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Meta-Analysis
. 2023 Jun:50 Suppl 26:285-316.
doi: 10.1111/jcpe.13775. Epub 2023 Feb 13.

The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis

Nikos Donos  1 , Elena Calciolari  1   2 , Mandeep Ghuman  3 , Michela Baccini  4 , Vanessa Sousa  3 , Luigi Nibali  3
Affiliations
Meta-Analysis

The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis

Nikos Donos et al. J Clin Periodontol. 2023 Jun.

Abstract

Aim: To evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at ≥12-month follow-up.

Materials and methods: Three databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question-FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms.

Results: Seven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (-0.387; p = .325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes.

Conclusions: Reconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.

Keywords: bone graft; membrane; meta-analysis; peri-implantitis; reconstructive therapies; systematic review.

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References

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