The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis

AimTo evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at >= 12-month follow-up. Materials and MethodsThree databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question-FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms. ResultsSeven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (-0.387; p = .325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes. ConclusionsReconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.

Automated summary

This study evaluated the efficacy of bone reconstructive procedures for peri-implantitis-related bone defects. Meta-analysis showed no significant difference in probing pocket depth (PPD) change between bone reconstructive surgery and access flap surgery (AFS) at 12 months. The network analysis also showed no clear differences in PPD and bleeding on probing (BOP) changes among different reconstructive therapies. Only a small percentage of cases achieved peri-implantitis resolution with any modality. Therefore, reconstructive surgery does not offer significant improvements in peri-implant clinical parameters.