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.