This systematic review aimed to assess the clinical efficacy of the local application of
minocycline hydrochloride for treating
peri-implantitis. Four databases-PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure-were searched from their inception through December 2020. English and Chinese randomized controlled trials (RCTs) that compared
minocycline hydrochloride with control regimes, including negative control,
iodine solution or
glycerin, and
chlorhexidine, for patients with peri-implant diseases were retrieved. Three outcomes-plaque index (PLI), probing depth (PD), and sulcus
bleeding index (SBI)-were assessed using meta-analysis based on the random-effects model. Fifteen RCTs were included in the present meta-analysis, and results suggested that
minocycline hydrochloride significantly affected PLI, PD, or SBI reduction regardless of the type of comparator regime. However, subgroup analyses suggested that
minocycline hydrochloride was not superior to
chlorhexidine in terms of reduction of PLI (1 week: MD = -0.18, 95% CI = -0.55 to 0.20, P = .36; 4 weeks: MD = -0.08, 95% CI = -0.23 to 0.07, P = .28; 8 weeks: MD = -0.01, 95% CI = -0.18 to 0.16, P = .91) and PD (1 week: MD = 0.07, 95% CI = -0.27 to 0.41, P = .68; 4 weeks: MD = -0.10, 95% CI = -0.43 to 0.24, P = .58; 8 weeks: MD = -0.30, 95% CI = -0.68 to 0.08, P = .12), and
minocycline hydrochloride was also not better than
chlorhexidine regarding reduction of SBI at 1 week
after treatment (MD = -0.10; 95% CI = -0.21 to 0.01; P = .08). This study concludes that
minocycline hydrochloride as adjuvant
therapy of nonsurgical treatment enhances the clinical results when compared to control regimes. However, the difference between
minocycline hydrochloride and
chlorhexidine should be further investigated by designing additional high-quality studies with large sample sizes.