Microbial and inflammatory parameters during and after the non-surgical treatment of peri-implantitis

Subgingival anaerobic gram-negative bacteria are involved in peri-implantitis. Here, we evaluated the changes in red-complex periodontal pathogens and inflammatory cytokines during and after non-surgical treatment of peri-implantitis. Thirteen peri-implantitis patients with pocket depth ≥5 mm, peri-implant tissue inflammation, and significant bone resorption were treated with minocycline ointment in the pockets for four consecutive weeks. Before treatment and 1 and 2 months after treatment, five periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia) and total bacterial counts were determined from gingival crevicular fluid samples. Tumor necrosis factor-alpha (TNF-) and matrix metalloproteinase 8 (MMP-8) levels were also analyzed. P. gingivalis, T. forsythia, and T. denticola counts decreased significantly 1 and 2 months after treatment. T. forsythia and P. intermedia occurred in all, while A. actinomycetemcomitans was found in none of the peri-implantitis cases. P. gingivalis was significantly correlated with pocket depth. TNF- and MMP-8 levels decreased significantly after treatment. Pocket depth and bleeding on probing (BOP) decreased considerably 2 months after treatment. After 6 months, radiographic analysis showed no significant changes in bone loss. Although BOP was not perfectly controlled, our treatment approach reduced red-complex bacteria, inflammatory cytokines, and clinical parameters, improving inflammatory condition around the implant. Key words: Peri-implantitis, Periodontal pathogens, Cytokines