Table 1 Included studies reporting on peri-implant mucositis treatment

Alternative measures for biofilm removal

Ji et al. (2014)

RCT, parallel

24 patients

Test: 12; mean age: 46.2 years; 50% female

Control: 12; mean age: 41.3 years: 67% female

8 patients – diagnosed with periodontitis

33 implants (test: 17, control: 16)

Molar/premolar sites

1 implant system (ITI Straumann, Standard Implant, SLA surface)

PD ≥ 4 mm, BOP + no radiographic

bone loss compared with baseline (i.e

immediately after prosthesis insertion)

3 months

OHI + mechanical debridement (ultrasonic

scaler with carbon fiber tips) + air abrasive device, glycine powder (sites with PD ≥ 4 mm)

OHI + mechanical

debridement (ultrasonic scaler with carbon fiber tips)

Subject level

BI

Test baseline: 1.4 (0.57); 3 months: 1.1 (0.58); p = 0.150

Implant level (at sites PD ≥ 4 mm): baseline: 1.7 (0.93); 3 months: 1.1 (0.98); p = 0.002

Control subject level:

Baseline:1.5 (0.65); 3 months: 1.0 (0.85); p = 0.058

Implant level (at sites PD ≥ 4 mm): baseline: 1.7 (1.0); 3 months: 0.9 (1.1); 3-months; p < 0.001

Between-group comparison: subject level: p = 0.764; implant level: p = 0.361

PD

Test baseline: 3.6 (0.47) mm; 3 months: 3.2 (0.48); p = 0.017

Implant level (at sites PD ≥ 4 mm): baseline: 4.6 (0.50); 3 months: 3.7 (0.95); p < 0.001

Control subject level:

Baseline: 3.5 (0.50); 3 months: 3.1 (0.38); p = 0.012

Implant level (at sites PD ≥ 4 mm): baseline: 4.5 (0.55); 3 months: 3.1 (0.38); 3-months; p = 0.012

Between-group comparison: subject level: p = 0.587; implant level: p = 0.831

During follow-up visits, oral hygiene instructions were reinforced (at 1- and 3-months)

Adjunctive air abrasive device with glycine powder appeared to have a limited beneficial effect as compared with mechanical debridement alone

De Siena et al. (2014)

CCT, parallel

30 patients (15 per group)

Test: 9 female; 6 male; mean age: 64.8 (12.5) years; mean cigarettes per day: 5.5 (2.6);

Control: 9 female, 6 male; mean age: 63.3(9.3) years; mean cigarettes per day: 4.3(2.3);

None of the patients were diagnosed with periodontitis

BOP or spontaneous bleeding with

local swelling + 

PD ≤ 3.5 mm + 

bone loss ≤ 3.0 mm

6 months

OHI + mechanical debridement Teflon

curettes, polishing + air abrasive devic with,

glycine powder

OHI + mechanical

debridement Teflon

curettes, polishing

Implant level

BI

Test: 13 patients did not present bleeding at 6 months;

Control: 9 patients did not present bleeding at 6 months

PD

Test baseline: 3.0 (0.4) mm; 6 months: 2.4 (0.5) mm; p < 0.05;

Control baseline: 2.9 (0.4) mm; 6 months: 3.0 (0.6) mm; p > 0.05

OHI were provided at baseline and repeated in each follow-up visit 3 and 6 months after intervention

Test group showed a significant reduction in PD values

Riben-Grundstrim et al. (2015)

RCT,

parallel

37 patients

Test:17; mean age: 64.4 (range: 25–85) years;

Control:18; mean age: 64.3 (range: 25–86) years;

5 patients – current smokers (test: 1; control: 4)

37 implants

3 implant systems (Astra Tech, Nobel Biocare, Straumann)

PD ≥ 4 mm, BOP + with or without

SUPP

 + bone loss ≤ 2 mm from implant

shoulder

12 months

OHI + air abrasive device with glycine powder

Repeated treatment at 3 and 6 months

OHI + mechanical

debridement (ultrasonic

scaler with plastic coated

tips)

