The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis

Nikos Donos*, Elena Calciolari, Mandeep Ghuman, Michela Baccini, Vanessa Sousa, Luigi Nibali*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)


Aim: To evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at ≥12-month follow-up. Materials and Methods: Three databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question—FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms. Results: Seven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (−0.387; p =.325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes. Conclusions: Reconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.

Original languageEnglish
Pages (from-to)285-316
Number of pages32
JournalJournal of Clinical Periodontology
Issue numberS26
Early online date12 Jan 2023
Publication statusPublished - Jun 2023


  • bone graft
  • membrane
  • meta-analysis
  • peri-implantitis
  • reconstructive therapies
  • systematic review


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