Surgical Treatment of Periimplantitis With Non-Augmentative Techniques.

OBJECTIVES: The aim of this review was to systematically screen the literature on surgical non-regenerative treatments of periimplantitis, especially for radiologic and clinical outcomes, and to determine predictable therapeutic options for the clinical management of periimplantitis lesions.

MATERIAL AND METHODS: The potentially relevant literature was assessed independently by 2 reviewers to identify clinical studies, trials, and case series in humans describing the surgical non-regenerative treatment outcomes of periimplantitis with a follow-up of at least 6 months. MEDLINE, EMBASE, and the Cochrane Library were searched for studies reporting changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone-level changes.

RESULTS: A total of 10 publications were included: 6 prospective randomized controlled trials, 1 prospective cohort study, 2 retrospective controlled studies, and 1 case series. Clinical parameters can be reduced by surgical non-regenerative treatments. Concerning 3 year follow-ups, BOP and PD values decreased more efficiently after implantoplasty than using systematic administration of antibacterials. Adjunctive local chemical irrigations or diode laser have no long-term effects. The non-regenerative surgical approach in combination with implantoplasty also shows improved radiographic parameters.

CONCLUSIONS: Surgical non-regenerative treatment of periimplantitis can reduce the amount of inflammation in the short-term follow-up. Using implantoplasty may result in the improvement of clinical and radiographic parameters. Because of limited evidence and heterogeneity in study design, there is a need for randomized controlled studies with proper design and powerful sample size in the future.