Access flap and pocket elimination surgery are effective procedures for peri-implantitis: study

Peri-implantitis is a site-specific infectious disease that
causes an inflammatory process in soft tissues, and bone loss around an Osseointegrated implant in function.

A study was conducted to evaluate the efficacy of access
flap and pocket elimination procedures in the surgical treatment of peri-implantitis.

Systematic electronic searches (Central/Medline/Embase) up
to March 2022 were conducted to identify prospective clinical studies
evaluating surgical therapy (access flap or pocket elimination procedures) of
peri-implantitis. Primary outcome measures were reduction of probing depth (PD)
and bleeding on probing (BOP). Risk of bias was evaluated according to study
design. Meta-analysis and meta-regression were performed. Results were
expressed as standardized mean effect with 95% confidence intervals (CI).

Results:

• Evidence from studies directly comparing
  surgical with non-surgical therapy is lacking.
• Based on pre-post data originating from 13
  prospective patient cohorts, pronounced reductions of PD and BOP% as well as
  MBL gain were observed at evaluation time points ranging from 1 to 5 years.
  Wide prediction intervals suggested a high degree of heterogeneity.
• Reduction of mean PD increased by 0.7 mm for
  every mm in increase of mean PD at baseline.
• During follow-up period ranging from 1 to
  5 years, disease recurrence occurred frequently and implant loss was not
  uncommon.

Access flap and pocket elimination surgery are effective
procedures in the management of peri-implantitis, although rates of disease
recurrence during 5 years were high. Treatment outcomes were affected by
baseline conditions.

Reference:

Karolina Karlsson, Anna Trullenque-Eriksson, Cristiano
Tomasi, Jan Derks. Efficacy of access flap and pocket elimination procedures in
the management of peri-implantitis – a systematic review and meta-analysis. https://doi.org/10.1111/jcpe.13732

Keywords:

Journal of Clinical Periodontology, Karolina Karlsson ,Anna
Trullenque-Eriksson, Cristiano Tomasi, Jan Derks, Efficacy, access, flap, pocket,
elimination, procedures, management, peri-implantitis, systematic review, and
meta-analysis