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. 2023 Jun:50 Suppl 26:224-243.
doi: 10.1111/jcpe.13821. Epub 2023 May 4.

Efficacy of adjunctive measures in the non-surgical treatment of peri-implantitis: A systematic review

Antonio Liñares  1   2 , Ignacio Sanz-Sánchez  3   4 , José Dopico  1   2 , Ana Molina  3   4 , Juan Blanco  1   2 , Eduardo Montero  3   4
Affiliations

Efficacy of adjunctive measures in the non-surgical treatment of peri-implantitis: A systematic review

Antonio Liñares et al. J Clin Periodontol. 2023 Jun.

Abstract

Aim: The aim of this systematic review was to evaluate the efficacy of patient-performed or administered adjunctive measures to non-surgical peri-implantitis therapy in terms of probing depth (PD) and/or bleeding on probing (BoP) reductions.

Materials and methods: Randomized and controlled clinical trials with at least 6 months of follow-up were searched in three databases. Secondary outcomes included implant loss, disease resolution, recurrence of peri-implantitis, need of re-treatment, changes in marginal bone levels, patient-reported outcomes and adverse effects.

Results: Of 567 titles, 10 publications, reporting 9 investigations, were included. Three types of adjunctive measures were found (local/systemic antimicrobials and probiotics). Four studies evaluated the effects of local antimicrobials (i.e., minocycline microspheres, chlorhexidine chips or a metronidazole + amoxicillin gel), three studies evaluated systemic antimicrobials (either amoxicillin + metronidazole or metronidazole alone) and two studies evaluated probiotics (Lactobacillus reuteri strains). The addition of local antimicrobials led to modest improvements in PD reduction. Systemic antimicrobials showed significantly greater reductions in PD and BoP, especially at initially deep sites (PD > 6 mm). Due to the large heterogeneity among included studies, no meta-analyses were performed.

Conclusions: Different adjunctive measures in the non-surgical treatment of peri-implantitis have different impact in terms of PD and BoP reductions. Improved PD reductions result after the use of systemic antimicrobials, and to a lesser extent, after the use of local antimicrobials.

Keywords: adjuncts; antimicrobials; non-surgical treatment; peri-implantitis; probiotics.

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References

REFERENCES

    1. Ahmed, P., Bukhari, I. A., Albaijan, R., Sheikh, S. A., & Vohra, F. (2020). The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients. Photodiagnosis and Photodynamic Therapy, 32, 102077. https://doi.org/10.1016/j.pdpdt.2020.102077
    1. Almohareb, T., Alhamoudi, N., Al Deeb, M., Bin-Shuwaish, M. S., Mokeem, S. A., Saad Shafqat, S., Vohra, F., & Abduljabbar, T. (2020). Clinical efficacy of photodynamic therapy as an adjunct to mechanical debridement in the treatment of per-implantitis with abscess. Photodiagnosis and Photodynamic Therapy, 30, 101750. https://doi.org/10.1016/j.pdpdt.2020.101750
    1. Bassetti, M., Schar, D., Wicki, B., Eick, S., Ramseier, C. A., Arweiler, N. B., Sculean, A., & Salvi, G. E. (2014). Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized controlled clinical trial. Clinical Oral Implants Research, 25(3), 279-287. https://doi.org/10.1111/clr.12155
    1. Berglundh, T., Armitage, G., Araujo, M. G., Avila-Ortiz, G., Blanco, J., Camargo, P. M., Chen, S., Cochran, D., Derks, J., Figuero, E., Hammerle, C. H. F., Heitz-Mayfield, L. J. A., Huynh-Ba, G., Iacono, V., Koo, K. T., Lambert, F., McCauley, L., Quirynen, M., Renvert, S., … Zitzmann, N. (2018). 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. Journal of Clinical Periodontology, 45(Suppl 20), S286-S291. https://doi.org/10.1111/jcpe.12957
    1. Blanco, C., Pico, A., Dopico, J., Gandara, P., Blanco, J., & Linares, A. (2022). Adjunctive benefits of systemic metronidazole on non-surgical treatment of peri-implantitis. A randomized placebo-controlled clinical trial. Journal of Clinical Periodontology, 49(1), 15-27. https://doi.org/10.1111/jcpe.13564

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