Resective surgical treatment of peri-implantitis: an integrative review

Objectives: This review aimed to analyze the resective surgical treatment of peri-implantitis (PI), evaluating whether it is an effective approach. Methods: An electronic search was done through the PubMed/MedLine and Online Knowledge Library (B-On) databases from 2011 to 2022. The section of studies was guided by reading the title, the abstract, and the full-text reading of the article. It included randomized controlled trials (RCTs), only clinical studies, and articles in the English language addressing the resective surgical treatment of PI, taking into account the respective parameters: probing depth (PD), bleeding on probing (BoP), marginal bone loss (MBL), and microbiological data. Results: According to the bibliographic research, we found 325 articles; therefore, only seven were included for full-text reading and integrated into this review. Over 401 implants were studied in 221 patients diagnosed with PI and treated with different resective surgical approaches. Two of the studies included had a 24-month follow-up; one had 12 months; two had a duration of 36 months; one of 3 months; and one study had 6-month follow-up. Regarding the mean age of the patients, an average of 59.3 years was found. All studies included both smoking and non-smoking patients, but these did not show any negative effects on surgical resective treatments for PI. There was a large heterogeneity of methods for treating PI: (1) resective surgery with osteoplasty and surface debridement (implantoplasty, IP); (2) the use of medications/antiseptic (0.12% chlorhexidine + 0.05% cetylpyridinium chlorine) or acids (phosphoric acid 35%); and (3) adjunctive use of laser. The best PD reduction result obtained was found in Bianchini et al.’s study, with a 75% PD decrease. The best result for %BoP reduction was present by Papadopoulos et al., with an average reduction of 73% and 67%, respectively, approaching PI with an isolated “open flap” debridement and adding laser. The best result for MBL was obtained by Englezos et al., with a difference of 4.9 mm. Conclusion: The resective surgical treatment of PI effectively reduced clinical parameters (PD, BoP, MBl, and inflammation) in the tissues affected by PI. More scientific evidence is limited regarding the success of this treatment of PI; however, additional scientific studies with a more significant number of patients and longer follow-ups are necessary.