Surgical Management of Peri‐Implantitis: A Systematic Review and Meta‐Analysis of Treatment Outcomes

Abstract

Within the limitation of this systematic review, the application of grafting materials and barrier membranes resulted in greater PD reduction and RBF, but there is a lack of high-quality comparative studies to support this statement. The results might be used to project treatment outcomes after surgical management of peri-implantitis.

Peri-Implant Infections of Oral Biofilm Etiology

“…A reduction in probing depth of 2-3 mm and a mean 2 mm radiographic bone gain is described for regenerative procedures. Most of these analyses have follow-ups of 1-2 years (Chan et al 2013). Outcomes for regenerative approaches are described to vary the most.…”

Can Periimplantitis Be Treated?

“…106 Recent systematic reviews and meta-analyses showed a weighted mean probing depth reduction of 2.97 mm (2.04 mm [33.4%] for surgical resection and 3.16 mm [48.2%] for guided bone regeneration), clinical attachment level gain of 1.65 mm, bleeding on probing reduction of 45.8%, and a weighted mean radiographic bone fill of 2.1 to 2.17 mm for guided bone regeneration. 108,109 It is important to realize that there are several limitations associated with the analyses, such as inclusion of case series and cohort studies, a limited number of high-quality studies available, and vast heterogeneity in the study designs and treatment modalities. Therefore, further validation of the various surgical techniques is necessary.…”

Treatment of Peri-Implantitis and the Failing Implant

“…These clinical parameters include reduction of periodontal PD, improvement in clinical attachment level, reduction of BOP, and radiographic bone fill. 12,66 It may or may not be possible, or even necessary, to re-establish osseointegration 67 ; it may only be possible to fill the osseous defect or to simply arrest the disease. As more cases of peri-implant disease are treated by the various modalities and protocols, relapse and the need for re-treatment may become considerations as well.…”

“…Although the first 2 of these would not be classified into the CIST protocol D, each of the 4 procedures yielded roughly 2 to 3 mm PD reduction based on shortterm outcomes, and 2-mm increase in bone height was associated with the regenerative procedures in a systematic review. 66 Notwithstanding the numerous case studies, clinical series, and systematic reviews showing favorable results and effectiveness with surgical approaches, 66,76,77,[81][82][83][84][85][86] it should be mentioned that there are reports in which the rigors of systematic review do not allow for the identification of the most effective option. [87][88][89] At the time of treatment decision, the choice of the procedure should be guided by clinical judgment, esthetic considerations, patient input, clinician experience, and treatment goals.…”