Nonsurgical debridement with chlorhexidine effectively reduces implant-sites bleeding on probing: Study

A new study published in the journal of Clinical Oral Implant Research showed that nonsurgical mechanical debridement with chlorhexidine was more effective in lowering bleeding on probing (BOP) at implant sites when compared to a placebo.

When there is bleeding (more than one spot at the site around the implant) and/or suppuration on gentle probing, it is known as peri-implant mucositis (PM), an inflammatory lesion in the soft tissue surrounding dental implants without peri-implant bone loss brought on by biofilm accumulation in the peri-implant sulcus. Even though dental implants have been shown to have rather constant survival rates at 95.7% after 5 years and 92.8% at 10 years which is acknowledged that peri-implantitis risk and growing marginal bone loss remain significant potential side effects.

Therefore, the main objective of PM therapy is to lessen the bleeding on probing surrounding implants, according to a recent international consensus study. Thus, Gaetano Isola and colleagues carried out this investigation to assess the efficacy of nonsurgical submarginal peri-implant instrumentation (NSPI) with or without chlorhexidine (CHX) solutions in treating peri-implant mucositis (PM).

The test group (NSPI + 0.12% mouthwash and subgingival CHX irrigation plus tongue brushing with 1% CHX gel) and the control group (NSPI + placebo mouthwash and subgingival placebo irrigation in addition to tongue brushing with placebo gel) were randomly allocated to 56 patients (28 each group).

The proportions of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were measured at baseline, 1, 3, and 6 months, as well as the full-mouth plaque score (FMPS), bleeding on probing (BOP), modified gingival index (mGI), probing pocket depth (PPD), modified plaque index (mPlI), and full-mouth bleeding score (FMBS).

One of the main goals was to lower the BOP. Data were examined using mixed generalized linear regression to find significant predictors of implant-site BOP and to evaluate BOP decrease at a 6-month follow-up.

Both groups showed a substantial decrease in BOP, mGI, PD, mPlI, FMBS, and FMPS after 6 months. At 6 months, however, the test group outperformed the controls in lowering the proportion of Treponema denticola, mPlI, and median BOP.

Additionally, test therapy, a history of periodontitis, smoking a lot of cigarettes per day, the percentage of Porphyromonas gingivalis, and Tannerella forsythia all had a substantial impact on the BOP decrease of implant sites.

Overall, at a 6-month follow-up, the current study shown that both therapeutic treatments increase microbiological and clinical parameters. However, BOP, mPll, and the percentage of T. denticola were all statistically significantly reduced when the test methodology was applied to NSPI.

Source:

Isola, G., Polizzi, A., Santagati, M., Alibrandi, A., Iorio-Siciliano, V., & Ramaglia, L. (2025). Effect of nonsurgical mechanical debridement with or without chlorhexidine formulations in the treatment of Peri‐implant mucositis. A randomized placebo‐controlled clinical trial. Clinical Oral Implants Research. https://doi.org/10.1111/clr.14405