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Strafela-Bastendorf N, Bastendorf KD:
PRACA POGLĄDOWA
ART DENT
Tom/Volumne 23; Numer/Number 2 (88)/2025: 106-118
E-ISSN 2392-2818
ISSN 2081-4798
Sprawdzona koncepcja praktyczna. Guided Biofilm Therapy (GBT) w niechirurgicznym leczeniu zapalenia tkanek okołowszczepowych
Proven practitical concept. Guided Biofilm Therapy (GBT) in the non-surgical treatment of peri-implantitis
Nadine Strafela-Bastendorf1,E,F, Klaus-Dieter Bastendorf1,E,F
¹ Familien-Zahnarztpraxis Strafela-Bastendorf, Eislingen, Niemcy
Authors’ Contribution: A - Study Design, B - Data Collection, C - Statistical Analysis, D - Data Interpretation, E - Manuscript Preparation, F - Literature Search, G - Funds Collection
Konflikt interesów: Autorzy oświadczają, że nie występuje konflikt interesów związany z publikacją niniejszego artykułu.
Finansowanie: Autorzy oświadczają, że praca nie była finansowana ze źródeł zewnętrznych.
Received: 10.10.2024. Accepted: 10.01.2025. Published: 22.08.2025
Prawa autorskie udzielone Wydawnictwu AS MEDIA
Kontakt z autorem: Nadine Strafela-Bastendorf, Gairenstraße 6, 73054 Eislingen, e-mail:
Cytowanie: należy cytować pierwotną, elektroniczną wersję artykułu: Strafela-Bastendorf N, Bastendorf KD: Sprawdzona koncepcja praktyczna. Guided Biofilm Therapy (GBT) w niechirurgicznym leczeniu zapalenia tkanek okołowszczepowych; Art Dent 2025;88(2):106-118.
Streszczenie
Celem opracowania jest przedstawienie zastosowania Guided Biofilm Therapy (GBT) jako systematycznego i ustrukturyzowanego podejścia do profilaktyki oraz niechirurgicznego leczenia zapalenia tkanek okołowszczepowych. W artykule przedstawiono praktyczny protokół obejmujący osiem etapów postępowania, od diagnostyki i ujawnienia biofilmu po indywidualnie zaplanowaną opiekę następową. Omówiono znaczenie kontroli biofilmu, odpowiedniego doboru metod i instrumentów do oczyszczania powierzchni implantów oraz edukacji pacjenta. Szczególną uwagę zwrócono na konieczność systematycznego monitorowania stanu tkanek okołowszczepowych i utrzymywania długoterminowej higieny. Ustrukturyzowany protokół GBT może stanowić praktyczne narzędzie wspierające profilaktykę i niechirurgiczne postępowanie w zapaleniu tkanek okołowszczepowych.
Słowa kluczowe:
biofilm, higienizacja, implanty stomatologiczne, profilaktyka, skaling, wybarwianie biofilmu, zapalenie tkanek okołowszczepowych
Summary
The aim of this article is to present Guided Biofilm Therapy (GBT) as a systematic and structured approach to the prevention and non-surgical management of peri-implant inflammation. A practical eight-step protocol is presented, covering the process from diagnosis and biofilm disclosure to individually planned supportive follow-up care. The importance of biofilm control, appropriate selection of methods and instruments for implant surface decontamination, and patient education is discussed. Particular attention is paid to systematic monitoring of peri-implant tissues and maintaining long-term oral hygiene. A structured GBT protocol may serve as a practical tool supporting prevention and non-surgical management of peri-implant inflammation.
Key words:
Biofilms, Dental Implants, Dental Scaling, Patient Education, Peri-Implantitis, Plaque, Prevention
PIŚMIENNICTWO/REFERENCES:
1. Axelsson P, Lindhe J: Effect on controlled oral hygiene procedures on caries and periodontal disease in adults; J Clin Periodontol 1978;5:133-151.
