technical parameters. The main therapeutic goal is to achieve complete root coverage (CRC) and a satisfactory esthetic result. The purpose of this work was to make an update on the different factors that determine the success of root coverage and to evaluate the efficacy of different surgical techniques reported in literature.

Treatment of multiple adjacent maxillary Miller Class I, II, and III gingival recessions with the modified coronally advanced tunnel, enamel matrix derivative, and subepithelial connective tissue graft: A report of 12 cases.

OBJECTIVE: To clinically evaluate the healing of multiple adjacent maxillary Miller Class I, II, and III gingival recessions (MAGR) treated with the modified coronally advanced tunnel (MCAT) in conjunction with an enamel matrix derivative (EMD) and subepithelial connective tissue graft (SCTG). METHOD AND MATERIALS: Twelve systemically healthy patients (6 females) with a total of 54 adjacent maxillary Miller Class I, II, or III MAGR were consecutively treated with MCAT in conjunction with EMD and SCTG. Out of the 54 recessions, 44 were classified as Miller Class I, five as Miller Class II, and five as Miller Class III. Patients were included in the study if they presented at least two adjacent recessions with a depth of ≥ 3 mm. Measurements were made at baseline (immediately before reconstructive surgery) and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (ie, 100% root coverage). RESULTS: Healing was uneventful in all cases without any complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG. At 12 months, statistically highly significant (P < .0001) root coverage was obtained in all patients and recessions. CRC was obtained in 37 Miller Class I, three Miller Class II, and one Miller Class III recessions, respectively. Mean root coverage was 96%. Mean keratinized tissue width increased statistically highly significantly (P < .004) from 2.04 ± 0.95 mm at baseline to 2.37 ± 0.89 mm at 12 months. CONCLUSION: The present findings indicate that the proposed treatment concept results in predictable coverage of multiple adjacent maxillary Miller Class I, II, and III MAGR.

Root Coverage in Smokers with Acellular Dermal Matrix Graft and Enamel Matrix Derivative: A 12-Month Randomized Clinical Trial.

This study investigated whether enamel matrix derivative (EMD) contributes to root coverage of gingival recessions performed with acellular dermal matrix graft (ADMG) in smokers during a 12-month follow-up. A sample of 19 smokers presenting bilateral Miller Class I or II gingival recessions were included. Selected sites randomly received both ADMG and EMD (test) or ADMG alone (control). Probing depth, clinical attachment level, gingival recession height, keratinized tissue, and root coverage were evaluated. Mean gain in recession height (P < .05), sites with complete root coverage (P < .05), and percentage of root coverage (59.7% and 52.8%, respectively) favored the test group compared with the control group.

Tratamiento de recesión única de clase III con injerto libre subepitelial mediante técnica de colgajo de doble papila reposicionado: informe de un caso clínico / Treatment of a single Class III recession combining free subepithelial connective tissue graft and a double papilla repositioned flap: report of a clinical case

Objetivo: mostrar y evaluar los resultados clínicos de un procedimiento de cirugía plástica periodontal, efectuada para cubrir una recesión radicular de clase III de Miller, con una técnica bilaminar. Además, analizar el aumento de la banda de encía y el cambio de biotipo gingival de la pieza dentaria. Caso clínico: paciente femenino de 30 años de edad, con una recesión gingival de Clase III de Miller por vestibular de la pieza 43 que no sobrepasa la línea mucogingival, con pérdida interproximal de tejidos duros y blandos. El tratamiento consiste en un colgajo de doble papila a espesor parcial, con injerto libre subepitelial tomado del paladar, con seguimiento a 1 año. Conclusiones: la técnica bilaminar es una solución viable en casos de recubrimiento radicular poco predecibles, como la recesión de clase III de Miller. El biotipo gingival se vio engrosado y la encía queratinizada no sufrió variaciones.

Gingival recession: its causes and types, and the importance of orthodontic treatment

abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature.

