Effectiveness of Various Treatments on Ailing and Failing Dental Implants

BACKGROUND: Peri-implantitis is a phenomenon associated with implants that have been contaminated by bacteria. These ailing or failing implants are often infected with Gram-negative, anaerobic, motile rods such as Porphymonas Gingivalis. OBJECTIVE: To compare and contrast the efficacy of differing treatments on implants contaminated with Porphymonas Gingivalis, with emphasis on new Carbon-Dioxide Laser technology. METHODS: Eighteen implant replica discs were cultured with Porphymonas Gingivalis. The discs were then treated with five different modalities, including: saline, citric acid, Doxycycline, chlorohexidine, and a Carbon-Dioxide Laser. The discs were then visually observed for bacterial growth, and data was further analyzed using a colony count and a Gram stain. RESULTS: Visual examination showed that Doxycycline, citric acid, and chlorohexidine all had minimal bacterial growth following treatment, while the CO2-laser treated implants had slightly more. Upon counting the Colony Forming Units (CFU's) associated with each implant, Doxycycline had the least (72), followed by CO2-laser (161), chlorohexidine (162), citric acid (210), saline (239), and control (331), respectively. All of the colonies were Gram-variable, except for those associated with the citric acid treatments, which were solely Gram-positive. CONCLUSION: Under the scope of this experiment we conclude that a CO2-laser is not the most effective treatment in the management of peri-implantitis. The results of our culture counts indicate that Doxycycline is the best treatment at creating an implant surface that resists all types of bacterial growth. With regards to eradicating P. gingivalis, it appears that previous research indicating that citric acid is the best treatment, still holds true.