From: Management of peri-implantitis: a systematic review, 2010–2015
References | Diagnosis of peri-implantitis | No. of implant | Treatment strategy | Follow up | Study parameters | Results | |
---|---|---|---|---|---|---|---|
Group 1 | Goup 2 | ||||||
Schar et al. (2013) | PPD 4–6 mm BOP Bone loss—0.5–2 mm No mobility | 67 | Photodynamic therapy | Minocycline Microspheres locally | 6 months | BOP CAL PPD Mucosal recession Modified plaque index | Both treatment equally effective but no complete resolution of inflammation |
Schwarz et al. (2006b) | PD 4 mm BOP Suppuration No mobility Keratinized peri-implant mucosa | 12 | Er:YAG laser | 6 months | Plaque index BOP PD Gingival recession CAL Histo-pathology | Improved clinical parameters Mixed chronic inflammatory cell infiltrate | |
PD ≥4 mm Bleeding/pus on probing Bone loss ≤1.8 mm Anaerobic bacteria | 95 | Minocycline microspheres locally 1 mg | 1 % chlorhexidine gel | 12 months | PD BOP Local plaque index Bonel level Bacterial count | Both treatment resulted marked reduction in indicator bacteria Minocycline treatment improved PD | |
Persson et al. (2010) | PPD ≥4 mm Bone loss >2.5 mm Bleeding/pus on probing | – | Curettes | Ultrasonic device | 6 months | PD BOP Bacterial count | Both methods failed to eliminate bacterial counts |
Hallstrom et al. (2012) | PPD ≥4 mm Bleeding/pus on probing | – | Non-surgical debridment Systemic antibiotics | Non-surgical debridment | 6 months | PD BOP Bacterial count | BOP and PPD were improved with antibiotic treatment No changes in bacterial count in both groups |
Sahm et al. (2011) | PPD ≥4 mm Bone loss ≤30 % Bleeding Suppuration No mobility No occlusal overload 2 mm keratinized attached mucosa Good PI | 43 | OHI (Oral Hygiene Instructions) Amino acid glycine powder (AAD) | Mechanical debridement with carbon curettes Antiseptic therapy chlorhexidine digluconate (MDA) | 6 months | BOP PD CAL | Both groups revealed comparable PD reduction and CAL gains Higher changes in BOP in AAD group |
PPD ≥5 mm Bone loss ≥2 mm BOP | 100 | Er:YAG laser | Air-abrasive device | 6 months | PPD BOP Bacterial counts | Both method showed limited clinical improvement but failed to reduce bacterial count. | |
Karring et al. (2005) | PPD ≥5 mm Bone loss ≥1.5 mm BOP | – | Vector® system | Submucosal debridment with carbon fiber curette | 6 months | Plaque BOP PPD Bone level | There was no significant difference between the two methods although BOP was reduced in Vector® system |
Machtei et al. (2012) | PD 6–10 mm BOP Bone loss | 77 | Implant debridement Matrix chips (MatrixC) | Implant debridement Chlorhexidine chips (PerioC) | 6 months | BOP PD CAL | PerioC showed greater clinical improvement than MatrixC |
Aghazadeh et al. (2012) | PD ≥5 mm BOP Bone loss ≥3 mm Suppuration Mucosal recession | 75 | Resection surgery Autogenous bone Collagen membrane Antibiotic | Resection surgery Bovine derived xenograft (BDX) Collagen membrane Antibiotic | 12 months | PD BOP Suppuration Bone loss | BDX with collagen membrane showed more radiographic bone defect fill Bothe treatment offered improvement in BOP, PD and suppuration |
PD >6 mm Bone loss >3 mm Keratinized mucosa | 22 | Access flap surgery Hydroxy-apatite nanocrystals | Access flap surgery Natural bone mineral Collagen membrane | 24 months and 4 years | Plaque BOP PPD Bone level Attachment loss | Natural bone plus membrane offered better result | |
Schwarz et al. (2006a) | PD >6 mm Bone loss >3 mm Keratinized mucosa | 22 | Access flap surgery Hydroxy-apatite nanocrystals | Access flap surgery Bovine derived xenograft Collagen membrane | 6 months | Plaque BOP PPD Bone level Attachment loss | Both treatment offered PD reduction and CAL gain |
Wohlfart et al. (2012) | PD ≥5 mm Bone loss ≥4 mm BOP | 32 | Resective surgery using titanium curettes 24 % ethylenediaminetetraacetic acid | Resective surgery using titanium curettes Porous titanium granules (PTG) | 12 months | PPD Bone level BOP | Reconstruction with PTG resulted better radiographic peri-implant defect fill |
Romeo et al. (2007) | PD ≥4 mm Bleeding Suppuration No implant mobility Radiographic horizontal peri-implant radiolucency | 38 | Amoxicillin 50 mg/kg prior to treatment for 8 days Implantoplasty | Amoxicillin50 mg/kg prior to treatment for 8 days Resective surgery | 3 Years | Marginal bone loss | Radiographs revealed implantoplasty as an effective treatment |
PD >6 mm Intrabony defect >3 mm- 2 mm Keratinized mucosa | 26 and 38 | Resective surgery Implantoplasty Er:YAG laser in intra bony components Natural bone Mineral Collagen membrane | Resective surgery Implantoplasty Cotton pellets dipped in sterile saline (CPS) Natural bone mineral Collagen membrane | 6 and 24 months | BOP Attachment loss Bone loss | 24 months treatments with CPS offered better clinical parameters as well as bony defect fill | |
de Waal et al. (2013) | PD ≥5 mm Bone defect ≥2 mm Bleeding Suppuration | 79 | Resective surgery with apically repositioned flap Bone recountouring Surface debridment/decontamination 0.12 % chlorhexidine 0.05 % cetylpyrinidium chloride (CPC) | Placebo | 12 months | BOP Suppuration PD Bacterial count | CHX + CCP treatment results immediate suppression of bacterial count |