Pondering the problem of peri-implant pathology

Randomised control trials were identified via searches of PubMed, Embase, Web of Science and The Cochrane Library. Only randomised control trials involving adults with at least a single dental implant which had experienced peri-implant mucositis or peri-implantitis were considered. Within studies, one cohort must have been treated with a combination of mechanical debridement (MD) and non-surgical strategies, and the other solely by mechanical debridement. Outcomes were measured using periodontal indices such as bleeding on probing, and each group needed to comprise minimum five patients. Extracted information included the name of the lead author, size of patient groups, length of follow-up and the main results from the studies. The results indicated that in peri-implantitis the most effective treatment in reducing periodontal pocketing depths (PPDs) was photo biomodulation therapy and MD, while systemic antibiotics and MD were the most effective in improving clinical attachment loss and marginal bone loss. With regards to peri-implant mucositis; probiotics and MD yielded the best improvement in PPDs and plaque index, whereas systemic antibiotics with MD improved bleeding on probing the most. This analysis gives potentially useful data regarding specific treatment combinations for peri-implant disease. In light of this, it may help in guiding clinical decisions, but should be used in conjunction with recognised guidelines, and further high quality primary research is still required in the field.