Clean & Seal ® – treatment concept against peri-implant and periodontal infections

Peridontitis, peri-implant mucositis
Perisolv, Hyadent BG
Hypochlorite sodium with amino acids, cross-linked hyaluronic acid

Products used

Why use Clean & Seal against peri-implant and periodontal infections?

The Clean & Seal concept, which was developed based on scientific data [1, 2], provides guidance and support for the interception of peri-implant and periodontal diseases. It allows clinicians to save the tooth or implants and prevent the further development of the peri-implant or periodontal disease, which helps to further prevent larger procedures required to rebuild tissue.

Periodontitis, peri-implant mucositis, and peri-implantitis are bacterial inflammations with similar symptoms. The underlying cause of all three indications, which progress in a similar way, is bacterial plaque forming a biofilm, rich in pathogenic bacteria.
The softening of the biofilm and effective elimination of the bacteria is the key prerequisite for successful treatment of these conditions [11].

With regard to peri-implant diseases, they are divided into two subgroups: peri-implant mucositis [1-3], which is characterized by soft tissue inflammation without bone loss, and peri-implantitis, which is characterized by progressive loss of the supporting bone [4]. If left untreated, in the worst-case, peri-implantitis can result in the loss of the affected implant. This problem is relatively new to clinicians and dissatisfying for patients. It is of great importance to treat peri-implant disease at an early stage, with infection control and extensive debridement being crucial for positive treatment outcomes [1, 2]. The likelihood of success is further increased by the supportive application of sealing agents for protection and regenerative support and by regular follow-up to monitor and control inflammation [6].

The Clean & Seal two-step process for periodontal and peri-implant infections

Cleaning effect with Perisolv:

  • Softening of the extracellular matrix of the biofilm[5]
  • Enhancing bacterial removal by mechanical debridement
  • Elimination of the biofilm

Sealing effect with Hyadent BG:

  • Attracts blood and stabilizes coagulum to support tissue regeneration
  • Bacteriostatic effect to provide protection to cleaned site
  • Growth factors attracted by hyaluronic acid
  • Coordinates inflammation and accelerates angiogenesis

The Clean & Seal protocol ?

Clean & Seal is a treatment protocol to tackle mucositis by erasing the biofilm with Perisolv and securing sustainable healing of the soft tissues with Hyadent BG.

Periodontal and peri-implant interception with Clean & Seal: hypochlorite sodium and hyaluronic acid against mucositis and periodontitis

How to apply PERISOLV and hyaDENT BG (Clean & Seal) ?

Case report: Mucositis treated with Clean & Seal

Treatment of mucositis by Dr Marisa Roncati with PeriSolv and HyadentBG

Scientific literature & clinical studies

  1. Jepsen S et al. Primary prevention of periimplantitis: managing periimplant mucositis. J Clin Periodontol 2015; 42(Suppl. 16): S152-S157. doi: 10.1111/jcpe.12369.
  2. 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): 173-183. doi: 10.1111/j.1600-051X.2011.01819.x.
  3. Heitz-Mayfield LJ and Salvi GE. Peri-implant mucositis. J Periodontol 2018; 89(Suppl 1): S257-S266. doi: 10.1002/JPER.16-0488.
  4. Berglundh T et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89(Suppl 1): S313-S318. doi: 10.1002/JPER.17-0739.
  5. Jurczyk K et al. In-vitro activity of sodium-hypochlorite gel on bacteria associated with periodontitis. Clin Oral Investig 2016; 20(8): 2165-2173. doi: 10.1007/s00784-016-1711-9.
  6. Pirnazar P et al. Bacteriostatic effects of hyaluronic acid. J Periodontol 1999; 70(4): 370-374. doi: 10.1902/jop.1999.70.4.370.
  7. Engstrom PE et al. The effect of hyaluronan on bone and soft tissue and immune response in wound healing. J Periodontol 2001; 72(9): 1192-1200. doi:10.1902/jop.2000.72.9.1192.
  8. Asparuhova M et al. Activity of two hyaluronan preparations on primary human oral fibroblasts. J Periodontal Res 2018; 54(1): 33-45. doi: 10.1111/jre.12602.
  9. Longaker T et al. Studies in fetal wound healing. V. A prolonged presence of hyaluronic acid characterizes fetal wound fluid. Ann Surg 1991; 213(4): 292-296. doi: 10.1097/00000658-199104000-00003.
  10. Mast BA et al. Hyaluronic Acid Modulates Proliferation, Collagen and Protein Synthesis of Cultured Fetal Fibroblasts. Matrix 1993; 13(6): 441-446. doi: 10.1016/s0934-8832(11)80110-1.
  11. Iorio-Siciliano V, Ramaglia L, Isola G, Blasi A, Salvi GE, Sculean A. Changes in clinical parameters following adjunctive local sodium hypochlorite gel in minimally invasive nonsurgical therapy (MINST) of periodontal pockets: a 6-month randomized controlled clinical trial. Clin Oral Investig. 2021 Mar 9. doi: 10.1007/s00784-021-03841-8. Epub ahead of print. PMID: 33687555.