Surgical regenerative treatment of peri-implantitis

Howe, Mark-Steven; Richards, Derek

doi:10.1038/sj.ebd.6401256

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Independent scrutiny of the titles and abstracts identified 34 potentially relevant SRs for full‐text review. After full‐text evaluation, 11 articles did not meet our inclusion criteria and were excluded (Table ) . Finally, a total of 23 SRs formed the basis for this study …”

Section: Resultsmentioning

confidence: 99%

“…After full-text evaluation, 11 articles did not meet our inclusion criteria and were excluded (Table 1). [21][22][23][24][25][26][27][28][29][30][31] Finally, a total of 23 SRs formed the basis for this study.…”

Section: Search Resultsmentioning

confidence: 99%

“…Steven-Howe and Richards, 21 Hur and Ogata, 22 Elangovan, 23 Romanos and Javed, 24 Esposito et al 25…”

Section: Structured Abstract Of Other Articlesmentioning

confidence: 99%

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Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Hasuike

Ueno²,

Nagashima

et al. 2019

J of Periodontal Research

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Background and Objectives The purpose of the present study was to evaluate the methodological quality and risk of bias in systematic reviews (SRs) on the effectiveness of peri‐implantitis treatments. Material and Methods We searched four electronic databases: MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and EMBASE. Previous SRs focusing on peri‐implantitis treatment published between 2010 and 2017 were identified. After literature screening, eligible SRs were qualitatively assessed using two validated instruments: Assessing the Methodological Quality of Systematic Reviews (AMSTAR2) and Risk Of Bias In Systematic reviews (ROBIS). The characteristics and findings of SRs are also reported. Results A total of 23 SRs formed the basis of this study. Of the 23, six included randomized controlled trials (RCTs) only. Overall, the AMSTAR2 assessment revealed three studies with high and six studies with low methodological quality, and all the other SRs were judged as having critically low methodological quality. ROBIS revealed only one Cochrane review with a low risk of bias and the others with a high risk of bias. In particular, the assessment of non‐randomized studies (NRSIs), appropriateness of ROB assessment, and meta‐analysis did not satisfy the criteria in AMSTAR2 assessment. Furthermore, there were a few SRs that interpreted and discussed the results of risk of bias (ROB) and heterogeneity assessment, together with the impact of treatment. Conclusions Due to the lack of head‐to‐head comparisons conducted in RCTs, review authors need to use other sources of evidence, such as clinical control trials (CCTs), cohort studies (CS), clinical research (CR), and animal studies. The end result is the presentation of low‐quality evidence, with high ROB. Several SRs conducted network meta‐analysis as an alternative to head‐to‐head conventional meta‐analysis of RCTs. We suggest that the best methods to generate, access, and assess evidence in situations where RCT evidence is lacking should be discussed on an urgent basis.

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Section: Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

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Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Hasuike

Ueno²,

Nagashima

et al. 2019

J of Periodontal Research

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“…Over the last decade, there have been several reviews investigating the efficacy of non-surgical therapies [ 12 ], surgical therapies [ 13 , 14 , 15 ], or both [ 1 , 16 , 17 , 18 ]. Furthermore, multiple reviews have investigated the efficacy of adjunctive treatment modalities, such as the use of dental laser [ 19 ], air-abrasive system [ 20 ], or antibiotics [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Peri-Implantitis Lesions without the Use of Systemic Antibiotics: A Systematic Review

et al. 2020

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Background: This systematic review aims to assess the current evidence on the efficacy of surgical and non-surgical debridement techniques in the treatment of peri-implantitis lesions without the use of any antimicrobials. Method: Five electronic databases (MEDLINE, Pubmed, Scopus, CINAHL and Cochrane) were used, alongside hand searches, to find relevant articles. Full-text articles that were randomised controlled trials, published in the English language from 2011 onwards without pre-operative, peri-operative and post-operative antibiotic usage were included. The study was conducted according to the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-P protocols, the latest Cochrane Risk of Bias tool and each investigated intervention was evaluated using the grading of recommendation, assessment, development and evaluation (GRADE) system. Results: The search yielded 2718 results. After initial screening, 38 full-text articles were assessed for eligibility. From these, 11 studies satisfied all inclusion criteria. These 11 articles described six non-surgical and five surgical debridement therapies. Most articles were classified as having either a high risk of bias or presenting with some concerns. Small sample sizes, in combination with this risk of bias, meant that all interventions were adjudged to be of either low or very low quality of evidence. Conclusion: While all investigated modalities displayed some sort of efficacy, this review suggests that a surgical approach may be best suited to treating peri-implantitis lesions in the absence of antibiotic therapy. Despite this weak indication, further research is required in this field.

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“…Surgical regenerative treatment is a predictable option in managing periimplantitis and improving clinical parameters of periimplant tissues, even there wasn't found an advantage of membrane use for bone graft coverage or the submergence of the implant site following peri-implant defect treatment on periimplant regeneration [1].…”

Section: Introductionmentioning

confidence: 99%

A modified surgical approach for hard and soft tissue reconstruction of severe periimplantitis defects: laser-assisted periimplant defect regeneration (LAPIDER)

Noelken

Al‐Nawas

2020

Int J Implant Dent

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Background The main problem in periimplantitis is often the combination of severe periimplant bone loss with a contaminated implant surface and an insufficient soft tissue situation. Classic surgical concepts with crestal access to the bony defect and debridement of the surface most often lead to partial defect regeneration and a soft tissue recession. An incision directly above the pathologic bony lesion is contrary to general surgical treatment rules. Aim To overcome this problem, a new surgical concept was developed which allows to clean the implant surface, reconstruct the bony defect, and improve soft tissue height and thickness without cutting the papilla complex. This publication presents the innovative regenerative treatment approach for severe periimplantitis defects. Material and methods After diagnosis and non-surgical pre-treatment of a severe periimplantitis lesion, the following treatment protocol was applied: horizontal mucosal incision 5 mm apical to marginal mucosa, supraperiosteal preparation in apical direction, cutting through periosteum at the level of the implant apex, subperiosteal coronal flap elevation, exploration and cleaning of the periimplant defect, thorough debridement of the implant surface with the Er:YAG laser, subperiosteal grafting with connective tissue, grafting of the bony defect with autogenous bone chips from the mandibular ramus, and bilayered suturing of periosteum and mucosa. Implant survival, marginal bone levels, periimplant probing depths, recession, and facial mucosa thickness (PIROP ultrasonic measurement) were evaluated in a pilot case at 1-year follow-up examination. Results Inter-proximal, oral, and buccal marginal bone levels increased significantly to the level of the implant shoulder from pre-operative to 1-year follow-up examination. No signs of suppuration or periimplant infection were present. Probing depths and recession decreased significantly, while the facial mucosa thickness improved from pre-operative to final examination. Conclusions Marginal bone levels and soft tissue improvement suggest feasibility for the regeneration of severe periimplant hard and soft tissue deficiencies by this new treatment approach. With the use of this concept, the simultaneous implant surface cleansing and improvement of hard and soft tissue seem to be possible and unfavorable postoperative exposition of titanium surface might be prevented. Comparative studies are planned to quantify the effects of this new surgical protocol.

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Surgical regenerative treatment of peri-implantitis

Cited by 4 publications

References 6 publications

Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Methodological quality and risk‐of‐bias assessments in systematic reviews of treatments for peri‐implantitis

Management of Peri-Implantitis Lesions without the Use of Systemic Antibiotics: A Systematic Review

A modified surgical approach for hard and soft tissue reconstruction of severe periimplantitis defects: laser-assisted periimplant defect regeneration (LAPIDER)

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