Repeated treatment at 3 and 6 months

Subject level

BOP

Test baseline: 43.9 (7.3)%; 12 months: 12.1 (3.8)%; p < 0.05

Control baseline: 53.7 (7.9)%; 12 months: 18.6 (6.4)%; p < 0.05

No significant difference between the groups

Number of diseased sites

(PD ≥ 4 mm

with BOP/

SUPP)

Test baseline: 38%; 12 months: 8%

Control baseline: 52%; 12 months: 17%

Supragingival maintenance care was provided at months 9 and 12

Both treatment approaches were effective in treating peri-implant mucositis

Wohlfahrt et al. (2018)

RCT, split-mouth desing

11 patients

Age: NR

Periodontal/smoking status: NR

24 implants (test: 12, control: 12)

3 implant brands (Astra, Nobel Mark III, Straumann)

BOP + at least on esite PD ≥ 4 mm + no perceptible bone loss

6 months

Chitosan brush (BioClean Labrida) with oscillating hand piece for 3 min + saline irrigation

Mechanical debridement (titanium curettes) for 3 min + saline irrigation

Implant level

mBOP

Test baseline: 1.54 (0.78), 6 months: 0.70 (0.70);

Control baseline: 1.35 (0.85); 6 months: 0.74 (0.80); no significant difference between groups

PD

Test baseline: 4.27 (1.36) mm; 6 months: 4.09 (1.68) mm

Control baseline: 4.29 (1.50) mm; 6 months: 3.95 (1.27) mm; no significant difference between groups

Reduced signs of inflammation were seen in both groups

Adjunctive diode laser/aPDT therapy

Javed et al. (2017)

RCT,

parallel

54 male patients

Test: 28 patients, mean age: 50.6 (0.8) years

Control: 26 patients, mean age: 52.5 (0.5) years

Nr of implants—NR

All patients smokers

PD ≥ 4 mm at least at 30% sites

3 months

Mechanical debridement (plastic curettes) + aPDT (photosensitizer: phenothiazine chloride (HELBO)) application for 2 min + light exposure (diode laser 660 nm 10 s.)

Mechanical debridement (plastic curettes)

Subject level

BOP

Test baseline: 10.2 (1.2)%, 3 months: 8.8 (0.2)%, p < 0.001;

Control baseline: 8.6 (0.8)%, 3 months: 6.9 (0.2)%, p < 0.001. Between group comparison: p > 0.001. No significant difference between the groups

PD

Test baseline: 7.4 (0.3) mm, 3 months: 1.5 (0.3) mm, p < 0.001;

Control baseline: 6.6 (NR) mm, 3 months: 3.8 (0.4) mm, p < 0.001. Between-group comparison: p < 0.001

In smokers, aPDT was more effective in the treatment of peri-implant mucositis compared to mechanical debridement alone

Al Rifaiy et al. (2018)

RCT

38 male patients

Test: 20 patients; mean age: 33.6(3.8) years; 28 implants

Control: 18 patients; mean age: 35.4(2.1) years; 27 implants

All patients reported on vaping e-cigarettes

BOP + no bone loss > 2 mm (7^th EWON)

3 months

OHI + mechanical debridement + aPDT(photosensitizer: 0.005% Methylene blue) application for 10 s. + diode laser irradiation (670 nm) at 150 milliwatts for 1 min

OHI + mechanical debridement

Subject level

BOP

Test baseline: 14.6 (3.1)%, 3 months: 11.7 (0.5)%; p < 0.001;

Control baseline: 9.2 (1.0)%, 3 months: 7.9 (0.2)%; p < 0.001. No significant difference between the groups

PD

Test baseline: 4.3 (0.8) mm; 3 months: 2.1 (0.3) mm; p < 0.001;

Control baseline:, 4.5 (0.9) mm; 3 months: 2.2 (0.5) mm; p < 0.001; Significantly higher reduction in the test group (p < 0.001)

aPDT was more effective compared to mechanical debridement alone

Aimetti et al. (2019)

