Table 6 Included studies—nonsurgical treatment of peri-implantitis: alternative measures for biofilm removal

Karring et al. [28]

11 patients

PD ≥5 mm, BOP + bone loss >1.5 mm and exposed threads

3 months

OHI + ultrasonic device with hydroxyapatite fluid polish

OHI + mechanical debridement (carbon fibre curettes)

Test

22 implants machined and medium-rough surfaces

BOP: 63.6 (BL) to 36.4 % (3 months, subject level)

PD: 5.8 (1.1) (BL) to 5.8 (1.2) mm (3 months, subject level)

Radiographic bone level changes: 0.1 (0.5) mm (3 months, subject level)

Control

BOP: 72.7 (BL) to 81.8 % (3 months, subject level)

PD: 6.2 (1.6) (BL) to 6.3 (2.2) mm (3 months, subject level)

Radiographic bone level changes: −0.2 (1.2) mm (3 months, subject level)

Absence of BOP at 7/11 (test) and 2/11 (control) sites

Schwarz et al. [25]

RCT, parallel

20 patients

PD ≥4 mm, BOP + and pus

6 months

OHI + Er:YAG laser device (cone-shaped glass fibre tip) at 12.7 J/cm²

OHI + mechanical debridement (plastic curettes), 0.2 % CHX pocket irrigation and 0.2 % CHX gel

Test

32 implants rough and medium-rough surfaces

Radiographic bone loss

BOP: 83.2 (17.2) (BL) to 31.1 (10.1) % (6 months, subject level)

PD: 5.4 (1.2) (BL) to 4.6 (1.1) mm (6 months, subject level)

Control

BOP: 81.3 (19.0) (BL) to 58.3 (16.9) % (6 months, subject level)

PD: 5.5 (1.5) (BL) to 4.8 (1.4) mm (6 months, subject level)

BOP scores at 6 months were significantly lower in the test group

Schwarz et al. [24]

RCT, parallel

20 patients

PD ≥4 mm, BOP + and pus

12 months

OHI + Er:YAG laser device (cone-shaped glass fibre tip) at 12.7 J/cm²

OHI + mechanical debridement (plastic curettes), 0.2 % CHX pocket irrigation and 0.2 % CHX gel

Test

40 implants rough and medium-rough surfaces

Radiographic bone loss

Moderately deep sites

BOP: 81.7 (6.7) (BL) to 35.0 (6.3) % (12 months, subject level)

PD: 4.5 (1.4) (BL) to 4.0 (0.1) mm (12 months, subject level)

Deep sites

BOP: 79.9 (4.8) (BL) to 55.0 (6.5) % (12 months, subject level)

PD: 5.9 (0.1) (BL) to 5.4 (0.1) mm (12 months, subject level)

Control

Moderately deep sites

BOP: 81.6 (5.2) (BL) to 53.3 (7.3) % (12 months, subject level)

PD: 4.4 (0.2) (BL) to 4.3 (0.1) mm (12 months, subject level)

Deep sites

BOP: 88.3 (3.5) (BL) to 66.6 (5.5) % (12 months, subject level)

PD: 5.9 (0.3) (BL) to 5.5 (0.2) mm (12 months, subject level)

No significant differences between groups at 12 months

Renvert et al. [31]

RCT, parallel

31 patients

PD ≥4 mm, BOP + and/or pus

6 months

OHI + ultrasonic device with hydroxyapatite fluid polish

OHI + mechanical debridement (titanium curettes)

Test

31 implants machined and medium-rough surfaces

Bone loss <2.5 mm

BI: 1.7 (0.6) (BL) to 1.2 (0.7) (6 months, subject level)

PD: 4.3 (0.6) (BL) to 3.9 (0.8) mm (6 months, subject level)

Control

BI: 1.7 (0.9) (BL) to 1.4 (1.0) (6 months, subject level)

PD: 6.2 (1.6) (BL) to 6.3 (2.2) mm (6 months, subject level)

No significant differences between groups

Renvert et al. [30]

RCT, parallel

42 patients

PD ≥5 mm, BOP + and/or pus

6 months

OHI + air abrasive device, glycine powder

OHI + Er:YAG laser device (cone-shaped glass fibre tip, 12.7 J/cm²)

Test

90 implants machined and medium-rough surfaces

Bone loss >3 mm

PD changes: 0.9 (0.8) mm (6 months, implant level)

Radiographic bone level change: −0.3(0.9) mm (6 months, subject level)

Positive treatment outcome: 47 %

Control

PD changes: 0.8 (0.5) mm (6 months, implant level)

Radiographic bone level change: −0.1(0.8) mm (6 months, subject level)

Positive treatment outcome: 44 %

No significant differences between groups

Sahm et al.; John et al. [27, 33]

RCT, parallel

32 patients (BL)

PD ≥4 mm, BOP + with suppuration

12 months

OHI + air abrasive device, glycine powder

OHI + mechanical debridement (carbon curettes + 0.1 % CHX)

Test

25 patients (12 months)

Bone loss ≤33 %

BOP: 99.0 (4.1) (BL) to 57.8 (30.7) % (12 months, subject level)

36 implants

PD: 3.7 (1.0) (BL) to 3.2 (1.1) mm (12 months, subject level)

8 implant systems

Control

BOP: 94.7 (13.7) (BL) to 78.1 (30.0) % (12 months, subject level)

PD: 3.9 (1.1) (BL) to 3.5 (1.2) mm (12 months, subject level)

BOP: significant difference between groups at 3, 6 and 12 months