Article

Therapy of peri-implantitis: A systematic review: Review article

Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece.
Journal Of Clinical Periodontology (Impact Factor: 4.01). 08/2008; 35(7):621-9. DOI: 10.1111/j.1600-051X.2008.01240.x
Source: PubMed

ABSTRACT

The objective of this study was to provide a systematic review of randomized controlled and/or comparative clinical trials published in the international peer-reviewed literature in the English language, up to and including July 2007, concerning the efficacy of all treatment modalities implemented for the therapy of peri-implantitis.
PubMed and The Cochrane Library databases were searched electronically and numerous journals were examined manually. In the first phase of selection, the titles and abstracts, and in the second phase, complete papers were screened independently and in duplicate by three reviewers (S. K., I. K. K. and M. T.).
The search yielded 1304 possibly relevant titles and abstracts. After the first phase of selection, 13 publications were singled out for a rigorous evaluation. Following the second phase, five studies were selected.
The selected studies are too limited in number and exhibit small sample sizes and short follow-up periods. Therefore, there is a definite need for more well-designed, preferably longitudinal, randomized controlled clinical trials. Within the limitations of the selected studies, mechanical debridement combined with antiseptic/antibiotic therapy, the Er:YAG laser or regenerative techniques may be used for treating peri-implantitis, but the indications for each of these techniques have not been delineated clearly.

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    • "The underlying principle in any type of treatment is to reduce bacterial load in peri-implant sites and to achieve peri-implant mucosal health [13] [14]. However, current evidence for the efficacy of each type of treatment is weak and limited, and the superiority of any modality over the others is unknown [1] [14] [15]. "
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    • "Peri-implantitis is defined as an inflammatory process affecting the implant’s supporting bone [4, 5]. By the growing popularity of dental implants the prevalence of peri-implantitis has increased as well [6]. The basics of peri-implantitis treatment include elimination of inflammation by removing calculus and granulation tissue and decontamination of implant surface without modifying the surface structure [7]. "
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    • "Effective decontamination of dental implant surfaces is one of the most difficult steps; and for this reason, several different treatments have been proposed in the literature [3–8]. Titanium implant surfaces can be cleaned by mechanical means (dental curettes, ultrasonic scalers, air–powder abrasive) and/or chemical procedures (citric acid, H2O2, chlorhexidine digluconate, and EDTA), usually associated with local or systemic antibiotics [9–12]. However, some of these methods can damage the surface properties of implants or promote bacterial resistance [13–15]. "
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