RCT, parallel

220 patients

Test: 110 patients; mean age: 58.1(10.1) years; 78 female; light smokers: 14 patients; history of periodontitis: 54 patients

Control: 110 patients; mean age: 56.8 (10.2) years; 71 female; light smokers: 20 patients; history of periodontitis: 45 patients

220 implants: 110 test, 110 control

PD ≥ 4 mm + BOP ± SUPP + no radiographic bone loss beyond bone remodeling or (in the absence of baseline radiographic data) < 2 mm

3 months

OHI + diode laser application (980-nm, 2.5 W 30 s. + irrigation with 3% H₂O₂ 10 s.(repeated 3 times) + debridement manual and ultrasonic (titanium-coated Gracey or carbon fiber curretes) + biostimulation 60 s. at 0.7 W

OHI + debridement manual and ultrasonic (titanium-coated Gracey or carbon fiber curretes)

Subject level

BOP

Test baseline: 48.3 (26.9)%, 3 months: 23.3 (23.5), p < 0.05

Control baseline: 46.2 (25.6)%, 3 months: 26.8 (23.0)%, p < 0.05. Between-group comparison: p > 0.05

PD

Test baseline: 3.5 (0.7) mm, 3 months: 2.9 (0.6), p < 0.05

Control baseline: 3.4 (0.9) mm, 3 months: 3.0 (0.7) mm, p < 0.05. Between-group comparison: p > 0.05

Reinforcement of OHI 1- and 3-months after the treatment and professional implant cleaning and polishing

The adjunctive use of diode laser did not yield any statistical significant clinical benefit as compared to mechanical treatment alone

Mariani et al. 2020 [follow-up study of Aimetti et al. (2019)]

73 patients

Tests: 28; mean age: 59.2 (9.3) years; female: 24; history of periodontitis: 12 patients

Control: 35; mean age: 62.1(6.8) years; female: 23; history of periodontitis: 13 patients

12 months

Subject level

Test baseline: 63.6 (24.2)%, 12 months: 25.8 (24.1); p < 0.001

Control baseline: 59.5 (25.0)%, 12 months: 27.6 (25.5)%, p < 0.001 Between-group comparison: p > 0.05

PD

Test baseline: 3.6 (0.7) mm, 12 months: 3.1 (0.7), p < 0.001

Control baseline: 3.8 (0.6) mm, 12 months: 3.3 (0.6) mm, p < 0.001. Between-group comparison: p > 0.05

During recalls (3, 6, 12 months after treatment) OHI reinforcement and professional implant cleaning and polishing

The adjunctive use of diode laser showed no statistically significant additional beneficial effect in treatment of peri-implant mucositis

Deeb et al. (2020)

RCT, parallel, 3 arm

45 male patients

Test 1: 15 patients; mean age: 52.6(0.9) years;

Test 2: 15 patients; mean age: 53.8(0.7) years;

Control: 15 patients

All patients smokers

Nr of implants – NR

BOP + no signs of bone loss

3 months

Test 1

OHI + mechanical debridement with titanium curettes and polishing with rubber cups and paste + aPDT (photosensitizer: Phenothiazine chloride (HELBO) application for 2 min, light exposure (diode laser 660 nm 10 s.) + CHX 0.12% mouthrinse twice daily 2 weeks

Test 2

debridement with titanium curettes and polishing with rubber cups and paste + aPDT (aPDT (photosensitizer: Phenothiazine chloride (HELBO) application for 2 min, light exposure (diode laser 660 nm 10 s.) + CHX 0.12% mouthrinse twice daily 2 weeks + Azithromycin 500 mg (1^st day), 150 mg (following 2–4 days)

OHI + mechanical debridement with titanium curettes and polishing with rubber cups and paste + CHX 0.12% mouthrinse twice daily 2 weeks

Subject level

BOP

Test 1 baseline: 12.3 (4.8)%, 3 months: 8.0 (3.7)%; p < 0.001

Test 2 baseline: 15.7 (3.9)%, 3 months: 10.1 (3.1)%; p < 0.001

Control baseline: 13.6 (4.0)%, 3 months: 11.8 (4.0); p < 0.001. Between-group comparison: p > 0.05

