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Review
. 2022 Dec 7;11(12):1766.
doi: 10.3390/antibiotics11121766.

Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis

Maria Gabriella Grusovin  1   2 , Alberto Pispero  3 , Massimo Del Fabbro  3   4 , Matteo Sangiorgi  5 , Massimo Simion  3 , Martina Stefanini  5 , Elena Maria Varoni  3
Affiliations
Review

Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis

Maria Gabriella Grusovin et al. Antibiotics (Basel). .

Abstract

The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution. Six studies were included: two using topical and four systemic antibiotics. Adjunctive local antibiotics improved PPD (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78), BOP (MD = 0.15% (95% CI 0.10, 0.19)) and the success rate (risk ratio = 9.89; 95% CI 2.39-40.84). No significant difference in bone level and success rate were found with the use of systemic antibiotics, although they appeared to improve PPD (MD = 1.15 mm; 95% CI 0.31-1.99) and PAL (MD = 1.10 mm; 95% CI 0.13-2.08). Within the limitations of this review, the adjunctive local antibiotics showed improved outcomes in terms of success rate, PPD and BOP, while adjunctive systemic antibiotics improved PPD and PAL only. Peri-implantitis resolution was about 20-30% using adjunctive local antibiotics, whilst it ranged from 2% to 65% with adjunctive systemic antibiotics. Findings are still controversial, since they are based on few studies with high heterogeneity, at the uncertain or high risk of bias and involve few patients. Non-surgical debridement and maintenance periodontal support therapy remain pivotal and the adjunctive use of antibiotics for peri-implantitis cannot be routinely recommended, even considering the increasing concern on antibiotic resistance.

Keywords: antibiotics; clinical studies; peri-implant diseases; peri-implantitis; systematic review; therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the screening process following PRISMA [18,19,20,21,22,23,24].
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References

    1. Berglundh T., Armitage G., Araujo M.G., Avila-Ortiz G., Blanco J., Camargo P.M., Chen S., Cochran D., Derks J., Figuero E., 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. Clin. Periodontol. 2018;45((Suppl. 20)):S286–S291. doi: 10.1111/jcpe.12957. - DOI - PubMed
    1. Schwarz F., Derks J., Monje A., Wang H.-L. Peri-Implantitis. J. Clin. Periodontol. 2018;45:S246–S266. doi: 10.1111/jcpe.12954. - DOI - PubMed
    1. Esposito M., Grusovin M.G., Worthington H.V. Treatment of Peri-Implantitis: What Interventions Are Effective? A Cochrane Systematic Review. Eur. J. Oral Implantol. 2012;5:S21–S41. - PubMed
    1. Mombelli A., Lang N.P. Antimicrobial Treatment of Peri-Implant Infections. Clin. Oral Implant. Res. 1992;3:162–168. doi: 10.1034/j.1600-0501.1992.030402.x. - DOI - PubMed
    1. Lang N.P., Mombelli A., Tonetti M.S., Brägger U., Hämmerle C.H.F. Clinical Trials on Therapies for Peri-Implant Infections. Ann. Periodontol. 1997;2:343–356. doi: 10.1902/annals.1997.2.1.343. - DOI - PubMed