Surgical regenerative methods for peri-implantitis treatment: A systematic review and meta-analysis

• Published in: Journal of advanced periodontology and implant dentistry 2024-07, Vol.16 (2), p.144-159
• Main Authors: Shahbazi, Soheil, Esmaeili, Saharnaz, Shirvani, Armin, Amid, Reza, Kadkhodazadeh, Mahdi
• Format: Article
• Language: English
• ISSN: 2645-5390; 2645-5390
• DOI: 10.34172/japid.2024.013

The purpose of this study was to review the literature on the efficacy of different surgical regenerative methods for peri-implantitis treatment. A preliminary search was conducted in seven electronic databases. The studies included in the analysis implemented surgical regenerative treatment in at least one study group. Baseline and follow-up values for bleeding on probing (BoP), pocket depth (PD), plaque index (PI), bone level (BL), and bone gain (BG) were extracted. The standardized mean difference (SMD) was calculated using Cohen's d or Hedges' g, and a random-effects-restricted maximum likelihood (REML) method was applied for the meta-analysis. Fifteen studies were included in the qualitative synthesis. The meta-analysis was performed on six studies comparing regenerative techniques that involved bone grafts with those that did not. The overall effect size for using bone grafts at the one-year follow-up was 0.04 (95% CI: -0.26‒0.35; =0.78) for BoP, -0.08 (95% CI: -0.42‒0.27; =0.66) for PD, 0.37 (95% CI: 0.08‒0.65; =0.01) for PI, -0.44 (95% CI: -0.84 to -0.03; =0.03) for BL, and 0.16 (95% CI: -0.68‒1.01; =0.70) for BG. Various materials have been employed for peri-implant defect filling and coverage. A bone substitute did not significantly improve BoP, PD, and BG values, while PI and BL were significantly ameliorated at one-year follow-up. However, recommending a single unified protocol as the most effective for surgical regenerative treatment of peri-implantitis was not feasible.