The Therapy of Peri-implantitis: A Systematic Review (original) (raw)

Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review

European journal of oral implantology, 2012

To identify the most effective interventions for treating peri-implantitis around osseointe-grated oral implants. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched up to the 9th of June 2011 for randomised controlled trials (RCTs) comparing agents or interventions for treating peri-implantitis around oral implants. Primary outcome measures were implant failure, radiographic marginal bone level change, complications and side effects, and recurrence of peri-implantitis. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. The statistical unit was the patient and not the implant unless the clustering of the implants within the patients had been taken into account. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence int...

Clinical outcomes of peri‐implantitis treatment and supportive care: A systematic review

Clinical Oral Implants Research, 2018

Objectives: To report the clinical outcomes for patients with implants treated for peri-implantitis who subsequently received supportive care (supportive peri-implant/ periodontal therapy) for at least 3 years. Material and methods: A systematic search of multiple electronic databases, grey literature and hand searching, without language restriction, to identify studies including ≥10 patients was constructed. Data and risk of bias were explored qualitatively. Estimated cumulative survival at the implant-and patient-level was pooled with random-effects meta-analysis and explored for publication bias (funnel plot) at different time intervals. Results: The search identified 5,761 studies. Of 83 records selected during screening, 65 were excluded through independent review (kappa = 0.94), with 18 retained for qualitative and 13 of those for quantitative assessments. On average, studies included 26 patients (median, IQR 21-32), with 36 implants (median, IQR 26-45). Study designs (case definitions of peri-implantitis, peri-implantitis treatment, supportive care) and population characteristics (patient, implant and prosthesis characteristics) varied markedly. Data extraction was affected by reduced reporting quality, but over 75% of studies had low risk of bias. Implant survival was 81.73%-100% at 3 years (seven studies), 74.09%-100% at 4 years (three studies), 76.03%-100% at 5 years (four studies) and 69.63%-98.72% at 7 years (two studies). Success and recurrence definitions were reported in five and two studies respectively, were heterogeneous, and those outcomes were unable to be explored quantitatively. Conclusion: Therapy of peri-implantitis followed by regular supportive care resulted in high patient-and implant-level survival in the medium to long term. Favourable results were reported, with clinical improvements and stable peri-implant bone levels in the majority of patients.

A follow-up study of peri-implantitis cases after treatment

Journal of Clinical Periodontology, 2011

The aim of this retrospective study was to follow patient cases in a longitudinal manner after peri-implantitis treatment. Materials and Methods: Two hundred and eighty-one patient cases were selected consecutively from the archives of the Oral Microbiological Diagnostic Laboratory, Gothenburg, Sweden based on microbial analysis of bacterial samples taken from diseased implants. It was feasible to follow-up 245 patients after treatment for a period ranging from 9 months to 13 years. Results: In 54.7% of the patients it was not feasible to arrest progression of periimplantitis. Smoking and smoking dose were found to be significantly correlated to failure of peri-implantitis treatment (po0.05). Early disease development was also significantly associated with failure (po0.05). Bone plasty in conjunction to antibiotics during surgery was significantly associated with arrested lesions (po0.05). In a multiple regression model disease development was the only independent variable to significantly predict the likelihood of treatment success. Conclusions: Peri-implant health may not be easy to establish, especially in cases that develop disease early. Homogenous treatment protocols rather than empirical treatment attempts should be adopted.

Comparative Assessment of Conservative and Surgical Treatment Methods of Peri- Implantitis

2017

While in many cases dental implants have been reported to achieve long-term success, these are also not immune from the complications. Peri-implantitis is one of the complications of implant treatment, which may lead to implant failure. The optimal result of peri-implantitis treatment is a regeneration of the lost implant supporting hard and soft tissues. Many different treatment strategies for peri-implantitis have been suggested, however, as of today, no consensus exists regarding effective peri-implantitis treatment. The aim of the present study is to assess the effectiveness of different treatment methods for peri-implantitis. The 32 patients involved in this study (14 females, 18 males, at a mean age 48, 3 years) with inflammatory-destructive processes in the field of peri-implant tissues of osseointegrated implants. A total of 46 implants were treated. (16 implants diagnosed with peri-implant mucositis, 14 implants-early peri-implantitis, 12 implants-moderate peri-implantitis ...

