Table 3 Result summary of systematic reviews of adjunctive antiseptic treatments
From: The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review
Author, year Title | Review characteristicsa | Review findingb | Conclusion | |||||
|---|---|---|---|---|---|---|---|---|
Antiseptic treatments | ||||||||
Barootchi et al., 2020 Nonsurgical treatment for peri-implant mucositis: A systematic review and meta-analysis | 5 RCTs (250) AMSTAR2: low | Meta-analysis | Clinical parameter (unspecified) No additional benefit from the adjunctive treatments (100%) PD MA shows no significant differences between the test and control groups in PD reduction CAL MA shows no significant differences between the test and control groups in CAL improvement | |||||
Outcomes | Studies | Certainty (GRADE) | Effect size | |||||
Type | Value (CI) | p-value§ | ||||||
PD | 3 RCTs | (NR) | WMD | − 0.07 [− 0.33, 0.20] | P = 0.62 | |||
ATL | 2 RCTs | (NR) | − 0.13 [− 0.60, 0.35] | P = 0.6 | ||||
Clinical parameter (unspecified) - 5/5 studies reported no significant difference between tests and controls | ||||||||
Liu et al., 2020 Does chlorhexidine improve outcomes in non-surgical management of peri-implant mucositis or peri-implantitis?: a systematic review and meta-analysis | 4 RCTs (212) AMSTAR2: low | Meta-analysis | PD No additional benefit from the adjunctive treatments (100%) MA shows no significant differences between the test and control groups in PD reduction BOP No additional benefit from the adjunctive treatments (100%) CAL Inconclusive (available studies less than three) | |||||
Outcomes | Studies | Certainty (GRADE) | Effect size | |||||
Type | Value (CI) | p-value§ | ||||||
PD | 4 RCTs | (NR) | SMD | 0.11 [− 0.16, 0.38] | P = 0.42 | |||
PD - 4/4 studies† reported no significant difference between tests and controls BOP - 4/4 studies reported no significant difference between tests and controls CAL - 1/1 study reported a significant difference favoured test | ||||||||
(linked systematic reviews) Schwarz, Becker, & Sager, 2015 Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri‐implant mucositis. A systematic review and meta‐analysis Schwarz, Schmucker, & Becker, 2015 Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: A systematic review and meta-analysis | 2 RCTs (64) AMSTAR2: critically low, low | PD - 1/2 study reported significant differences favoured test - 1/2 studies reported no significant difference between tests and controls BOP - 2/2 studies reported no significant difference between tests and controls GI - 1/1 study reported no significant difference between tests and controls mBI - 1/1 study† reported no significant difference between tests and controls Microbiological - 1/1 study reported no significant difference between tests and controls | Inconclusive (available studies less than three) | |||||
Zhao et al., 2020 Clinical efficacy of chlorhexidine as an adjunct to mechanical therapy of peri-implant disease: A systematic review and meta-analysis | 5 RCTs (250) AMSTAR2: low | Meta-analysis | BOP No additional benefit from the adjunctive treatments (80%) MA shows no significant differences between the test and control groups in BOP reduction PD MA shows no significant differences between the test and control groups in PD reduction CAL MA shows no significant differences between the test and control groups in CAL improvement | |||||
Outcomes | Studies | Certainty (GRADE) | Effect size | |||||
Type | Value (CI) | p-value§ | ||||||
BOP (reduction in 1 month) | 2 RCTs | low | MD | 0.10 [− 0.6, 0.25] | P = 0.21 | |||
BOP (reduction in 3–4 months) | 3 RCTs | moderate | MD | 0.06 [− 0.03, 0.15] | P = 0.19 | |||
BOP (reduction in 6–8 months) | 2 RCTs | moderate | MD | 0.05 [− 0.04, 0.13] | P = 0.30 | |||
PD (reduction in 1 month) | 3 RCTs | moderate | MD | − 0.16 [− 0.38, 0.06] | P = 0.16 | |||
PD (reduction in 3–4 months) | 4 RCTs | moderate | MD | 0.02 [− 0.17, 0.20] | P = 0.86 | |||
PD (reduction in 6–8 months) | 2 RCTs | moderate | MD | 0.10 [− 0.07, 0.27] | P = 0.24 | |||
CAL (reduction in 1 month) | 2 RCTs | moderate | MD | − 0.24 [− 0.69, 0.20] | P = 0.29 | |||
CAL (reduction in 3–4 months) | 2 RCTs | moderate | MD | − 0.20 [− 0.77, 0.38] | P = 0.50 | |||