2. Marsh PD: Are dental diseases examples of ecolo¬gical catastrophes?;Clin Periodont 2004;31:749-757.
3. Klinge B; Hultin M, Berglundh T: Peri-implantitis; Dent Clin N Am 2005;49:661–676.
4. Roos-Jansåker AM, Renvert H, Lindahl C, Renvert S: Nine- to fourteen-year follow-up of implant treatment. Part III: Factors associated with peri-implant lesions; J Clin Periodontol 2006;33:296- 301.
5. Derks J, Tomasi C: Peri-implant health and disease. A systematic review of current epidemiology; J Clin Periodontol 2015;42,Suppl 16:158-171. doi: 10.1111/jcpe.12334.
6. Bäumer A, Toekan S, Saure D, Körne G: Survival and success of implants in a private periodontal practice: a 10-year retrospective study; BMC Oral Health 2020;30(1):92. doi: 10.1186/s12903-020-01064-z.
7. Khammissa RAG, Feller L, Meyerov R, Lemmer J: Peri-implant mucositis and peri-implantitis: clinical and histopathological characteristics and treatment; SADJ 2012;67(3):124-126.
8. Heitz-Mayfield LJA, Salvi GE: Peri-implant mucositis; J Clin Periodontol 2018;45Suppl 20:237-245. doi: 10.1111/jcpe.12953.
9. Schwarz F, Derks J, Monje A, Wand HL: Peri-implantitis; J Periodontol 2018;89Suppl 1:267-290. doi: 10.1002/JPER.16-0350.
10. Heitz-Mayfield LJA, Mombelli A: The therapy of peri-implantitis: a systematic review; Int J Oral Maxillofac Implants 2014;29:325-345.
11. Schwarz F, Ramanauskaite A: Die Behandlung der periimplantären Infektionen an Zahnimplantaten; zm 2023;740:50-55.
12. Tonetti MS, Chapple ILC, Jepsen S, Sanz M; Primary and secondary prevention of periodontal and peri-implant diseases–Introduction to, and objectives of the 11Th European workshop on periodontology consensus conference; J Clin Periodontol 2015;42(16):1–4. doi: 10.1111/jcpe.12382.
13. Strafela-Bastendorf N, Bastendorf KD: Prävention und Therapie periimplantärer Infektionen; zm 2016;106(11):1240.
14. Chetrus V, Ion IR: Dental plaque-classification, formation and identification; International Journal of Medical Dentistry 2013;3(2):139-143.
15. Bastendorf-Strafela N, Bastendorf KD, Mann P: Pilotstudie-Verbessert das Anfärben der Plaque die Ergebnisse der PZR; PlaqueNcare 2016;10(2):91-93.
16. Mensi M, Scotti E, Sordillo A, Agosti R, Calza S: Plaque disclosing agent as a guide for professional biofilm removal: A randomized controlled clinical trial; Int J Dent Hygiene 2020;18(3):285-294.
17. Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G, Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R, Needleman I, Newton T, Nibali L, Pretzl B, Ramseier C, Sanz-Sanchez I, Schlagenhauf U, Suvan JE, Fabrikant E, Fundak A: Principles in prevention of periodontal diseases–Consensus report of group 1 of the 11th European workshop on periodontology on effective prevention of periodontal and peri-implant diseases; J Clin Periodontol 2015;42(16):5–11. doi: 10.1111/jcpe.12368.
18. Figuero E, Graziani F, Sanz I, Herrera D, Sanz M: Management of periimplant-mucositis and periimplantitis – review; Periodontol 2000 2014;66(1):255-73. doi:10.1111/prd.12049.
19. Jepsen S, Berglundh T, Genco R, Aass AM, Demirel K, Derks J, Figuero E, Giovannoli JL, Goldstein M, Lambert F, Ortiz-Vigon A, Polyzois I, Salvi GE, Tomasi C, Zitzmann NU: Primary prevention of periimplantitis: managing peri-implant mucositis; J Clin Periodontol 2015;42(16):152-157. doi: 10.1111/ jcpe.12369.
20. Serino G, Ström C: Peri-implantitis in partially edentulous patients: association with in-adequate plaque control; Clin Oral Implants Res 2009;20(2):169-174. doi: 10.1111/j.1600- 0501.2008.01627. x.
