Surgical regenerative treatment of peri-implantitis

Data sourcesOvid, Medline, PubMed, Embase and Dentistry and Oral Sciences Source. Databases were searched from January 2006 to March 2016 and restricted to English, manual searches were also carried out in the relevant major journals.Study selectionTwo reviewers independently selected studies. Human prospective and retrospective observational studies with a minimum sample size of ten implants and involving at least one surgical regenerative treatment method for peri-implantitis were considered. Excluded studies included animal and in vitro studies, patients with uncontrolled systemic disease that put the implant at risk and ceramic or coated implants.Data extraction and synthesisData abstraction and quality appraisal were carried out by two independent reviewers. The Cochrane Collaboration tool for assessing risk of bias in randomised trials was used.(1) Meta-analysis of similar studies was conducted and the main outcome measures were; changes in radiologic bone level, probing depth and bleeding on probing change.ResultsEighteen studies were included, eight prospective clinical studies, seven case series and three randomised clinical trials (RCTs). A total of 528 patients with 713 implants were treated. Two studies were at low risk of bias, one moderate, and three high. The remainder were classified as unclear.ConclusionsWithin the limits of this systematic review, surgical regenerative treatment is a predictable option in managing peri-implantitis and improving clinical parameters of peri-implant tissues. There is no fundamental advantage of membrane use for bone graft coverage or submergence of the healing site on the final outcome of peri-implant defect regeneration. Due to the limited number of randomised clinical trials, at the time there is a lack of scientific evidence in the literature regarding the superiority of the regenerative versus non-regenerative surgical treatment.