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

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. 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. 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. 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 rationale for postsurgical laser use to effectively treat dental implants affected by peri-implantitis: two case reports

Peri-implantitis is a biologic complication that can affect the survival of a dental implant. Most surgical and nonsurgical treatments have been relatively ineffective even when using targeted antimicrobial approaches. A growing number of reports are documenting the presence of titanium granules and/or cement in the soft tissues surrounding peri-implantitis-affected dental implants. Two case reports are presented demonstrating how the Nd:YAG or a carbon dioxide (CO2) laser used following regenerative surgeries changed failures into successes as measured by radiographic bone fill and improved clinical parameters. These cases suggest that successful peri-implantitis treatment may need to incorporate decontamination of the soft tissues in addition to the implant's surface. Further studies are warranted to determine if each of these lasers would be successful over a larger patient cohort

Peri-implant mucositis

Peri-implant mucositis has been defined as a reversible inflammatory reaction in the soft tissues around a functioning implant with no bone loss. This paper reviews the prevalence, etiology, risk indicators, prevention, and treatment of mucositis. Relying on the literature concerning mucositis, the bacterial etiology is discussed as well as the varying ranges of prevalence, reported to be from 20% to 80% of subjects (13% to 62% of implants) after a minimum of 5 years of implant function. A discussion of the definition of mucositis questions the assumption of it being completely reversible following treatment and challenges the concept of mucositis "transfer" (conversion) to peri-implantitis