Resumo As recessões gengivais têm causas diretas e fatores predisponentes. O tratamento ortodôntico pode prevenir as recessões e, até, contribuir para o seu tratamento, com ou sem uma abordagem por parte do periodontista, dependendo do tipo e da severidade do comprometimento dos tecidos gengivais. Não há evidências de que o tratamento ortodôntico possa induzir, de forma primária, as recessões gengivais, muito embora possa levar os dentes envolvidos (comumente, os incisivos inferiores e os caninos superiores) a situações que ajam como fatores predisponentes para que as causas diretas possam atuar e produzir recessões - em especial, quando deixa-se uma tábua óssea vestibular muito fina ou, até, com deiscência. Vários aspectos da relação entre o tratamento ortodôntico e as recessões gengivais já foram abordados, assim como a importância do periósteo no mecanismo de formação delas. Trabalhos clínicos e experimentais sobre o assunto ajudariam a esclarecer o assunto, que ainda se apresenta muito pouco aprofundado na literatura pertinente.

The Octagon Model: a clinical tool for assessing marginal tissue recession.

The Octagon Model is a clinical assessment tool designed to assess marginal tissue recession (MTR) and estimate the level of difficulty in achieving root coverage. It evaluates eight patient- and siterelated factors: patient's expectations, smoking status, width of keratinized tissue, absence/presence of cervical lesion, interproximal soft tissue/bone level, depth and width of recession defect, and buccal bone thickness. The model is presented in a three-colored diagram to facilitate communication between clinicians and between clinicians and their patients, and to assist clinicians in optimizing treatment plans at both site and patient levels.

Peri-implant Hard and Soft Tissue Stability in Implants Placed Simultaneously Versus Delayed with Intraoral Block Bone Grafts in Horizontal Defects: A Retrospective Case Series Study.

PURPOSE: To compare the 3-year outcome of dental implants placed simultaneously or delayed with intraoral onlay block bone grafts. MATERIALS AND METHODS: A retrospective study was conducted of patients subjected to localized lateral alveolar ridge augmentation with intraoral onlay autogenous block bone grafts before or at implant placement between 2005 and 2010 in the Oral Surgery Unit of the University of Valencia (Valencia, Spain). The parameters evaluated at follow-up visits were implant survival and success rates, peri-implant soft tissue conditions (Plaque Index and Bleeding Index, probing depth, width of keratinized mucosa, and facial mucosal retraction), radiographic peri-implant marginal bone loss, and patient satisfaction. RESULTS: Thirty-four patients with 53 implants (23 delayed and 30 simultaneous) were included. After 3 years of loading, the cumulative implant success rate was 83.3% for simultaneous and 96.9% for delayed implants (P = .217). Average marginal bone loss was 1.15 ± 1.67 mm for simultaneously inserted implants and 0.29 ± 0.35 mm for delayed implants (P < .01). There were no significant differences in Plaque Index or modified Bleeding Index between the groups. Peri-implant facial mucosal recession was more frequent in the simultaneous implant group (26.6% vs. 13%), though the difference was not statistically significant. General patient satisfaction averaged 9.05 ± 0.82, and good quality of life was reported by all patients. CONCLUSION: Despite its sample size and design limitations, the delayed procedure showed less marginal bone loss and a lower prevalence of facial mucosal recession than the simultaneous implant placement procedure at 3 years postloading.

Treatment of Multiple Adjacent Miller Class III Gingival Recessions with a Modified Tunnel Technique: A Case Series.

Modified coronally advanced tunnel (MCAT) technique with connective tissue graft (CTG) was used in treating multiple adjacent Miller Class III gingival recessions in nine patients. Clinical evaluations were recorded at baseline and 12 months after surgery. The results showed that 50% of complete root coverage and 78% of mean root coverage were attained 1 year after surgery and interdental space fill was 73% at 12 months. The study demonstrated that CTG using the MCAT technique may be an efficient way to treat multiple adjacent Miller Class III gingival recessions, especially when aiming for interdental space fill. Success, however, seems to be related to the amount of tissue present initially.

Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study.

BACKGROUND: Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. The authors seek to examine to what extent periodontal disease is associated with kidney function decline. METHODS: This retrospective cohort study examines 699 African American participants with preserved kidney function (defined by estimated glomerular filtration rate (eGFR) >60 mL/minute/1.73 m(2) at baseline) who underwent complete dental examinations as part of the Dental-Atherosclerosis Risk in Communities study (1996 to 1998) and subsequently enrolled in the Jackson Heart Study (2000 to 2004). Using multivariable Poisson regression, the authors examined the association of periodontal disease (severe versus non-severe) with incident CKD, defined as incident eGFR <60 mL/minute/1.73 m(2) and rapid (5% annualized) eGFR decline at follow-up among those with preserved eGFR at baseline. RESULTS: Mean (± SD) age at baseline was 65.4 (± 5.2) years, and 16.3% (n = 114) had severe periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow-up of 4.8 (± 0.6) years. Compared with participants with non-severe periodontal disease, those with severe periodontal disease had a four-fold greater rate of incident CKD (adjusted incidence rate ratio 4.18 [95% confidence interval 1.68 to 10.39], P = 0.002). CONCLUSIONS: Severe periodontal disease is prevalent among a population at high risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration.

Bias in estimating the cross-sectional smoking, alcohol, obesity and diabetes associations with moderate-severe periodontitis in the Atherosclerosis Risk in Communities study: comparison of full versus partial-mouth estimates.

OBJECTIVE: To assess whether partial-mouth protocols (PRPs) result in biased estimates of the associations between smoking, alcohol, obesity and diabetes with periodontitis. METHODS: Using a sample (n = 6129) of the 1996-1998 Atherosclerosis Risk in Communities study, we used measures of probing pocket depth and clinical attachment level to identify moderate-severe periodontitis. Adjusting for confounders, unconditional binary logistic regression estimated prevalence odds ratios (POR) and 95% confidence limits. Specifically, we compared POR for smoking, alcohol, obesity and diabetes with periodontitis derived from full-mouth to those derived from 4-PRPs (Ramfjörd, National Health and Nutrition Examination survey-III, modified-NHANES-IV and 42-site-Random-site selection-method). Finally, we conducted a simple sensitivity analysis of periodontitis misclassification by changing the case definition threshold for each PRP. RESULTS: In comparison to full-mouth PORs, PRP PORs were biased in terms of magnitude and direction. Holding the full-mouth case definition at moderate-severe periodontitis and setting it at mild-moderate-severe for the PRPs did not consistently produce POR estimates that were either biased towards or away from the null in comparison to full-mouth estimates. CONCLUSIONS: Partial-mouth protocols result in misclassification of periodontitis and may bias epidemiologic measures of association. The magnitude and direction of this bias depends on choice of PRP and case definition threshold used.

Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial.

AIM: To evaluate the clinical treatment effects of a glycine powder air-polishing or ultrasonic device on peri-implant mucositis. MATERIALS AND METHODS: Thirty-seven patients with one implant diagnosed with peri-implant mucositis (probing depth ≥4 mm (0.2N) and bleeding on probing (BOP) (primary outcome)) were randomly assigned to treatment with either glycine powder air-polishing (GPAP) or ultrasonic (US) debridement. Treatment was performed at baseline and at 3 and 6 months. Professional supra gingival cleaning was performed at 9 and 12 months. Oral hygiene instructions were reinforced at each visit. RESULTS: At 12 months there was a statistically significant reduction in mean plaque score, bleeding on probing and number of periodontal pockets ≥4 mm within the treatment groups compared to baseline. The percentages of diseased sites were significantly reduced for both groups. CONCLUSIONS: Treatment with a glycine powder air-polishing or an ultrasonic device is effective in non-surgical treatment of peri-implant mucositis.