Periimplantitis: von der Diagnose zur Therapie. Ein neues Behandlungsprotokoll mit Pulverstrahlsystemen

This clinical practice article reviews the current state of peri-implantitis diagnosis and therapy, highlighting the lack of established gold standards. The authors discuss diagnostic challenges (probing depth interpretation, crestal bone loss thresholds, BOP as key parameter), prevention pillars (risk assessment, proper implant positioning, supportive periodontal therapy), and therapeutic approaches. Traditional instrumentation with curettes and ultrasonic scalers is critically evaluated regarding titanium surface damage and particle release. Air polishing with low-abrasive powders (glycine, erythritol) emerges as a promising alternative for biofilm removal without surface alterations. The article introduces the MAINST protocol (Multiple Anti Infective Non Surgical Therapy) developed at the University of Brescia, combining topical doxycycline 14% application, full-mouth erythritol air polishing (FM-EPAPT), PEEK ultrasonic debridement, and pocket curettage. Preliminary case series results show significant improvements in BOP and probing depth at 12 months.