Airflow for initial nonsurgical treatment of peri‐implantitis: A systematic review and meta‐analysis

Abstract

Background Nonsurgical treatment of peri‐implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta‐analyses was to evaluate the outcomes of nonsurgical treatment of peri‐implantitis using airflow method in terms of changes in periodontal parameters, peri‐implant marginal bone level, postoperative pain/discomfort, and patient satisfaction. Methods Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. Results A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta‐analysis showed more reduction in probing pocket depths at 1–3 months (mean difference [MD] −0.23; 95% confidence interval [CI] −0.50–0.05; p = 0.10) and 6 months (MD −0.04; 95% CI −0.34 to 0.27; p = 0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri‐implant mucosal recession. The differences in plaque score, peri‐implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant. Conclusions The short‐term clinical and radiographic outcomes following nonsurgical treatment of peri‐implantitis using airflow or mechanical debridement were comparable. The airflow has short‐term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.

Radiographic evaluation of marginal bone levels around implants supporting splinted fixed bridges: A retrospective study on 412 implants

“…Another limit to be mentioned is the fact that no evaluations were made on emergence profiles and angles of the prosthetic restorations investigated, which seem to have a certain impact on peri‐implant bone remodeling (Yi et al., 2020). However, it is worth noting that more recent studies have not found a statistically significant correlation between prosthetic profiles and peri‐implant bone resorption (Atieh et al., 2023). While our study provides valuable insights into some factors influencing MBL, the power to detect differences or associations with patient‐level variables may be limited due to our sample size, and this constitutes an additional limitation of the present study.…”

Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis

“…PI has been a public health problem for several years, and the nonsurgical therapy methods of peri-implant diseases involve mechanical debridement, chemical modalities, antibiotic medicine, lasers, and oral hygiene instructions [ 22 ]. Many methods have been suggested for the treatment of PI [ 10 23 24 25 26 27 ]. A systematic review and meta-analysis showed that airflow had positive effects on reducing BOP in the short term [ 23 ].…”

“…Many methods have been suggested for the treatment of PI [ 10 23 24 25 26 27 ]. A systematic review and meta-analysis showed that airflow had positive effects on reducing BOP in the short term [ 23 ]. Another systematic review and meta-analysis reported that systemic antibiotic administration in PI treatment did not reduce clinical parameters such as PPD and BOP [ 24 ].…”

Systemic azithromycin versus amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta‐analysis

“…2 Hence, a variety of adjunct therapies were used to enhance the efficacy of non-surgical instrumentation in terms of reducing probing pocket depths, improving clinical attachment levels or modifying subgingival microbiota. [3][4][5][6] The use of adjunct therapies was also claimed to achieve endpoints of periodontal treatment, prevent disease recurrence and avoid the need for surgical periodontal treatment to manage residual probing pocket depths. 7,8 One of the most commonly used adjunct therapies in the management of periodontitis is systemic antibiotics.…”

“…The non‐surgical mechanical SI, however, can be suboptimal due to anatomical complexities and severity of the periodontitis 2 . Hence, a variety of adjunct therapies were used to enhance the efficacy of non‐surgical instrumentation in terms of reducing probing pocket depths, improving clinical attachment levels or modifying subgingival microbiota 3–6 . The use of adjunct therapies was also claimed to achieve endpoints of periodontal treatment, prevent disease recurrence and avoid the need for surgical periodontal treatment to manage residual probing pocket depths 7,8 …”