PD

Test 1 baseline: 4.8 (1.0) mm, 3 months: 3.9 (0.9) mm; p < 0.001

Test 2 baseline: 4.6 (1.1) mm, 3 months: 3.9 (1.0) mm; p < 0.001

Control baseline: 4.5 (0.8) mm, 3 months: 4.1 (1.0); p < 0.001. Between-group comparison: p > 0.05

Adjunctive aPDT to mechanical debridement was as efficacious as adjunctive antibiotic therapy

Additional benefits in reducing BOP scores were observed for adjunctive aPDT among the smokers

Adjunctive local antiseptic/systemic antibiotic therapy

Porras et al. (2002)

RCT,

parallel

16 patients

Mean age: 58.9 (8.4) years (range: 34–76)

Smokers excluded

Periodontal status – NR

28 implants

Test: 16

Control: 12

3 implant types

(plasma-sprayed Ti/

cp Ti (HA-coated Ti)

Supra- and subgingival plaque + PD ≤ 5 mm BOP

 + “incipient”

radiographic lesion

3 months

OHI + mechanical cleansing

(plastic scaler, rubber cups, polishing paste) + local irrigation

CHX (0.12%) and topical CHX gel application + 0.12%

CHX mouthrinse twice for 10 days

OHI + mechanical cleansing

(plastic scaler, rubber cups, polishing paste)

Implant level

mSBI and BOP (%) scores: no sign. differences between

groups at 1 and 3 months

PD values

Test: baseline: 3.27 (0.81); 3 months: 2.71

(0.70)mm

Control: baseline: 3.48 (0.61); 3 months: 2.55

(0.72) mm

Changes in mean PD between test and control groups at 3 months were statistically significant (p = 0.035)

The addition of CHX to mechanical debridement did not enhance the outcomes as compared to mechanical debridement alone

Thöne-Mühling et al. (2010)

RCT,

parallel

11 patients with treated chronic periodontitis

Mean age: 51.5 years (range: 37–67)

Smokers included

36 implants

Tests: 22

Control: 14

2 implant types (MK ii; Nobel Biocare and Osseotite 3i Implant innov.)

BOP + and/or gingival index (GI) ≥ 1

absence of

radiographic bone

loss during the last

2 years

8 months

OHI + mechanical cleansing (plastic scaler and

polyetheretherketone-coated ultrasonic instruments) + 

topical CHX gel application once + full mouth

disinfection (deep scaling in one session + CHX

disinfection of tongue and tonsils) + 0.2% CHX

mouthrinse 2 × /day and tonsil spraying 1 × /day for 14 days

OHI + mechanical cleansing

(plastic scaler and

polyetheretherketone-coated

ultrasonic instruments) + full

mouth scaling in one session

Implant level

BOP

Test baseline: 0.22 (0.11); 8 months: 0.16

(0.09) %

Control baseline: 0.17 (0.19); 8 months: 0.17 (0.11) %

PD

Test baseline: 3.49 (0.78); 8 months: 2.84 (0.64) mm

Control baseline: 3.4 (0.62) mm; 8 months: 2.82 (0.59) mm

PD reduced significantly after 8 months compared to baseline (test: p = 0.033; control: p = 0.004). No significant difference between the groups

ML (recession)

Test baseline: 0.21 (0.25) mm; 8 months: 0.35 (0.65) mm;

Control baseline: 0.33 (0.42) mm; 8 months: 0.33 (0.44) mm

Both treatments lead to an improvements of the clinical parameters, but without significant differences between the groups after 8 months

Hallström et al. (2012)

RCT,

parallel

45 patients, 45 implants: 22 test, 23 control

Mean age: test 54.6 (18.2) years; control 54.6 (19.8) years

PD ≥ 4 mm BOP + and/or

SUPP + radiographic bone loss

 ≤ 2 mm

6 months

OHI + mechanical cleansing

(titanium curettes + rubber

cups + polishing paste) + 

Azithromycin® 500 mg day 1

and 250 mg days 2–4

OHI + mechanical cleansing

(titanium curettes + rubber cups + polishing paste)

