Treatment of peri-implant mucositis using subgingival polishing with erythritol powder: A clinical, immunological, microbiological and patient-centered evaluation.

• Grant number: 23/11923-4
• Support Opportunities: Regular Research Grants
• Start date: November 01, 2024
• End date: October 31, 2026
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Márcio Zaffalon Casati
• Grantee: Márcio Zaffalon Casati
• Host Institution: Vice-Reitoria de Pesquisa e Pós-Graduação. Universidade Paulista (UNIP). São Paulo , SP, Brazil
• Associated researchers: Mabelle de Freitas Monteiro ; Mônica Grazieli Corrêa ; Raissa Micaella Marcello Machado ; Suzana Peres Pimentel

Abstract

This randomized, split-mouth, clinical study aim to determine the effect of treating peri-implant mucositis with subgingival air-polishing with erythritol powder and chlorhexidine on 1) peri-implant clinical characteristics; 2) the local profile of anti- and pro-inflammatory mediators and factors related to bone metabolism - IL-1², IL-4, IL-6, IL-10, IL-17, TGF-², TNF-±, INF-³, DKK1, OC, OPN, OPG, SOST, RANKL, MMP-1, MMP-2, MMP-9- present in the peri-implant fluid; 3) the peri-implant microbiome and 4) patient-centered outcomes. Twenty individuals presenting a fixed-implant-supported mandibular rehabilitation - protocol type - supported by 4 or 6 implants in function for more than 12 months and that present peri-implant mucositis will be included in the study. The implants in each patient will be divided into two groups: 1) Control (2 implants) - treatment of mucositis with ultrasonic instrument and polishing with a rubber cup; and 2) Test (2 implants) - treatment of mucositis using subgingival polishing with Erythritol powder. Patients will be assessed at baseline, 3 and 6 months for clinical evaluation, collection of peri-implant fluid and submucosal biofilm. The imunoenzymatic levels of bone and inflammatory markers will be evaluated using the Luminex/MAGpix platform. The submucosal microbiome will be assessed by sequencing the V3-V4 region of the 16S rRNA gene and bioinformatics analysis. The patient-centered outcomes will be performed at the end of the mucositis treatment and 24 hours after the procedure. Two-way ANOVA and mixed generalized models will be used to compare the data between groups during the follow-up periods. A significance level of 5% will be used for all analysis. (AU)