TY - JOUR
T1 - Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis
T2 - a systematic review and meta-analysis
AU - Barbato, Luigi
AU - Cavalcanti, Raffaele
AU - Rupe, Cosimo
AU - Scartabelli, Daniele
AU - Serni, Lapo
AU - Chambrone, Leandro
AU - Cairo, Francesco
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/6/9
Y1 - 2023/6/9
N2 - Background: The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis. Materials and methods: The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction. Results: Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction. Conclusions: Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution.
AB - Background: The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis. Materials and methods: The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction. Results: Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction. Conclusions: Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution.
KW - Adjunctive methods
KW - Non-surgical treatment
KW - Peri-implant debridement
KW - Peri-implantitis
KW - Submarginal instrumentation
KW - Systemic antibiotics
KW - Humans
KW - Treatment Outcome
KW - Dental Care
KW - Plastic Surgery Procedures
KW - Dental Implants
KW - Peri-Implantitis/therapy
KW - Anti-Bacterial Agents/therapeutic use
UR - http://www.scopus.com/inward/record.url?scp=85163111710&partnerID=8YFLogxK
U2 - 10.1186/s12903-023-03058-z
DO - 10.1186/s12903-023-03058-z
M3 - Article
C2 - 37296382
AN - SCOPUS:85163111710
SN - 1472-6831
VL - 23
SP - 375
JO - BMC Oral Health
JF - BMC Oral Health
IS - 1
M1 - 375
ER -