Efficacy of professionally administered chemical agents as an adjunctive treatment to sub-marginal instrumentation during the therapy of peri-implant mucositis

AimTo evaluate the efficacy of professionally administered chemical agents as an adjunctive treatment to sub-marginal instrumentation (SMI) in the therapy of peri-implant mucositis. Materials and MethodsThe primary outcome criteria were reduction in bleeding on probing (BOP), whereas resolution of disease, elimination of suppuration, including suppuration on probing, reduction of peri-implant probing pocket depth, reduction of plaque, and patient-reported outcome measures were considered as secondary outcome parameters. A literature search was performed on three electronic databases (01/1980 to 05/2022) focused on clinical studies with at least 3 months of follow-up, and meta-analyses were performed when appropriate. ResultsFrom a total of 139 publications, 40 articles were identified for full-text reading, and 5 randomized controlled clinical trials (RCTs) on antimicrobial photodynamic therapy (aPDT), 1 RCT on chlorhexidine (CHX), and 1 RCT on sodium hypochlorite (NaOCl) were included. Three studies had a low risk of bias and four had a mid-level (some concerns) risk of bias. The application of aPDT, 0.95% NaOCl, or 0.12% CHX as an adjunctive treatment to SMI showed no difference in changes in BOP and PD compared with SMI alone (p > .05). ConclusionsWithin the limitations of this review and based on a low level of evidence from seven RCTs, it is concluded that the professional adjunctive topical application of aPDT, 0.95% NaOCl, and 0.12% CHX may not be effective to improve changes for BOP and PD when compared with SMI alone.

Automated summary

This study evaluated the efficacy of professionally administered chemical agents as an adjunctive treatment to sub-marginal instrumentation (SMI) in the therapy of peri-implant mucositis. The results showed that the application of antimicrobial photodynamic therapy (aPDT), sodium hypochlorite (NaOCl), or chlorhexidine (CHX) as adjunctive treatment to SMI did not show significant differences in changes in bleeding on probing (BOP) and probing pocket depth (PD) compared with SMI alone. In conclusion, these professional adjunctive topical applications may not be effective in improving inflammation indicators.