BOP - 4/5 studies reported no significant difference between tests and controls - 1/5 study reported significant improvement in the test groups | ||||||||
Probiotic treatment | ||||||||
Albaker, 2019 The Effect of Probiotic Administration in the Treatment of Peri-implant Diseases: A Systematic Review and Meta-analysis | 5 RCTs (195) AMSTAR2: critically low | Meta-analysis | PD, BOP, PI No additional benefit from the adjunctive treatments (100%) MA shows no significant differences between the test and control groups in PD, BOP and PI reduction | |||||
Outcomes | Studies | Certainty (GRADE) | Effect size | |||||
Type | Value (CI) | p-value§ | ||||||
PPD | 4 RCTs | (NR) | WMD | − 0.11 [− 0.43, 0.21] | 0.50 | |||
BOP | 2 RCTs | (NR) | OR | 1.03 [0.40, 2.62] | 0.94 | |||
PI | 2 RCTs | (NR) | OR | 0.8 [0.29, 2.18] | 0.66 | |||
PD, - 3/3 studies‡ reported no significant difference between tests and controls BOP - 4/4 studies‡ reported no significant difference between tests and controls PI - 5/5 studies‡ reported no significant difference between tests and controls | ||||||||
Barootchi et al., 2020 Nonsurgical treatment for peri-implant mucositis: A systematic review and meta-analysis | 2 RCTs (62) AMSTAR2: low | PD - 1/1 study† reported no significant difference between tests and controls BOP - 2/2 studies† reported no significant difference between tests and controls PI - 2/2 studies† reported no significant difference between tests and controls Total bacteria load - 1/1 study † reported no significant difference between tests and controls | Inconclusive (available studies less than three) | |||||
Gao et al., 2020 Does Probiotic Lactobacillus Have an Adjunctive Effect in the Nonsurgical Treatment of Peri-Implant Diseases? A Systematic Review and Meta-analysis | 6 RCTs (221) AMSTAR2: critically low | Meta-analysis | PD, BOP, PI MA shows no significant differences between the test and control groups in PD, BOP and PI reduction | |||||
Outcomes | Studies | Certainty (GRADE) | Effect size | |||||
Type | Value (CI) | p-value§ | ||||||
PPD (immediately after treatment) | 4 RCTs | moderate | MD | − 0.05 [− 0.28, 0.18] | 0.67 | |||
PPD (≥ 2 months after treatment) | 5 RCTs | low | MD | − 0.17 [− 1.01, 0.67] | 0.69 | |||
BOP (immediately after treatment) | 4 RCTs | moderate | OR | 0.75 [0.36, 1.56] | 0.44 | |||
BOP (≥ 1 months after treatment) | 4 RCTs | moderate | SMD | 0.77 [0.38, 1.56] | 0.47 | |||
PI (immediately after treatment) | 5 RCTs | moderate | SMD | − 0.03 [− 0.38, 0.31] | 0.85 | |||
PI (≥ 1 months after treatment) | 4 RCTs | moderate | SMD | − 0.37 [− 0.76, 0.02] | 0.06 | |||
Silva et al., 2020 Effect of Adjunctive Probiotic Therapy on the Treatment of Peri-implant Diseases–A Systematic Review | 4 RCTs (201) AMSTAR2: low | PD - 4/4 studies† reported no significant difference between tests and controls BOP - 2/2 studies†‡ reported no significant difference between tests and controls PI - 4/4 studies‡ reported no significant difference between tests and controls | PD, BOP No additional benefit from the adjunctive treatments (100%) PI No additional benefit from the adjunctive treatments (100%) | |||||
Air-polishing treatment | ||||||||
Barootchi et al., 2020 Nonsurgical treatment for peri-implant mucositis: A systematic review and meta-analysis | 1 RCT (33) AMSTAR2: low | Clinical parameter (unspecified) - 1/1 study reported no additional clinical benefits of adjunctive glycine powder air polishing PD, BI, PI - 1/1 study reported no significant difference between tests and controls | Inconclusive (available studies less than three) | |||||
(linked systemaic reviews) Schwarz, Becker, & Renvert, 2015 Efficacy of air polishing for the non‐surgical treatment of peri‐implant diseases: A systematic review Schwarz, Schmucker, & Becker, 2015 Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: A systematic review and meta-analysis | 1 RCT (33) 21 CCT (30 patients) AMSTAR2: low | PD - 1/2 study reported no significant difference between tests and controls - 1/2 study reported significant differences favoured test BI - 1/2 study reported no significant difference between tests and controls - 1/2 study reported significant differences favoured test | Inconclusive (available studies less than three) | |||||
