Surgical Regenerative Treatments for Peri-Implantitis: Meta-analysis of Recent Findings in a Systematic Literature Review.
OBJECTIVE
The purpose of the present study was to systematically review the literature on the surgical regenerative treatment of the peri-implantitis and to determine an effective therapeutic predictable option for their clinical management.


METHODS
The study searched MEDLINE and EMBASE databases from 2006 to 2016. Clinical human studies that had reported changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone level (RBL) changes after peri-implantitis surgical treatment at 12-month follow-up or longer were included accordingly to PRISMA guidelines.


RESULTS
The initial search obtained 883 citations. After screening and determination of eligibility, 18 articles were included in the review. The meta-analysis of selected studies revealed that the weighted mean RBL fill was 1.97 mm (95% confidence interval [CI] = 1.58 to 2.35 mm), PD reduction was 2.78 mm (95% CI = 2.31 to 3.25 mm), and BOP reduced by 52.5% (95% CI = 41.6 to 63.1%). Defect fill in studies using and not using barrier membranes for graft coverage was 1.86 mm (95% CI = 1.36 to 2.36 mm) and 2.12 mm (95% CI = 1.46 to 2.78 mm) correspondingly. High heterogeneity among the studies regarding defects morphology, surgical protocols, and selection of biomaterials were found.


CONCLUSIONS
All included studies underlined an improvement of clinical conditions after the surgical regenerative treatment of peri-implantitis, however, there is a lack of scientific evidence in the literature regarding the superiority of the regenerative versus non-regenerative surgical treatment. The presence of a barrier membrane or submergence in the regenerative procedure does not seem to be fundamental in order to obtain clinical success of the surgery.
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania.
Povilas
P
Daugela
Human Pathology Department, Messina University, Messina Italy.
Marco
M
Cicciù
Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern Switzerland.
Nikola
N
Saulacic
alveolar bone grafting; alveolar bone loss; biocompatible materials; bone regeneration; oral surgery; peri-implantitis