Efficacy of adjunctive measures in peri‐implant mucositis. A systematic review and meta‐analysis

Abstract

Aim

To answer the following PICO question: In systemically healthy humans with peri‐implant mucositis, what is the efficacy of patient‐performed or administered (by prescription) measures used adjunctively to submarginal instrumentation, as compared to submarginal instrumentation alone or combined with a negative control, in terms of reducing bleeding on probing (BOP), in randomized controlled clinical trials (RCTs) with at least 3 months of follow‐up?

Materials and Methods

Three databases were searched until April 2022. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) and predictive intervals were calculated.

Results

Sixteen parallel RCTs corresponding to 14 studies with low/moderate risk of bias were included. Test groups showed greater reductions in BOP (%) than control groups ( n _studies = 16; n _patients = 650; WMD = 14.25%; 95% CI [9.06–19.45]; p < .001; I ² = 98.7%). The greatest WMD in BOP reductions (%) were obtained by antiseptics ( n _s  = 5; n _p  = 229; WMD = 22.72%; 95% CI [19.40–26.04]; p < 0.001; I ² = 94.8%), followed by probiotics ( n _s  = 6; n _p  = 260; WMD = 12.11%; 95% CI [3.20–21.03]; p = .008; I ² = 93.3%) and systemic antibiotics ( n _s  = 3; n _p  = 101; WMD = 5.97%; 95% CI [1.34–10.59]; p = .012; I ² = 58.1%). Disease resolution was scarcely reported ( n = 6).

Conclusions

Significant clinical improvements can be obtained when professional submarginal instrumentation is combined with patient‐performed or administered (by prescription) adjunctive measures, although a complete disease resolution may not be achieved.