Surgical and Nonsurgical Treatment Protocols for Peri-implantitis: An Overview of Systematic Reviews

The International Journal of Oral & Maxillofacial Implants

The goal of this overview was to systematically verify the best available literature on surgical and nonsurgical treatments of peri-implantitis to determine evidence-based treatment protocols for peri-implantitis. Three databases (MEDLINE/ PubMed, Web of Science, and Cochrane Library/Evidence) were searched by two independent reviewers, including systematic reviews (SRs) that involved randomized controlled trials (RCTs). The search was limited to articles between January 2014 to January 2021 with an English language restriction. In total, 437 articles were initially found, of which only 34 were selected for full-text reading. Nine SRs were included in this study, enrolling 59 different RCTs. Some studies investigated both surgical and nonsurgical techniques, while others focused on only one approach or the other. In total, six of the studies included nonsurgical techniques, and eight included surgical techniques (ie, augmentative, regenerative, and corrective/resective techniques). Nonsurgical interventions appeared to offer some degree of clinical improvements, especially in bleeding on probing levels, but they were not enough to fully treat peri-implantitis. Whereas surgical techniques seemed to be more effective in improving overall clinical parameters, especially probing depth, bleeding on probing, and to some extent, marginal bone level, no specific surgical technique or material (graft or membrane) had a clear advantage over others. Therefore, resective surgical and implantoplasty techniques demonstrated significant improvements in clinical parameters. Although surgical interventions are more indicated to treat peri-implantitis than nonsurgical procedures, the predictability is still a concern due to titanium particles scattered within the local tissue.

Management of peri-implantitis - A contemporary synopsis

Singapore dental journal, 2017

Prevalence of peri-implant complication is expected to be on the rise with the increased number of implants being placed. Depending on the degree of osseous involvement, the clinician needs to decide if the treatment goal is to arrest the disease progression, regeneration or explantation and replacement. Host's medical status, defect configuration, aesthetic outcome, ability to access for plaque control post-treatment, and the patient's wishes are key factors to consider. The purpose of this review is to provide a contemporary synopsis on the management of peri-implantitis with emphasis on explantation. Guidance on the identification of factors/situations where salvaging an implant may be less favourable is discussed and the various techniques to remove a fractured, or peri-implantitis-affected non-mobile implant are described.

Therapy of peri-implantitis: a systematic review

Journal of Clinical Periodontology, 2008

The authors concluded that mechanical debridement with antiseptic or antibiotic therapy, Er:YAG laser and resective or regenerative surgical techniques could not be ruled out as being useful treatments for peri-implantitis, but it was not possible to determine relative efficacy. The authors acknowledged limitations in the quality of the studies and their cautious conclusions were appropriate. The reliability of the conclusions was unclear, as relevant studies may have been missed. Authors' objectives To assess the efficacy of all treatments for peri-implantitis. Searching PubMed and The Cochrane Library were searched up until July 2007. Search terms were reported. Studies needed to be in English and published in peer-reviewed journals. A large number of relevant journals were handsearched up until July 2007. Retrieved articles and reviews were cross checked for relevant studies.

Treatment Modalities for Peri- Implantitis: A Review of Literature

2021

Peri-implantitis is an infectious disease which causes an inflammatory process in soft tissues followed by bone loss around an osseo integrated implant. Its etiology depends on the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load in presence of the most important factor, bacteria such as spirochetes and mobile forms of Gram-negative anaerobes. Diagnosis is made by assessing the changes of color in the gingiva, bleeding and probing depth of peri-implant pockets, suppuration, X-ray, and gradual loss of bone height around the tooth. The management of implant infection should be focused on the control of infection, the detoxification of the implant surface, and regeneration of the alveolar bone. This review of literature gives an overview of aetiopathogenesis, clinical features, and diagnosis of periimplantitis along with various treatment options in its management.

Prevalence of Peri-Implantitis: A Multi-Centered Cross-Sectional Study on 248 Patients

Dentistry Journal, 2020

The aim of this multicenter cross-sectional study was to determine the prevalence of peri-implantitis and to assess its association with several patient- and implant-related factors. Patients with at least one implant, who came for a recall visit to one of the four centers over a period of five months, were enrolled. Presence of peri-implantitis (defined as bleeding on probing, exudate/suppuration, bone loss > 0.2 mm/year and increased pocket depth) and several other variables (e.g., smoking habits, history of periodontitis, diabetes) were recorded. Out of 248 enrolled patients (1162 implants), 10 patients had at least one implant with peri-implantitis (4.03%); a total of 14 implants were affected (1.20%). A statistically significant association between peri-implantitis and diabetes was found (OR 8.65; CI: 1.94–38.57). Smoking more than 10 cigarettes per day (OR: 0.53; CI 0.03–9.45) and history of periodontitis (OR: 2.42; CI: 0.49–11.89) were not found to be statistically associa...