Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri-implant mucositis. A systematic review and meta-analysis

Focused QuestionIn patients with peri-implant mucositis, what is the efficacy of professionally administered plaque removal (PAPR) with adjunctive measures on changing signs of inflammation compared with PARP alone? Materials and MethodsAfter electronic database and hand search, 19 full-text articles were independently screened by two reviewers. Finally, a total of seven studies fulfilled the inclusion criteria. The weighted mean difference (WMD) in bleeding on probing- (BOP) (primary outcome), gingival index- (GI) and probing pocket depth- (PD) reductions was estimated (random effect model). ResultsWMD in BOP reduction between test and control groups amounted to -8.16% [SD=4.61; p=0.07; 95% CI (-17.20, 0.88)] not favouring adjunctive antiseptic or antibiotic (local, systemic) therapy over PAPR alone. WMD in GI and PD reductions amounted to -0.12 [SD=0.13; p=0.34; 95% CI (-0.38, 0.13)] and -0.056mm [SD=0.10; p=0.60; 95% CI (-0.27, 0.16)] not favouring adjunctive (antiseptics, systemic antibiotics, air abrasive device) over control measures respectively. Most studies evaluated reported on residual BOP and GI scores after therapy. ConclusionsAdjunctive therapy may not improve the efficacy of PAPR in reducing BOP, GI and PD scores at mucositis sites. Despite clinically important improvements, a complete disease resolution may not be expected by any of the treatment protocols investigated.