Long-term prognosis of peri-implantitis treatment: A systematic review of prospective trials with more than 3 years of follow-up

Abstract

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. A multitude of clinical trials have tested therapeutic approaches to treat peri-implantitis but there is still no consensus on what treatment modality leads to the most favorable clinical improvement and reduced implant loss. Therefore, the present systematic review reported on the long-term clinical and radiological outcomes after treatment of peri-implantitis with different surgical approaches. A PICO question was defined; manual and electronic searches were completed to screen for human prospective studies with at least 3 years of follow-up after surgical treatment of peri-implantitis. Analyses were performed using a random-effect model. Thirteen trials reported on 706 implants and 399 patients. Open flap, resective and reconstructive approaches led to a probing depth reduction of 2.23, 2.25 and 3.78 mm with a survival rate of 84%, 90% and 95%, respectively. Reconstructive treatments were followed by an average of 2.34 mm of radiographic bone gain, flap had negligible bone changes (0.11 mm) and resective approaches resulted in a mean bone loss of 0.5 mm. Large heterogeneity existed among studies for diagnostic criteria and decontamination modalities. Within the existing limitations, regenerative approaches for the treatment of peri-implantitis lead to advantageous long-term improvement of peri-implant tissues and higher implant survival rate.