Non-Surgical Peri-Implantitis Therapy: What Now?

Aim: This Clinical Feature discusses current non-surgical treatments for peri-implantitis, focusing on their efficacy, limitations, and possible adjunctive strategies for optimising non-invasive management. Background: Peri-implantitis is a biofilm-induced inflammatory condition causing progressive bone loss. Mechanical decontamination remains the mainstay of non-surgical therapy, sometimes combined with antimicrobials and chemical agents. Findings: Non-surgical therapy reduces probing depths and bleeding on probing but rarely achieves full resolution of the disease. Low-abrasive air powders (glycine, erythritol) and novel systems like electrolysis, improve biofilm removal with minimal surface damage. Chemical and systemic adjuncts show limited, short-term benefits. Supportive maintenance and strict plaque control are essential for the long-term success of the non-surgical treatment. Conclusions: Non-surgical therapy can stabilise peri-implantitis and delay surgery when combined with maintenance care. Future management is shifting toward minimally invasive, regenerative, and technology-enhanced approaches to improve predictability and tissue preservation.