Subject level

BOP

Test baseline: 82.6 (24.4)%, 6 months: 27.3

(18.8)%

Control baseline: 80.0 (25.0)%, 6 months: 47.5

(32.3)%;

Between group comparison: p > 0.05

Mean PD

Test baseline: 4.4 (1.0) mm, 6 months: 3.5 (1.1) mm

Control baseline: 4.1 (0.9) mm; 6 months: 4.1 (1.2) mm;

Between-group comparison: p < 0.16

Odds ratio of a positive

treatment outcome (PD ≤ 

4.0 mm and BOP ≤ 1) was

4.5:1 (test vs. control)

No short-term differences were found between study groups

Menez et al. (2016)

RCT,

parallel

37 patients: 6 male, 31 female. Age range: 33–75 years, mean age: 57.4 years

Only non-smokers included

Test: 61 implants; control: 58 implants

BOP + PD ≥ 5 mm + no radiographic evidence of bone loss beyond the first two threads of the implants

6 months

OHI + subgingival debridement with plastic curets + CHX (0.12%) mouthrinse used for brushing the dorsum of the tongue for 1 min. + rinsing for 10 s. + subgingival irrigation for 10 min. + CHX mouthrinse (0.12%) every 12 h, 30 min. 14 days

OHI + subgingival debridement with plastic curets + placebo mouthrinse used for brushing the dorsum of the tongue for 1 min. + rinsing for 10 s. + subgingival irrigation for 10 min. + placebo mouthrinse every 12 h, 30 min. 14 days

Implant level

BOP

Test baseline: 75.82 (33.98)%, 6 months: 45.76 (34.85)%, p < 0.001

Control baseline: 67.54 (34.38)%, 6 months: 41.08 (41.0)%; p < 0.001

Between-group comparison: p = 0.21

PD

Test baseline: 2.85 (0.60) mm; 6 months: 2.49 (0.60) mm; p < 0.001;

Control baseline: 2.72 (0.68) mm; 6 months: 2.49 (0.67) mm, p < 0.001;

Between-group comparison: p = 0.32

Patients were further motivated with respect to oral hygiene habits during the entire period of the study

Use of 0.12% CHX did was not more effective than placebo

Iorio-Siciliano et al. (2020)

RCT, parallel

45 patients

Smokers included;

Patients with gingivitis or treated periodontitis included;

67 implants

Test: 22 patients; mean age: 46.5(15.35) years; 22.7% smokers; 40.9% of patients with treated periodontitis; 33 implants

Control: 23 patients; mean age: 45.96(9.84) years; 26.1% smokers; 43.5% of patients with treated periodontitis; 34 implants

 ≥ 1 site with BOP + absence of radiographic bone loss compared to previous radiograph

6 months

Amino acid buffered sodium hypochlorite (Perisolv) application + ultrasonic scaler + application of Perisolv repeated 5 times + CHX (0.12%) gel twice daily for 2 weeks

Application of placebo gel + ultrasonic scaler + application of placebo gel repeated 5 times + CHX (0.12%) gel twice daily for 2 weeks

Implant level

BOP-positive implants

Test baseline: 33%, 6 months: 18%; p < 0.001

Control baseline: 34%, 6 months: 23%, p < 0.001. Between-group comparison: p = 0.271

PD

Test baseline: 3.93 (1.09) mm, 6 months: 3.04 (0.46) mm; p < 0.001;

Control baseline: 3.68 (0.85) mm; 6 months: 3.07 (0.58) mm; p < 0.001

Between-group comparison: p = 0.53

Clinical parameters were recorded at 1, 3 and 6 months following the treatment

Test: 110 patients; mean age: 58.1 ± 10.1 years; 78 female; light smokers; 14; history of periodontitis: 54 patients

Changes in PD from baseline to 6 months were not statistically significantly different between groups. Complete resolution was not achieved with either of the therapies

