A systematic review and meta-analysis of the clinical outcomes for adjunctive physical, chemical, and biological treatment of dental implants with peri-implantitis

Mehreen, Zakir, Thomas, David ORCID: https://orcid.org/0000-0001-7319-5820, Adams, Robert, Farnell, Damian ORCID: https://orcid.org/0000-0003-0662-1927 and Claydon, Nicholas ORCID: https://orcid.org/0000-0002-4151-1515 2023. A systematic review and meta-analysis of the clinical outcomes for adjunctive physical, chemical, and biological treatment of dental implants with peri-implantitis. Journal of Oral Implantology 10.1563/aaid-joi-d-21-00204

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Abstract

The present systematic review evaluated the efficacy of adjunctive therapies in the treatment of peri-implantitis. Studies comparing the outcome of conventional surgical- or nonsurgical mechanical debridement with the addition of an adjunctive therapeutic modality were identified through an electronic and hand search of available literature. Following data extraction, meta-analyses were performed on the primary outcome measures. The effects of the adjunctive therapies on bleeding on probing (13 studies), probing pocket depth (9 studies), and radiographic bone level changes (7 studies) were analyzed to evaluate potential clinical benefit. Heterogeneity was expressed as the I2 index. Fixed and random effect models were demonstrated. The potential benefit of adjunctive therapies over control procedures was evaluated in 18 studies, representing a total of 773 implants. Quality assessment of the studies found only 3 studies to be at a low risk of bias. Meta-analysis among the different additional modalities revealed chemical therapy demonstrating significant effects in probing pocket depth reduction (0.58 mm; 0.44–0.72) and radiographic bone level gain (0.54 mm; 0.16–0.92). No significant improvements in bleeding on probing reduction were found using any adjunctive therapy. Available evidence on the benefits of adjunctive therapy to nonsurgical or surgical mechanical debridement in the treatment of peri-implantitis is limited by low numbers of standardized, controlled studies for individual therapies, heterogeneity between studies, and a variety of outcome measures. The lack of effect of any adjunctive therapy in reducing bleeding on probing questions the overall effectiveness over conventional treatment. The long-term clinical benefit potential of these therapies is not demonstrated.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Dentistry
Additional Information:	Publisher does not allow AAM to be stored. Published copy can be held.
Date of First Compliant Deposit:	22 May 2023
Date of Acceptance:	21 December 2022
Last Modified:	04 Jan 2024 08:37
URI:	https://orca.cardiff.ac.uk/id/eprint/159779

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