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

Abstract

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. K E Y W O R D Sdental implants, dental restoration failure, long-term care, meta-analysis, peri-implantitis, periodontal maintenance, supportive periodontal therapy, surgical treatment, survival, systematic reviewThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

The effect of supportive care in preventing peri‐implant diseases and implant loss: A systematic review and meta‐analysis

“…SPT has been regarded as the first protective barrier to prevent from peri‐implant disease progression (Hultin et al, ; Monje et al, ). A recent review further supports the importance of SPT after treatment of peri‐implantitis (Roccuzzo et al, ). In accordance with the findings, the statistical analysis in present review revealed that SPT patients obtained higher SR and lower prevalence of peri‐implant mucositis and peri‐implantitis during long‐term follow‐up.…”

“…SPT plays a critical role in maintaining the stability of periodontal status from the perspective of bacteria amount, clinical outcomes, and further disease progression (Lang & Tonetti, ; Ramfjord, ). Nevertheless, the concept of preventive maintenance should also be advocated in dental implants in terms of bacterial patterns (Agerbaek, Lang, & Persson, ; Ziebolz, Schmalz, Gollasch, Eickholz, & Rinke, ), cost‐effectiveness (Schwendicke, Tu, & Stolpe, ), biological complications (Berglundh et al, ; Salvi & Zitzmann, ), peri‐implant tissue and SR (Goh & Lim, ), and the long‐term stability of treated peri‐implantitis (Roccuzzo, Layton, Roccuzzo, & Heitz‐Mayfield, ).…”

Peri-Implantitis Diagnosis and Prognosis Using Biomarkers in Peri-Implant Crevicular Fluid: A Narrative Review

“…Recontouring of the bony architecture and smoothing of the implant surface may improve infection control. Regenerative procedures using a membrane and bone graft substitutes attempting to partially fill the bony defects caused by peri-implantitis can be successful [14]. Therapy of peri-implantitis followed by regular supportive care resulted in favorable clinical improvements and stable peri-implant bone levels in the majority of patients according to a systematic review [15].…”

A prospective case series on surgical treatment of circumferential and semi-circumferential defects due to peri-implantitis

“…A B Nevertheless, the perception among clinicians is that the peri-implantitis treatment is unpredictable and may not lead to success. 8 Esposito et al 9 in a systematic review on the therapy found that in some studies with a follow-up longer than 1 year, recurrence of peri-implantitis was up to 100% of the treated cases. In contrast, Renvert and coworkers found that stable clinical results could be achieved up to 5 years after initial therapy but highlighting that adequate oral hygiene across this period appeared to be an essential prerequisite.…”