Surgical therapy for peri‐implantitis management: a systematic review and meta‐analysis

Aim Peri‐implantitis is a common cause of late implant failure. Studies have investigated different treatment strategies. The effectiveness of these modalities, however, remains unclear. This study aimed to evaluate the success of surgical peri‐implantitis treatment using clinical and radiographic parameters. Material and methods A systematic review of published literature was employed. Key words were selected to conduct an electronic search using four databases for literature on human clinical studies. Meta‐analyses were carried out for clinical probing, pocket depth and radiographic bone level. Results A total of 16 papers met the inclusion criteria. Four treatment modalities to supplement mechanical debridement were identified: (i) apically repositioned flap, (ii) chemical surface decontamination, (iii) implantoplasty, and (iv) bone augmentation. Inconsistent results were evident which were dependent on several treatment‐independent factors. No clinical benefits were identified for the additional use of surface decontamination, while limited evidence demonstrated improvement of clinical and radiographic outcomes after implantoplasty. The effect of bone augmentation appeared limited to ‘filling’ radiographic defects. Conclusions The outcomes of the currently available surgical interventions for peri‐implantitis remain unpredictable. There is no reliable evidence to suggest which methods are the most effective. Further randomised‐controlled studies are needed to identify the best treatment methods.