Reconstructive procedures for treating peri-implantitis: a systematic review

Abstract

This review aimed at evaluating the effectiveness of reconstructive procedures for treating peri-implantitis. Searches of electronic databases and cross-referencing were performed for human comparative clinical trials with ≥ 10 implants for ≥ 12 months of follow-up, reporting radiographic defect fill and at least one of the following parameters: probing depth reduction, clinical attachment level gain, bleeding on probing reduction, and mucosal recession. The searches retrieved 430 citations. Only 1 randomized controlled trial was identified, which compared reconstructive therapy and open flap debridement. Case series studies were also included to evaluate the overall performance of the reconstructive procedures. Twelve studies were finally included. Meta-analysis revealed that the weighted mean radiographic defect fill was 2.17 mm (95% confidence interval [CI]: 1.46-2.87 mm), probing depth reduction was 2.97 mm (95% CI: 2.38-3.56 mm), clinical attachment level gain was 1.65 mm (95% CI: 1.17-2.13 mm), and bleeding on probing reduction was 45.8% (95% CI: 38.5%-53.3%). Great variability in reparative outcomes was found, attributed to patient factors, defect morphology, and reconstructive agents used. Currently, there is a lack of evidence for supporting additional benefit of reconstructive procedures to the other treatment modalities for managing peri-implantitis.

Keywords: bone regeneration; dental/oral implants; guided bone regeneration; implantology; osseointegration; peri-implant.

Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.

Meta-analysis for the amount of defect fill among selected studies. The weighted mean was 2.17 mm (range, 0.66-3.50 mm), with a 95% confidence interval of 1.46 mm to 2.87 mm.

Figure 2.

Meta-analysis for probing depth reduction among selected studies. The weighted mean was 2.97 mm (range, 1.33-5.21 mm), with a 95% confidence interval of 2.38 mm to 3.56 mm.

Figure 3.

Meta-analysis for clinical attachment level gain among selected studies. The weighted mean was 1.65 mm (range, 1.17-2.43 mm), with a 95% confidence interval of 1.17 mm to 2.13 mm.

Figure 4.

Meta-analysis for the amount of bleeding on probing reduction among selected studies. The weighted mean was 45.8% (range, 36.0%-63.3%), with a 95% confidence interval of 38.5% to 53.3%.