Purpose: To assess the effectiveness of different nonsurgical protocols for the treatment of peri-implant mucositis. Materials and methods: The identification of randomised clinical trials (RCTs) was systematically performed in three databases and supplemented by a thorough manual search of the literature in periodontics/implantology-related journals. Studies investigating the effect of mechanical and/or chemical plaque control agents aimed at preventing the development of peri-implant mucositis were excluded. When comparable trials were found, a meta-analysis was performed. Results: Fourteen studies were included in the systematic review and three in the meta-analysis. None of the selected studies reported a complete resolution of the peri-implant mucositis lesions. A nonsurgical therapy alone showed an average reduction of: 0.57 mm (95% CI [0.30 to 0.83]) in probing pocket depth (PPD); 22.41% (95% CI [12.74 to 32.08]) in bleeding on probing (BOP); 17.28% (95% CI [3.99 to 30.58]) in the plaque index (PI); and 13.41% (95% CI [3.50 to 23.31]) in the bleeding index (BI). The meta-analysis failed to demonstrate significant improvements with the adjunct use of chlorhexidine disinfectant to nonsurgical mechanical debridement for PPD reduction (–0.07 mm; 95% CI [–0.33 to 1.15], P = 0.62), and relative attachment level (RAL) gain (–0.13 mm; 95% CI [–0.6 to 0.35]), P = 0.6). Conclusion: Conventional nonsurgical mechanical therapy alone may be considered the standard treatment for peri-implant mucositis as there is still a lack of evidence supporting the use of additional chemical/mechanical agents for clinical and/or microbiological improvement.
Keywords: chlorhexidine, dental implants, mechanical therapy, nonsurgical treatment, probiotics, triclosan
Conflict-of-interest statement: The authors declare no financial interest, either directly or indirectly, in the products or information listed in the manuscript. The work was partially supported by the University of Michigan Periodontal Graduate Student Research Fund.
