In patients with peri-implant
mucositis and
peri-implantitis, what is the efficacy of nonsurgical (i.e. referring to peri-implant
mucositis and
peri-implantitis) and surgical (i.e. referring to
peri-implantitis) treatments with alternative or adjunctive measures on changing signs of
inflammation compared with conventional nonsurgical (i.e. mechanical/ultrasonic
debridement) and surgical (i.e. open flap
debridement) treatments alone? After electronic database and hand search, a total of 40 publications (reporting on 32 studies) were finally considered for the qualitative and quantitative assessment. The weighted mean changes (WM)/ and WM differences (WMD) were estimated for
bleeding on probing scores (BOP) and probing pocket depths (PD) (random effect model). Peri-implant
mucositis: WMD in BOP and PD reductions amounted to -8.16 % [SE = 4.61] and -0.15 mm [SE = 0.13], not favouring adjunctive
antiseptics/
antibiotics (local and systemic) over control measures (p > 0.05).
Peri-implantitis (nonsurgical): WMD in BOP scores amounted to -23.12 % [SE = 4.81] and -16.53 % [SE = 4.41], favouring alternative measures (
glycine powder air polishing,
Er:YAG laser) for plaque removal and adjunctive local
antibiotics over control measures (p < 0.001), respectively.
Peri-implantitis (surgical): WMD in BOP and PD reductions did not favour alternative over control measures for surface decontamination. WM reductions following open flap surgery (±resective
therapy) and adjunctive augmentative
therapy amounted to 34.81 and 50.73 % for BOP and 1.75 and 2.20 mm for PD, respectively. While mechanical
debridement alone was found to be effective for the management of peri-implant
mucositis, alternative/adjunctive measures may improve the efficacy over/of conventional nonsurgical treatments at
peri-implantitis sites. Adjunctive resective and/or augmentative measures are promising; however, their beneficial effect on the clinical outcome of surgical treatments needs to be further investigated.