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

TY - JOUR

T1 - The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis

AU - Donos, Nikos

AU - Calciolari, Elena

AU - Ghuman, Mandeep

AU - Baccini, Michela

AU - Sousa, Vanessa

AU - Nibali, Luigi

N1 - Funding Information: The authors do not have any conflict of interest in relation to this systematic review. Nikos Donos received grants/lecture fees from Osteology Foundation, Geistlich, ITI, BTI, Sunstar, Oral B, Straumann, GSK, and Academy of Osseointegration, outside the submitted work. Elena Calciolari received grants from Osteology Foundation, ITI, Geistlich, and Academy of Osseointegration outside the submitted work. Vanessa Sousa received grants from Osteology Foundation, BBSRC, and Unilever, outside the submitted work. Luigi Nibali received grants from Unilever, outside the submitted work. Publisher Copyright: © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2023/6

Y1 - 2023/6

N2 - 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.

AB - 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.

KW - bone graft

KW - membrane

KW - meta-analysis

KW - peri-implantitis

KW - reconstructive therapies

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85147996259&partnerID=8YFLogxK

U2 - 10.1111/jcpe.13775

DO - 10.1111/jcpe.13775

M3 - Review article

C2 - 36635029

AN - SCOPUS:85147996259

SN - 0303-6979

VL - 50

SP - 285

EP - 316

JO - Journal of Clinical Periodontology

JF - Journal of Clinical Periodontology

IS - S26

ER -