Objective: Compared to periodontal literature, the knowledge on the effect of local antibiotic delivery systems on peri-implantitis therapy is very limited. The purpose of this study is to determine the possible clinical and microbiological effects of tetracycline-HCl coated etylene vinyl acetate fiber on peri-implantitis therapy.

Material and Methods: 10 recall patients presenting at least 2 sites with peri-implantitis at 2 different quadrants were included into the study (total of 32 implants). The control group included 16 implants treated with only subgingival curettage. Remaining implants received 25% tetracycline-HCl coated etylene vinyl acetate fiber (ActisiteŽ) following subgingival curettage. Clinical measurements and peri-implant pocket microbiological samples were obtained prior and 1, 3 and 6 months post therapy. These samples were cultured for total bacterial count anaerobically and in 10% carbondioxide+air using selective and nonselective media.

Results: There was no statistical difference between the two groups for various clinical parameters (P>0.05, Mann-Whitney U test and Friedman test). Compared to the baseline values, probing depth was decreased in both groups at 1st month following therapy and stayed decreased during 6 months (P<0.05, Dunn's multiple comparison test). Significant decrease in clinical attachment loss was mainly due to slight decrease in gingival recession in both groups (P<0.05). This, in turn, appeared to occur as a result of inflammatory resolution. Microbiological findings revealed a statistically significant decrease in anaerobic bacterial count in both groups at 1 month post therapy (P<0.05). The difference seen at first month did not continue during follow-up period.

Conclusion: Within the limits of this study, we concluded that tetracycline-HCl coated fiber application following subgingival curettage has no additional benefit to improve clinical and microbiological parameters in peri-implantitis therapy. Further studies are needed to develop treatment modalities for detoxification of exposed implant surfaces. (This study was supported by Istanbul University Research Funds, project number T-887/17072000)

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