Title	Both Surgical and Non-Surgical Therapies Provide Similar and Limited Levels of Improvement of Peri-Implantitis
Clinical Question	In patients with peri-implantitis, surgical bone regeneration therapy will be more effective in treating peri-implantitis compared to non-surgical chemo-mechanical methods.
Clinical Bottom Line	Surgical therapy and non-surgical chemo-mechanical therapy both appear to provide similar and limited levels of improvement of peri-implantitis.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 22258958 Esposito/2012 Patients with peri-implantitis around oral implants Systematic review of RCTs Key results There have been no comparative studies addressing this question. Limited study results suggest either treatment approach offers only minimal improvements. In looking at the results from one of the two studies, patients that received manual debridement in addition to local antibiotics showed 0.61 mm improvement in probing attachment levels and 0.59 mm reduction in probing pocket depths after 4 months. In the second study, patients that received Bio-Oss and resorbable barriers showed 1.4 mm improvement in both probing attachment levels and probing pocket depths after 4 years.
Evidence Search	"Peri-Implantitis"[Mesh]
Comments on The Evidence	Since the risk of bias for the studies analyzed were unclear at best, and the follow-up as short as four months, the results from this systemic review should be taken with caution. The authors note that there is no comparable difference between surgical methods and non-surgical methods in treating patients with peri-implantitis. Based on the limited results reported from this systemic review, there seems to be no single definitive treatment method that is particularly effective in treating patients with peri-implantitis. The gains reported in these studies are likely of limited clinical benefit. Randomized controlled trials with longer follow-up that specifically compare non-surgical and surgical methods to treat patients with peri-implantitis are needed.
Applicability	The systemic review reports results obtained from patients with peri-implantitis around oral implants. The study offers only limited expectation of improvement with either approach to practitioners treating patients with peri-implantitis.
Specialty	(General Dentistry) (Oral Surgery) (Periodontics) (Dental Hygiene)
Keywords	Peri-implantitis, oral implants, dental implants, pocket depth, attachment level
ID#	2454
Date of submission	03/25/2013
E-mail	KimJR@livemail.uthscsa.edu
Author	Jason Kim
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Thomas Oates, DMD, PhD
Faculty mentor e-mail	Oates@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available