Treatment of peri-implantitis with implantoplasty – A systematic review

Background

Peri-implantitis is characterized by an inflammatory reaction that affects peri-implant hard and soft tissues, resulting in the loss of supporting bone and the formation of pockets around the osseointegrated implant. The concept of implantoplasty treatment was described by different authors, who proposed to polish the rough surface of the exposed implant, not only with the aim of decontaminating it, but also to reduce future bacterial colonization of the surface.

Aim/Hypothesis

To assess the benefit of implant surface decontamination and polishing with the technique of implantoplasty in the peri-implantitis treatment and also to verify if there is any benefit when associating implantoplasty with other treatment options.

Material and Methods

The search strategy was performed using an electronic database (MEDLINE®+ ScienceDirect+ Cochrane Library). First, a search was performed on the following terms and keywords- implantoplasty AND ì peri-implantitis î. Additionally, using limit strategies, it was also selected ìfull textî, with no geographical or language restriction and inclusion of all publications with date until April 2019. After this first search phase an evaluation of all the titles and abstracts of the selected articles was carried out. At this stage, a new selection of articles was performed according to the inclusion exclusion criteria of the studies in the systematic review. Reporting has been guided by PRISMA protocol for systematic reviews.

Results

The first electronic search resulted in 36 citations. From 15 full-text articles eligible for review, 7 were included. The present studies included a follow-up time of 46.42 ± 32.94 months, with a minimum of 12 months. From a total of 172 implants it was obtained a 94.7% of success, with the use of this technique alone or the combination with an additional procedure. The use of implantoplasty technique showed an improvement of the evaluated parameters such as BoP and plaque score in the groups treated either with implantoplasty alone or with the conjunction of other treatment option. In two RCT studies, that compared implantoplasty and resective surgery alone, the implant survival rate was favorable for the first treatment modality (100% versus 87.5% and 100% versus 77.5%, respectively) at the 36-months follow-up.

Conclusion and Clinical Implications

The literature shows advantages in the use of this technique in terms of periimplantitis treatment and maintenance when compared with traditional resective surgery alone. More randomized controlled clinical trials with larger follow-up periods are needed to assess the long-term efficacy of implantoplasty therapy of peri-implantitis.