21. Sanz M, Bäumer A, Buduneli N, Dommisch H, Farina R, Kononen E, Linden G, Meyle J, Preshaw PM, Quirynen M, Roldan S, Sanchez N, Sculean A, Slot DE, Trombelli L: West N, Winkel E: Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consensus report of group 4 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases; J Clin Periodontol 2015;42(16):214-220. doi: 10.1111/jcpe.12367.
22. Ramfjord S, Morrison E, Burgett F, Nissle R, Shick R, Zann G, Knowles J: Oral hygiene and maintenance of periodontal support; J Periodontol 1982;53(1):26-30.
23. Ronay V, Merlini A, Attin T, Schmidlin PR, Sahrmann P: In vitro cleaning potential of three implant debridement methods. Simulation of the non-surgical approach; Clin Oral Implants Res 2017;28(2):151-155. doi: 10.1111/clr.12773. Epub 2016 Jan 22. Iatrou P, Chamilos C, Nickles K, Ratka C, Eickholz P, Petsos H: In Vitro Efficacy of Three Different Nonsurgical Implant Surface Decontamination Methods in Three Different Defect Con¬figurations; Int J Oral Maxillofac Implants. 2021 Mar-Apr;36(2):271-280. doi: 10.11607/jomi.8864. PMID: 33909716.
24. Tuchscheerer V, Eickholz P, Dannewitz B, Christoph Ratka C, Zuhr O, Petsos H: In vitro surgical and non-surgical air-polishing efficacy for implant surface decontamination in three different defect configurations; Clin Oral Investig 2021;25(4):1743- 1754. doi: 10.1007/s00784-020-03476-1. Epub 2020 Aug 19.
25. Mensi M, Cochis A, Sordillo A, Uberti F, Rimondini L: Biofilm Removal and Bacterial Re-Colonization Inhibition of a Novel Erythritol/Chlorhexidine Air-Polishing Powder on Titanium Disks; Materials 2018;11(9):1510. doi:10.3390/ma11091510.
26. Luengo F, Sanz-Esporrín J, Sanz-Sánchez I, Solonko M, Herrera D, Sanz M: Clinical, microbiological and biochemical impact of a supportive care protocol with an air-polishing device, after surgical treatment of peri-implantitis: Randomized clinical trial; Clin Oral Implants Res 2023Apr;34(4):378-392. doi: 10.1111/clr.14049. Epub 2023 Feb 24. PMID: 36789504.
27. Stiesch M, Grischke J, Schaefer P, Heitz-Mayfield LJA: Supportive care for the prevention of disease recurrence/progression following peri-implantitis treatment: A systematic review; J Clin Periodontol 2023;50(26):113-134. DOI: 10.1111/jcpe.13822.
28. Derks, Tomasi C: Peri-implant health and disease. A systematic review of current epidemiology; J Clin Periodontol 2015;42(16):158-171.
29. Costa FO et al.: Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up; J Clin Periodontol 2012;39(2):173-181.
30. DGI/DGZMK S3-Leitlinie: Die Behandlung pe¬riimplantärer Infektionen an Zahnimplantaten AWMF-Registernummer: 083-023, Stand: Dezember 2022. Gültig bis: Dezember 2027.
31. Jepsen S, Berglundh T, Genco R, Aass AM, Demirel K, Derks J, Figuero E, Giovannoli JL, Goldstein M, Lambert F, Ortiz-Vigon A, Polyzois I, Salvi GE, Schwarz F, Serino G, Tomasi C, Zitzmann NU: Primary prevention of peri-implantitis: managing peri-implant mucositis; J Clin Periodontol 2015;42 Suppl 16:152-157. doi: 10.1111/jcpe.12369.
32. Mensi M, Scotti E, Sordillo A, Dalè M, Calza S: Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic debridement and rubber cup polishing for the treatment of gingivitis: A split-mouth randomized controlled clinical trial; Int J Dent Hyg 2022;20(2):371-380. doi: 10.1111/ idh.12537. Epub 2021 Jul 28.
