The efficacy of interventions to treat peri-implantitis: a Cochrane systematic review of randomised controlled clinical trials

摘要: Objectives To identify the most effective interventions for treating peri-implantitis around osseointegrated dental implants. Data sources The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched several journals handsearched with no language restriction up to January 2008. Review methods Randomised controlled trials (RCTs) comparing eligible. Screening of studies, quality assessment data extraction conducted in duplicate. Missing information was requested. Outcome measures were: implant failure; complications; changes radiographic marginal bone level, probing 'attachment' level (PAL), pocket depth (PPD), recession; aesthetics evaluated by patients dentists; cost treatment time. Results Ten eligible identified, seven included (148 patients). They tested: (1) local antibiotics vs ultrasonic debridement; (2) adjunctive (3) different techniques subgingival (4) laser manual debridement chlorhexidine irrigation/ gel; (5) systemic plus resective surgery two without surface smoothening; (6) nanocrystalline hydroxyapatite Bio-Oss resorbable barriers. Follow ranged from 3 months 2 years. After 4 months, who lost at least 50% peri-implant showed improved PAL PPD (0.6 mm). 6 infrabony defects > mm treated barriers gained 0.5 more than those hydroxyapatite. In four mechanical seemed achieve results similar complex therapies. Conclusions There is very little reliable evidence suggesting which could be peri-implantitis. Sample sizes too small follow short. This not say that currently used are ineffective. Larger well-designed RCTs needed.