title: The therapy of peri-implantitis: a systematic review.
abstract: OBJECTIVE
  To evaluate the success of treatments aimed at the resolution of peri-implantitis in patients with osseointegrated implants.
  
  
  METHODS
  The potentially relevant literature was assessed independently by two reviewers to identify case series and comparative studies describing the treatment of peri-implantitis with a follow-up of at least 3 months. Medline, Embase, and The Cochrane Library were searched. For the purposes of this review, a composite criterion for successful treatment outcome was used which comprised implant survival with mean probing depth < 5 mm and no further bone loss.
  
  
  RESULTS
  A total of 43 publications were included: 4 papers describing 3 nonsurgical case series, 13 papers describing 10 comparative studies of nonsurgical interventions, 15 papers describing 14 surgical case series, and 11 papers describing 6 comparative studies of surgical interventions. No trials comparing nonsurgical with surgical interventions were found. The length of follow-up varied from 3 months to 7.5 years. Due to the heterogeneity of study designs, peri-implantitis case definitions, outcome variables, and reporting, no meta-analysis was performed. Eleven studies could be evaluated according to a composite success criterion. Successful treatment outcomes at 12 months were reported in 0% to 100% of patients treated in 9 studies and in 75% to 93% of implants treated in 2 studies. Commonalities in treatment approaches between studies included (1) a pretreatment phase, (2) cause-related therapy, and (3) a maintenance care phase.
  
  
  CONCLUSIONS
  While the available evidence does not allow any specific recommendations for the therapy of peri-implantitis, successful treatment outcomes at 12 months were reported in a majority of patients in 7 studies. Although favorable short-term outcomes were reported in many studies, lack of disease resolution as well as progression or recurrence of disease and implant loss despite treatment were also reported. The reported outcomes must be viewed in the context of the varied peri-implantitis case definitions and severity of disease included as well as the heterogeneity in study design, length of follow-up, and exclusion/inclusion criteria.
authors.forename: Lisa J A
authors.initials: LJ
authors.lastname: Heitz-Mayfield
authors.forename: Andrea
authors.initials: A
authors.lastname: Mombelli
mesh_terms: D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects; D019232:Dental Restoration Failure; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D057873:Peri-Implantitis / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants