Limosilactobacillus Reuteri as an Adjuvant in the Treatment of Peri-implant Mucositis

Inclusion Criteria: (i) dental implants placed for at least 12 months according to the All-on-4® concept; (ii) removal of the dental prosthesis as part of the conventional implant maintenance protocol; (iii) modified Bleeding Index19 score \>0 in at least one implant in the studied rehabilitation; (iv) implants connected to the prosthesis by means of transepithelial abutments; (v) if there were natural teeth in opposing arch, they were periodontally healthy or had been treated for periodontitis and were on periodontal support with residual pockets ≤5mm; (vi) demonstrated previous compliance with oral hygiene appointments; (vii) read and signed the informed consent. Exclusion Criteria: (i) Peri-implantitis proven clinically (implant mobility, suppuration and/or pocket depth (PD) ≥5mm) and/or radiographically (bone remodeling greater than 2mm in the first year of function20 and mean marginal bone loss greater than 0.2mm for each subsequent year21 in the rehabilitated arch that was intended to be studied); (ii) clinically active peri-implantitis (mobility, suppuration and/or PD ≥5mm) in the opposing arch to the one intended to be studied; (iii) presence of an extra-maxillary/zygomatic implant in the rehabilitated arch that was intended to be studied; (iv) current probiotic supplementation; (v) diabetes mellitus not controlled by medication; (vi) current use of oral hygiene products containing chlorohexidine or essential oils; (vii) special needs individuals who depended on others for their oral hygiene and medication uptake.