Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri-implant mucositis. A systematic review and meta-analysis.

FOCUSED QUESTION: In patients with peri-implant mucositis, what is the efficacy of professionally administered plaque removal (PAPR) with adjunctive measures on changing signs of inflammation compared with PARP alone? MATERIALS AND METHODS: After electronic database and hand search, 19 full-text articles were independently screened by two reviewers. Finally, a total of seven studies fulfilled the inclusion criteria. The weighted mean difference (WMD) in bleeding on probing- (BOP) (primary outcome), gingival index- (GI) and probing pocket depth- (PD) reductions was estimated (random effect model). RESULTS: WMD in BOP reduction between test and control groups amounted to -8.16% [SD = 4.61; p = 0.07; 95% CI (-17.20, 0.88)] not favouring adjunctive antiseptic or antibiotic (local, systemic) therapy over PAPR alone. WMD in GI and PD reductions amounted to -0.12 [SD = 0.13; p = 0.34; 95% CI (-0.38, 0.13)] and -0.056 mm [SD = 0.10; p = 0.60; 95% CI (-0.27, 0.16)] not favouring adjunctive (antiseptics, systemic antibiotics, air abrasive device) over control measures respectively. Most studies evaluated reported on residual BOP and GI scores after therapy. CONCLUSIONS: Adjunctive therapy may not improve the efficacy of PAPR in reducing BOP, GI and PD scores at mucositis sites. Despite clinically important improvements, a complete disease resolution may not be expected by any of the treatment protocols investigated.