Surgical or non-surgical treatment of peri-implantitis — what is the verdict?,

Abstract

• The aim was to compare ST and NST in relation to peri-implantitis. • Indexed databases were searched. • Only one experimental study addressed the focused question. • Standardized protocols are needed in this regard. It remains unclear whether treatment of peri‑implantitis should be performed surgically after mucoperiosteal flap elevation or non-surgically. The aim of the present evidence-based literature review was to assess whether surgical or non-surgical treatment should be performed for the treatment of peri‑implantitis. The focused question was “Should peri‑implantitis be treated surgically or non-surgically?”. Clinical and experimental studies on animal-models were included. In-vitro studies, letters-to-the-Editor, reviews and commentaries were excluded. Indexed databases were searched up to and including May 2020 using guidelines of the preferred reporting guidelines for systematic reviews and meta-analysis. Hand searching was also performed. Initially, 588 studies were identified out of which, 587 were excluded. One split-mouth study on dogs with 3-months’ follow-up was included. In this study, test- and control-sites underwent surgical and non-surgical treatment, respectively. There was no statistically significant difference in bleeding on probing, probing depth and crestal bone loss between the test- and control-sites. Histomorphometic results that new bone formation was significantly higher at the most apical part of the peri‑implant defects in the test- than control-sites. Clinical attachment levels were significantly higher in the test- versus control-sites. In conclusion, due to the lack of clinical comparative studies, the selection of the therapeutic protocol (surgical or non-surgical) for the treatment of peri‑implantitis remains unclear. Hence, evidence-based protocols are needed to determine whether peri‑implantitis treatment should be performed surgically or non-surgically.