Abstract

Articles on surgical treatment of peri-implantitis in humans published up to December 2011 were included. Twenty-six studies were selected, thus limiting the available evidence. There is marked heterogeneity between study designs and case definitions for peri-implantitis in the studies cited, limiting the generalization of the reported results. Adjunctive systemic antibiotics were used in most studies, but no study evaluated the adjunctive benefit of systemic antibiotics. Access flap surgery, removal of granulation tissue and implant surface decontamination has been demonstrated to decrease plaque index, BOP, suppuration, probing depths and to arrest bone loss for 58% of implant sites over 5 years. Laser treatment of the exposed implant surface during surgery was not shown to be beneficial. Available data indicate that it is possible to obtain defect fill of peri-implantitis defects following surgical-treatment modalities with concomitant placement of bone or bone substitutes in such defects. However, there is lack of evidence that placement of membranes in addition to grafting procedures provides any additional defect fill. Surgical therapy for treating peri-implantitis is a predictable method for treating peri-implant disease and patients receiving this therapy have benefited from it in the short term.

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