Uso adjuvante de irrigadores orais na higiene bucal em terapia de manutenção periodontal / peri-implantar desfechos clínicos e microbiológicos em um seguimento de 7 anos

Abstract

No long-term prospective studies investigating the influence of the use of oral irrigators (OIs) as an adjunct to conventional oral hygiene (OH) procedures during periodontal/peri-implant maintenance therapy (PMMT) have been reported. The aim of this study was to compare and longitudinally evaluate the peri-implant, periodontal and microbiological conditions of regular cooperators (RCs) in PMMT who perform conventional OH (manual/interdental brushing and dental floss) compared with those who add OIs to conventional OH. In a prospective PMT program over 7 years, 51 RCs were considered eligible for this study (non-smokers, non-diabetics, both genders and without age limit). Based on the use of OIs for conventional OH, two groups were categorized: 1) Conventional OH [(manual brushing/dental flossing) + interdental brushes [OH; n=27]) and 2) Conventional HO + IOs (OH+IOs; n=24). Periodontal and peri-implant examinations, in addition to microbiological evaluations, were performed at two time points: T1 (first consultation for TMP after adherence to the use of IOs) and T2 (after 7 years). The levels of total bacterial load, Tanerella forsythia, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Actinomyces naeslundii were evaluated by real-time polymerase chain reaction (q-PCR). The OH+IOs group presented better peri-implant and periodontal clinical parameters, with lower counts of total bacterial load, T. denticola and F. nucleatum in peri-implant and periodontal sites compared to the OH group. Furthermore, the OH+IOs group showed a significantly greater reduction in plaque index between T1 and T2, revealing an additional positive effect of IOs. In the long term, RCs in TMPP achieved clinical and microbiological benefits in both groups. However, the OH+IOs group demonstrated significantly better peri-implant and periodontal clinical parameters, with lower counts of total bacterial load, T. denticola and F. nucleatum compared to the OH group.