Evaluation of dental hygiene prophylaxis systems on dental implants: randomized clinical trial of changes in oral health status

Abstract

This randomized clinical trial investigated the effectiveness of two professional biofilm decontamination protocols in the long-term maintenance of peri-implant health. The two approaches compared were erythritol-based air polishing and ultrasonic instrumentation with PEEK-coated tips. A total of 120 patients with at least one implant-supported crown—restored with feldspathic ceramic, zirconia, or lithium disilicate—were recruited and randomly assigned to one of the two treatment groups. Clinical parameters including probing pocket depth (PPD), bleeding on probing (BoP), and plaque index (PI) were recorded at baseline and at 6, 12, 18, and 24 months. Patients were also stratified according to the type of prosthetic crown, forming six distinct subgroups.

The results demonstrated that both treatment protocols led to statistically significant improvements in all clinical parameters over the 24-month follow-up period. However, patients treated with erythritol-based air polishing exhibited a more rapid and consistent reduction in PPD, BoP, and PI, achieving complete plaque control and absence of bleeding sites earlier than those treated with ultrasonic debridement. No significant differences were observed between subgroups based on crown material, suggesting that the effectiveness of both interventions was independent of the prosthetic material used.

In conclusion, while both methods proved effective in maintaining periimplant tissue health, erythritol-based air polishing emerged as the more efficient and clinically advantageous option. Its superior ability to control inflammation and biofilm accumulation supports its recommendation as a preferred strategy for longterm peri-implant maintenance.