Adjunctive probiotics

Pena et al. (2019)

RCT, parallel

50 patients, 50 implants

Test: 25 patients; mean age: 55.96(10.81) years; 0% smokers; 64% of patients with a history of treated periodontitis

Control: 25 patients; mean age: 61.16(10.62) years; 4% smokers; 68% of patients with a history of treated periodontitis

BOP ± gingival redness, swelling + no bone loss (7^th EWOP)

135 days (4.5 months)

OHI + mechanical debridement (ultrasound titanium tip) + CHX 0.12% mouthrine twice a day, 2 weeks + after 15 days: probiotic tablets containing two strains of L. reunteri for 1 month

OHI + mechanical debridement (ultrasound titanium tip) + CHX 0.12% mouthrine twice a day, 2 weeks + after 15 days: placebo tablets

Subject level

BOP

Test baseline: 100%; 135 days: 64%

Control baseline: 100%, 135 days: 60%;

Between group comparison: p = 0.771

PD

Test baseline: 3.10 (0.74) mm, 135 days: 2.88 (0.62) mm;

Control baseline: 3.32 (0.65) mm, 135 days: 2.98 (0.60) mm;

Between-group comparison: p = 0.599

None of the patients received any other mechanical periodontal treatment during the follow-up

Administration of probiotics did not seem to provide an additional clinical benefit. Complete disease resolution was not always achieved

Galofre et al. (2018)

RCT, parallel

22 patients with history of periodontitis; 22 implants

Test: 11 patienst; mean age: 61.5(10.4) years; 27% female

Control: 11 patients; mean age: 60.0(9.5) years; 45% female

Inflammed mucosa with BOP and/or suppuration and no evidence of radiographic bone loss (8^th EWOP)

3 months

Mechanical debridement (ultrasound with carbon tip and titanium curettes) + 30 probiotic lozenges (once a day, 30 days) (L. reuteri, PerioBalance)

Mechanical debridement (ultrasound with carbon tip and titanium curettes) + 30 placebo lozenges (once a day, 30 days)

Subject level

BOP

Test baseline: 0.61 (0.27)%, 3 months: 0.29 (0.09)%, p = 0.01

Control baseline: 0.42 (0.18)%, 3 months: 0.35 (0.22)%, p = 0.377

Between-group comparison of the difference baseline-3 months: p = 0.024

PD

Test baseline:3.84 (0.55) mm, 3 months: 3.35 (0.76) mm, p = 0.09

Control baseline: 3.82 (0.64) mm; 3 months: 3.66 (0.62)mm, p = 0.187

Between-group comparison: p = 0.094

During the study period patients received neither oral hygiene instructions nor any other mechanical periodontal treatment

Administration of probiotics together with mechanical debridement improved clinical parameters at peri-implant mucositis sites

Adjunctive home care mouthrinse

Pulcini et al. (2019)

RCT, parallel

46 patients, 54 implants

Untreated or recurrent periodontitis patients excluded

Test: 24 patients; 27 implants; mean age: 61.3(8.9) years; smokers: 7.4%; 11 female; 6 patients with systemic diseases

Control: 22 patients; 27 implants; mean age: 61.0(12.0) years; smokers: 14.8%; 14 female; 4 patients with systemic diseases

BOP and/or SUPP without progressive radiographic bone loss

12 months

OHI + mechanical debridement (ultrasound with plastic tip and air-polishing with erythritol) + home care mouthrinse (0.03% CHX + 0.05% cetylpiridinium chloride (CPC)) (twice a day, 30 s.) 12 months

OHI + mechanical debridement (ultrasound with plastic tip and air-polishing with erythritol) + home care placebo mouthrinse (twice a day, 30 s.) 12 months

Implant level

BOP

Test baseline: 58.64 (27.49)%, 12 months: 10.42 (13.74)%

Control baseline: 46.30 (24.17)%, 12 months: 14.39 (18.04)%

Between group comparison: p = 0.402

PD

Test baseline: 3.36 (0.78) mm; 12 months: 2.50 (0.43) mm

Control baseline:3.38 (0.60) mm; 12 months: 2.57 (0.57) mm

Between group comparison: p = 0.650

After 12 months, 58.3% of test implants, and 50% of control implants demonstrated complete disease resolution (i.e., absence of BOP); p > 0.05