Schwarz, Becker, & Sager, 2015 Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri‐implant mucositis. A systematic review and meta‐analysis | 1 RCT (33) AMSTAR2: critically low | Clinical parameter (unspecified) - 1/1 study reported limited efficacy of the adjunctive glycine powder air polishing PD, BI - 1/1 study reported no significant difference between tests and controls | Inconclusive (available studies less than three) | |||||
Laser and photodynamic treatment | ||||||||
Chala et al., 2020 Adjunctive Use of Lasers in Peri-Implant Mucositis and Peri-Implantitis Treatment: A Systematic Review | 2 RCTs (288) AMSTAR2: critically low | Clinical parameter (unspecified) - 1/2 study reported no significant clinical benefits of adjunctive use of lasers compared to conventional treatments - 1/2 study reported the benefit of adjunctive use of lasers in reducing bleeding on probing PD - 1/1 study† reported no significant difference between tests and controls BOP - 1/2 study† reported no significant difference between tests and controls - 1/2 study reported a significant difference favoured test PI - 1/1 study† reported no significant difference between tests and controls | Inconclusive (available studies less than three) | |||||
Sánchez-Martos, Samman, Priami, et al., 2020 The diode laser as coadjuvant therapy in the non-surgical conventional treatment of peri-implant mucositis: A systematic review and meta-analysis | 2 RCTs (288) AMSTAR2: critically low | PD - 2/2 studies reported no significant difference between tests and controls BOP - 1/2 study no significant difference between tests and controls after 3 months - 1/2 study reported significant differences favoured test after 3 months PI - 2/2 studies reported no significant difference between tests and controls Meta-analysis (There was an insufficient presentation of information about the meta-analysis.) | Inconclusive (available studies less than three) | |||||
Saneja et al., 2020 Efficacy of different lasers of various wavelengths in treatment of peri-implantitis and peri-implant mucositis: A systematic review and meta-analysis | 2 RCTs (288) AMSTAR2: low | Outcomes | Studies | Certainty (GRADE) | Effect size | PD MA shows no significant differences between the test and control groups in PD reduction | ||
Type | Value (CI) | p-value§ | ||||||
PD | 2 RCTs | (NR) | MD | − 0.10 [− 0.18, − 0.02] | 0.02 | |||
PD - 2/2 studies reported no significant difference between tests and controls | ||||||||
Antibiotic treatment | ||||||||
Barootchi et al., 2020 Nonsurgical treatment for peri-implant mucositis: A systematic review and meta-analysis | 2 RCTs (69) AMSTAR2: low | Clinical parameter (unspecified) - 1/2 study reported slightly better results in the local antibiotic group with no statistical significance - 1/2 studies reported no additional clinical and microbiological benefits of adjunctive systemic antibiotics PD - 1/1 study reported a greater reduction of PD in the antibiotic group.* BOP - 2/2 study reported greater BOP reduction in the test group.* BI - 1/1 study reported a greater reduction of BI in the antibiotic group.* PI - 1/1 study reported a greater reduction of PI in the antibiotic group.* Microbiological - 1/1 study reported no significant difference in the bacterial counts for all bacterial species between tests and controls | Inconclusive (available studies less than three) | |||||
(linked systematic reviews) Schwarz, Becker, & Sager, 2015 Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri‐implant mucositis. A systematic review and meta‐analysis Schwarz, Schmucker, & Becker, 2015 Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: A systematic review and meta-analysis | 2 RCTs (69) AMSTAR2: critically low, low | Clinical parameter (unspecified) - 1/1 study reported no significant differences between antibiotic and control groups for all clinical and microbiological parameters BOP - 1/1 study reported BOP reduction in the antibiotic group, while BOP increased in the control group.* | Inconclusive (available studies less than three) | |||||