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Changes in peri-implant soft tissue levels following surgical treatment of peri-implantitis: A systematic review and meta-analysis

Authors
 Ignacio Sanz-Martín  ;  Jae-Kook Cha  ;  Ignacio Sanz-Sánchez  ;  Elena Figuero  ;  David Herrera  ;  Mariano Sanz 
Citation
 CLINICAL ORAL IMPLANTS RESEARCH, Vol.32(Suppl 21) : 230-244, 2021-10 
Journal Title
CLINICAL ORAL IMPLANTS RESEARCH
ISSN
 0905-7161 
Issue Date
2021-10
MeSH
Dental Implants* ; Dental Plaque Index ; Humans ; Peri-Implantitis* / diagnostic imaging ; Peri-Implantitis* / surgery ; Reconstructive Surgical Procedures* ; Surgical Flaps
Keywords
mucosal recession ; peri-implant diseases ; peri-implantitis ; peri-implantitis therapy ; recession ; systematic review
Abstract
Aim: To assess the changes in peri-implant soft tissue levels after the surgical treatment of peri-implantitis.

Methods: Randomized controlled trials, controlled clinical trials, cohort studies and case series, evaluating the changes in the position of the mucosal margin before and after surgical treatment of peri-implantitis, were searched. Secondary outcomes were changes in keratinized mucosa (KM), radiographic bone levels, probing depths (PD), plaque indices, bleeding on probing and patient perception. Meta-analyses were performed to determine weighted mean differences (WMD) or effects (WME).

Results: Twenty-six articles, reporting 20 investigations, were included. Reconstructive approaches yielded significantly less increase in mucosal recession, when compared to access flaps (n = 3, WMD = -1.35 mm, 95% confidence interval [CI] [-2.62; -0.07], p = .038). When comparing among reconstructive surgical interventions similar outcomes were observed irrespective of the use of a barrier membrane (n = 3, WMD = -0.01 mm, 95% CI [-0.15; 0.13], p = .917). When considering the effects over time, limited mucosal recession was observed after reconstructive procedures (n = 23, WME = 0.389 mm, 95% CI [0.204; 0.574]), p = .001), while increased recession was reported with either resective or access flap surgery (n = 6, WME = 1.21 mm, 95% CI [0.70; 1.72], p = <.001; and n = 3, WME = 0.95 mm, 95% CI [0.20; 2.10], p = .106; respectively). When resective and reconstructive approaches were combined the highest values on peri-implant recession were reported (n = 2, WME = 1.97 mm, 95% CI [0.81; 3.14], p < .001). Reconstructive surgical interventions were associated with greater radiographic bone level gains, while similar values were reported for PD reduction when comparing reconstructive, access and resective procedures.

Conclusions: Resective surgical procedures were associated with significant post-surgical recession while minimal recession was observed in regenerative interventions.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/clr.13840
DOI
10.1111/clr.13840
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Periodontics (치주과학교실) > 1. Journal Papers
Yonsei Authors
Cha, Jae Kook(차재국) ORCID logo https://orcid.org/0000-0001-6817-9834
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187314
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