The use of test mouthrinse demonstrated some adjunctive benefits. Complete disease resolution could not be achieved in every case

Bunk et al. (2020)

RCT,

parallel, three-arm

60 patients/60 implants

Test 1: 20 patients, 20 implants

Test 2: 20 patients, 20 implants

Control: 20

Periodontally healthy

Smokers excluded

BOP and/or SUPP + absence of radiographic bone loss compared to previous examination, visual signs of inflammation (modified gingival index ≠ 0)

3 months

Test 1

OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste) + home use of oral irrigator (Waterpick) with water once a day, 3 months

Test 2

OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste) + home use of oral irrigator (Waterpick) with 0.06% CHX solution once a day, 3 months

OHI + mechanical debridement (titanium curettes + polishing with low-abrasive paste)

Subject level

BOP-positive sites

Test 1 baseline: 2.25 (1.02), 3 months: 0.45 (0.69)

Test 2 baseline: 2.40 (0.88), 3 months: 0.10 (0.45)

Control baseline: 2.35 (0.99), 3 months: 0.85 (1.09)

Test 2 group showed significantly lower BOP-positive sites compared to control group (p = 0.004)

After 3 months prevalence of peri-implant mucositis was 5% in Test 2, 35% in Test 1, and 50% in the control group

All patients returned for follow-up and data collection after 4, 8, 12 weeks. Mechanical debridement was not performed at follow-up visits

The adjunctive use of oral irrigator with 0.06% CHX in addition to mechanical debridement can reduce the presence of peri-implant mucositis

Philip et al. (2020)

RCT,

Parallel 3-arm

Test 1: 31 patients/31 implants; 15 female; mean age: 59 (10.6) years; current smokers: 4; 19 implant in maxilla; 12 in mandible

Test 2: 30 patients/30 implants; 14 female; mean age: 62 (9.3) years; current smokers: 2; 19 implant in maxilla; 11 in mandible

Control: 28 patients/28 implants; 12 female; mean age: 65 (10.3) years; current smokers: 3; 20 implant in maxilla; 8 in mandible

BOP and/or suppuration with SUPP progressive radiographic bone loss compared to baseline radiograph

3 months

OHI + ultrasonic scaler with plastic tip + homecare mouthrinse:

Test 1: Decapinol mouthrinse consisting (0.2%) delmopinol hydrochloride

Test 2: CHX (0.2%)

OHI + ultrasonic scaler with plastic tip + homecare Placebo mouthrinse

Subject level

mBI

Baseline test 1: 1.0 (0.49); 3 months: 0.13 (0.23)

Baseline test 2: 1.03 (0.44); 3 months: 0.28 (0.30)

Baseline control: 1.08 (0.52); 3 months: 0.19 (0.32); statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p = 0.42

BOP

Baseline test 1: 45 (25.52); 3 months: 3.22 (10.01)

Baseline test 2: 43.88 (22.52); 3 months: 8.88 (12.17)

Baseline control: 47.02 (24.45); 3 months: 7.73 (13.96); statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p = 0.14

PD

Baseline test 1: 3.18 (0.69) mm; 3 months: 2.65 (0.45) mm

Baseline test 2: 3.44 (0.60) mm; 3 months: 2.76 (0.47) mm

Baseline control: 3.17 (0.78) mm; 3 months: 2.40 (0.67) mm; statistically significant reduction compared to baseline (p = 0.001); between-group comparison: p > 0.05

Complete disease resolution (i.e., absence of BOP)

3 months:

Test 1: 27 (87%)

Test 2: 18 (60%)

Control: 20 (71%); p = 0.29

Supragingival maintenance care was provided at 1 and 3 months

Mechanical debridement combined with OHI is effective in treating peri-implant mucositis