A Comparative Study for Peri-Implantitis: Minocycline Microspheres versus Chlorehexidine Gel

A Comparative Study for Peri-Implantitis: Minocycline Microspheres versus Chlorehexidine Gel
A. HANLON1, S. RENVERT2, F. DOHERTY1, and J. LESSEM1, 1 Orapharma Inc, Warminster, PA, USA, 2 Kristianstad University, Krishianstad, Sweden
March 2004
Clinical Implant Studies
The increased use of implants in reconstructive dentistry is leading to a higher prevalence of peri-implantitis lesions. Locally administered antibiotics offer an alternative to chlorhexidine or systemic antibiotic therapy for treatment of peri-implantitis. Objective: The aim of this study was to evaluate the clinical efficacy of a locally administered antibiotic, minocycline microspheres (MM), compared to a control application of 1% chlorhexidine gel for treatment of peri-implantitis.
Methods: In a single center pilot study, 30 patients were randomly assigned to test or control treatment as defined by a unit dose of MM or 1% chlorhexidine gel administered to all study implant sites. Study implant sites were defined as all sites with probing depth of =4mm. The study endpoints were reduction of pocket depth (PD) and bleeding on probing (BOP) as observed on Days 10, 30, 90, and 360 following initial treatment. Univariate comparisons across treatments were accomplished using two-tailed t-tests with the patient as the unit of measure.
Results: Mean PD's observed at Baseline, Day 10, 30, 90, and 360 were 3.9, 3.7, 3.7, 3.9, and 3.9mm for the control group and 3.9, 3.8, 3.6, 3.5, and 3.6mm for the MM group (p values for the reduction from Baseline are p=.82, p=.01, p=.0005, and p=.0007 respectively). Mean percentage of sites with BOP were 86%, 69%, 63%, 71%, and 78% for the control group and 88%, 56%, 40%, 45%, and 71% for the MM group (p=.10, p=.004, p=.002, and p=.20 for comparing reductions at Day 10, 30, 90 and 360, respectively).
Conclusion: The use of MM in patients with peri-implantitis compared to chlorhexidine gel is clinically and statistically more effective in reducing pocket depth and inflammation. The onset of pocket depth reduction is rapid and sustained. It is possible that re-treatment at 30 days would lead to additional benefit. Supported by OraPharma