Andrea Mombelli: Peri-implant anti-infective therapy

Peri-implantitis is an infection around implants associated with the presence of submucosal bacterial biofilm, with the biofilm microorganisms adhering and hiding on irregular surface structures such as the rough implant surface, crown margin areas and unfavorably designed restoration areas. Dr Mombelli presents what microrganisms are involved in the development of either periodontitis or peri-implantitis or both and discusses mechanical ways how to remove them, such as mechnical deplaquers and rotating titanium debridement brushes. Implantoplasty with rotating instruments risks to leave titanium tattoos due to titanium dust. Highlighting with a clinical patient treatment example, Dr Mombelli presents a basic treatment option comprising mechanical cleaning and saline decontamination, followed by an antibiotic therapy. To cover a sufficient broad spectrum of microoragnisms including anaerob species, Dr Mombelli suggests a combination of Metronidazol and Amoxicilline. Patient homecare is rinsing with CHX solution. Dr Mombelli concludes that peri-implantitis treatment can achieve some improvement, but there is no guarantee for healing or long-term resolution of the problem.