Efficacy of chemical approaches for implant surface decontamination in conjunction with sub-marginal instrumentation, in the non-surgical treatment of peri-implantitis: A systematic review.

Aim: To answer the following PICOS question: In adult patients with peri-implantitis, what is the efficacy of sub-marginal instrumentation combined with chemical surface decontamination in comparison with sub-marginal instrumentation with or without placebo, in terms of changes in probing depth (PD) and/or bleeding on probing, as reported in prospective randomized controlled trials, non-randomized controlled trials, or prospective cohort studies, with a minimum of 6-month "follow-up".

Materials And Methods: A systematic literature search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and The Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until March 2022. Data addressing the primary and secondary outcomes were extracted.

Results: The search gave 2033 results of which 3 fulfilled the inclusion criteria. Two studies investigated the use of anti-microbial photodynamic therapy as adjunct to sub-marginal instrumentation and the third study assessed the adjunctive use of a desiccant material. A meta-analysis was not deemed meaningful because of the large heterogeneity among the studies. All three studies showed favourable results in terms of PD reduction for chemical surface decontamination over control approaches, but were inconsistent or showed no differences for the other outcome variables.

Conclusions: Adjunctive chemical approaches for implant surface decontamination may offer an advantage over sub-marginal instrumentation alone, in terms of improved PD.