CLEAN&SEAL – Therapy for periodontitis, mucostits and periimplantitis


Current established non-surgical subgingival treatments might not show satisfying, long-lasting improvement of clinical parameters in case of severe periodontitis, mucositis and periimplantitis. In recent clinical studies, the non-surgical treatment of deep persistent pockets with the CLEAN&SEAL concept was presented showing rapid improvement of clinical parameters, so that invasive surgical intervention can be delayed or even completely avoided. [4,19, 22,26,27]


Despite careful post-operative oral hygiene protocols, deep periodontal and peri-implant pockets and inflammatory reactions may persist, leading to the resorption of tissues [1] and thus contributing to the risk of bone loss [2]. The challenges to be addressed are :

Removal of the bacterial load from soft tissue and tooth/implant surface without hurting further healthy tissues.

Preserve the root/implant surfaces facilitating cellular adhesion for its proliferation.

Removal of the biofilm composed of a persistent matrix encapsulating a bacterial load.

Restore the bacterial symbiosis.

Remove granulated tissue without impacting healthy tissue and as mini-invasively as possible.

Protect the oral wound from further bacterial aggression during the healing phases.

Accelerate soft and hard tissue regeneration to reduce Pocket Depth, increase Clinical Attachment, limit Gingival Recession, and stop bleeding on probing.

Removal of biofilm and granulated tissue are prerequisites for periodontal and peri-implant wound healing.



CLEANing step with A²H gel (after 60 seconds):

  • In comparison to chlorhexidine, A²H reduces pocket depth (PD) and increases clinical attachment (CAL) to limit tissue recession [17]
  • Facilitates periodontal and peri-implant site decontamination [17]
  • Breaks the biofilm matrix down and reduces the bacterial load [11]
  • Facilitates the separation of the granulated tissues from healthy tissues [18]
  • With a 0.5% concentration, the A²H is gentle to the tissues, tooth- and implant surface and effective against the biofilm [16]

Perisolv Schmidlin et al 2016

SEALing step with xHyA before the patient leaves:

  • Enhances cell adhesion and regeneration of the periodontium leading to shallower pockets (PD) and better clinical attachment (CAL) [4,19,21,22]
  • Bacteriostatic properties protect the decontaminated wound for healing [7,9]
  • Speeding-up pocket closure through blood clot stabilization and growth factor attraction [20]
  • Supports soft tissue and bone regeneration [9–15]
  • Adhesive gel, easy to apply especially in contact with blood

Diehl et al 2022_Clean&Seal

The synergies of CLEAN&SEAL are that A²H and xHyA, both enhance cellular adhesion [16,26] for better regeneration of hard and soft tissues. While SEALing speeds the healing and protects the oral wound, the crosslinked hyaluronic acid (xHyA) enhances the effects of CLEANing: the diluted gel of amino acids with sodium hypochlorite (A²H), is tough against biofilm, bacteria, and granulated tissue while staying gentle to healthy tissues and root/implant surfaces.   



Treatment of moderate periimplantitis Dr Thomas Liechti with CLEAN&SEAL

Treatment of severe periimplantitis Dr Thomas Liechti with CLEAN&SEAL


Treatment of mucositis by Dr Marisa Roncati with A²H and xHyA


Treatment of severe periodontitis by Prof Anton Friedmann with A²H and xHyA


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