33. Petersilka GJ, Steinmann D, Häberlein I, Heinecke A, Flemmig TF: Subgingival plaque removal in buccal and lingual sites using a novel low abrasive air-polishing powder; Journal of Clinical Periodontology 2003;30:328-333.
34. Petersilka GJ, Tunkel J, Barakos K, Heinecke A, Häberlin I, Flemmig TF: Subgingival plaque removal at interdental sites using a low abrasive air polishing powder; Journal of Periodontology 2003;74:307-311.
35. Hägi T, Hofmänner P, Eick S, Donnet M, Salvi G, Ramseier C, Sculean A: Clinical outcomes following subgingival application of a novel Erythritol powder by means of air polishing in supportive periodontal therapy; Quintessence Int 2013;44:753-761.
36. Flemmig TF, Hetzel M, Topoll H, Gerss J, Häberlein I, Petersilka GF: Subgingival debridement efficacy of glycine powder air-polishing; Journal of Periodontology 2007;78:1002-1010.
37. Nastri L, Miraldi G, Ripoli R: Treatment of peri-implantitis using an air polishing device with erythritol powder or mechanical debridement: a randomized, controlled split mouth clinical study; Clin Oral Impl Res 2014;25(10), Poster.
38. Drago L, Del Fabbro M, Bortolin M, Vassena C, De Vecchi E, Taschieri S: Biofilm Removal and Antimicrobial Activity of Two Different Air-Polishing Powders. An in Vitro Study; Journal of Periodontology 2014;85(11):363-369. doi: 10.1902/ jop.2014.140134.
39. Schwarz F , Becker K, Renvert S: Efficacy of air polishing for the non-surgical treatment of peri-implant diseases: a systematic review; J Clin Periodontol 2015;42(10):951-959. doi: 10.1111/ jcpe.12454. Epub 2015 Oct 16.
40. Iatrou P, Chamilos C, Nickles K, Ratka C: In Vitro Efficacy of Three Different Nonsurgical Implant Surface Decontamination Methods in Three Different Defect Configurations; The International journal of oral & maxillofacial implants 2021;36(2):271-280. DOI:10.11607/jomi.8864.
41. Hatz CR, Janson TM, Solderer A, Bastendorf KD, Schmidlin PR, Liu CC: An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients; Appl Sci 2022;12(14):730-735; https://doi. org/10.3390/app12147203.
42. Ichioka Y, Virto L, Nuevo P, Gamonal JD, Derks J, Larsson L, Sanz M, Berglundh T: Decontamination of biofilm-contaminated implant surfaces: An in vitro evaluation; Clin Oral Implants Res 2023;34(10):1058-1072. doi: 10.1111/clr.14136. Epub 2023 Jul 20. PMID: 37469250.
43. Francis S, Caponio VCA, Spirito F, Perrotti V, Quaranta A: Microbiological and Physical Changes Produced by Different Air–Powders on Contaminated Titanium Implant Surfaces: An In Vitro Pilot Study; Applied Sciences 2023;13(3):1301. https://doi.org/10.3390/app13031301.
44. Fischer KR, Büchel J, Gubler A, Liu CC, Sahrmann P, Schmidlin PR: Nonsurgical cleaning potential of deep-threaded implants and titanium particle release: A novel in vitro tissue model; Clin Oral Implants Res 2023;34(5):416-425. doi: 10.1111/clr.14045. Epub 2023 Mar 7. PMID: 36757141.
45. Korello K, Eickholz P, Zuhr O, Ratka C, Petsos H: In vitro efficacy of non-surgical and surgical implant surface decontamination methods in three different defect configurations in the presence or absence of a suprastructure; Clin Implant Dent Relat Res 2023;25(3):549-563. doi: 10.1111/cid.13198. Epub 2023 Mar 14. PMID: 36918345.
46. Brandenberger T, Stübinger S, Gubler A, Schmidlin PR, Liu CC: Efficient cleaning of a macro-structured micro-rough dental implant shoulder with a new coronal vertical groove design: A technical note; Swiss Dental Journal 2023;133:730–734.