Erythritol air polishing in the surgical treatment of peri-implantitis: A randomized controlled trial

Clin Oral Implants Res. 2022 Feb;33(2):184-196. doi: 10.1111/clr.13881. Epub 2021 Dec 2.


Objectives: To compare erythritol air polishing with implant surface cleansing using saline during the surgical treatment of peri-implantitis.

Material and methods: During a resective surgical intervention, implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline-soaked cotton gauzes (control group n = 31 patients/ 40 implants). Primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow-up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full-mouth scores (PFMS), and levels of 8 classical periodontal pathogens. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann-Whitney U test.

Results: No differences between the test and control group were found for BoP over 12 months of follow-up, nor for the secondary parameters Plq, PPD, and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1-year follow-up, a successful treatment outcome (PPD<5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%).

Conclusions: Erythritol air polishing as implant surface cleansing method was not more effective than saline during resective surgical treatment of peri-implantitis in terms of clinical, radiographical, and microbiological parameters. Both therapies resulted in low treatment success.

Trial registry: Identifier: NL8621.

Keywords: dental implant; intervention study; peri-implantitis; randomized controlled trial; surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Implants*
  • Dental Polishing
  • Erythritol
  • Humans
  • Peri-Implantitis* / surgery
  • Periodontal Index
  • Treatment Outcome


  • Dental Implants
  • Erythritol