Study Year of
publication
Type of
study
Groups Treatment provided N
patients
N
implants
Follow-up
(months)
Diagnosis Treatment outcomes Microbiological
results
Conclusions
Self-
performed
Professionally-
delivered
Mucositis/
peri-implantitis
PDs reduction
Mean (SD),
mm
Radiographic
MBL changes
Mean (SD), mm
BOP changes
Mean (SD), mm
Exudate changes PI or MPI (SD) changes CAL
Mean (SD), mm
Recession
Mean (SD), mm
John et al. [24] 2015 RCT AAD OHI on 2 to 4 appointments Submucosal AAD employed with amino acid glycine powder (Air-Flow® Perio Powder, EMS) 12 18 12 Peri-implantitis 3.7 (1)
to
3.2 (1.1)
NA 99 (4.1)
to
57.8 (30.7)%
NA 1.2 (1.1)
to
1.8 (1.1)
5.2 (1.9)
to
4.6 (1.8)
1.5 (1.4)
to
1.4 (1.3)
NA Both treatments resulted in comparable but limited CAL gains at 12 months. AAD was associated with significantly higher BOP decrease than MDA.
MD (carbon curettes
+ local antiseptic therapy)
OHI on 2 to 4 appointments MD was performed using carbon curets followed by pocket irrigation with a 0.1 % CHX solution and submucosal application of 1 % CHX gel 13 18 3.9 (1.1)
to
3.5 (1.2)
NA 94.7 (13.7)
to
78.1 (30)%
NA 1.2 (1)
to
0.9 (0.7)
5 (1.5)
to
4.5 (1.3)
1 (1.1)
to
0.9 (1.1)
NA
Machtei et al. [25] 2012 Double-blind RCT Control OHI
patients were given sodium fluoride toothpaste
Surface MD+ biodegradable crosslinked gelatin matrix chip (placebo) 30 37 6 Peri-implantitis 7.21
to
5.48
NA 100 to 42.5% NA NA 7.63 (0.3)
to
5.94 (0.3)
NA NA Substantial reduction in PD, gain in CAL and reduction in BOP in sites with peri-implantitis.
Test OHI
patients were given sodium fluoride toothpaste
Surface MD+ matrix containing 2.5 mg CHX chips 30 40 7.60
to
5.47
NA 100 to 59% NA NA 7.88 (0.2)
to
5.7 (0.3)
NA NA
Persson et al. [26] 2011 RCT Er:YAG laser OHI and patients received a sonic toothbrush (Er:YAG) laser: 100 mJ/pulse and 10 Hz (12.7 J/cm2) 21 55 6 Peri-implantitis PD reductions: 0.9 (0.8) Statistical analyses failed to demonstrate differences in bone-level changes between baseline and 6 months Statistical analyses also failed to demonstrate differences in the BOP at 6 weeks after treatment NA NA NA NA Both treatments failed to reduce bacterial counts at 6 months. Porphyromonas gingivalis counts were higher in cases with progressive peri-implantitis At 1 month, P. aeruginosa, S. aureus, and S. anaerobius were reduced in the air-abrasive group, and Fusobacterium spp. were reduced in the laser group. 6 month data demonstrated that both methods failed to reduce bacterial counts. Clinical improvements were limited.
AAD subgingival
polishing
OHI patients received a sonic toothbrush AAD subgingival
polishing for 15 sec in each position
21 45 PD reductions: 0.8 (0.5) Statistical analyses failed to demonstrate differences in bone-level changes between baseline and 6 months Statistical analyses also failed to demonstrate differences in the BOP at 6 weeks after treatment NA NA NA NA
Riben-Grundstrom et al. [27] 2015 RCT Glycine
powder air-polishing group
OHI Glycine powder air-polishing was performed at baseline, 3 and 6 months. Supragingival DE was provided at month 9 and 12. 18 NA 12 Mucositis NA NA 43.9 (7.3) to 12.1 (3.8) No differences were
found
Implant 25.5 (6.8) to
5.6 (3.8)
NA No differences were
found
NA Non-surgical treatment with a glycine powder air-polishing or ultrasonic device is effective in reducing inflammation and number of peri-implant pockets subject to patient compliance
Ultrasonic group OHI Cleaning with ultrasonic was performed at baseline, 3 and 7 months. Supragingival MD was provided at month 9 and 12. 18 NA NA NA 53.7 (7.9) to 18.6 (6.4) No differences were
found
Implant 24.1 (6.6) to
7.4 (6.4)
NA No differences were
found
NA
Swierkot et al. [28] 2013 RCT Sonic toothbrush group Brush 2 min twice daily with
toothpaste, brush their teeth with sonic tooth brush according to the manufacturer's instructions
NA 35 Mean count:
4.19
12 No peri-implantitis, 22% mucositis 3.4 (0.88)
to
3.4 (0.8)
NA 0.22 (0.3) to 0.27 (0.26) NA 0.86 (0.73)to
1 (0.79)
4.64 (1.63) to
5.1 (1.78)
1.23 (1.33) to
1.7 (1.48)
After 12 months, both groups exhibited a small increase in total bacterial load at implants and teeth. P gingivalis, P micra and D. pneumosintes were consistently detected at nearly every examination time for implant and teeth groups. No difference between sonic and manual tooth brushing for plaque reduction at implants and teeth. Sonic and manual toothbrushes maintained clinical, microbiological and immunological parameters over a period of 12 months at implants and teeth with no signs of soft tissue damage or technical complications.
Manual toothbrush group Brush 2 min twice daily with toothpaste, modified Bass technique NA 36 Mean count:
4.32
No peri-implantitis,
19% mucositis
3.13 (0.75)
to
3.13 (0.78)
NA 0.19 (0.28) to 0.28 (0.38) NA 0.56 (0.52) to
0.92 (0.93)
4.41 (1.65) to
4.43 (1.28)
1.28 (1.26) to
1.29 (0.85)

AAD = air-abrasive device; BOP = bleeding on probing; CAL = clinical attachment level; CHX = chlorhexidine digluconate; DE = debridement; LD = local delivery; MBL = marginal bone level; MD = mechanical debridement; MPI = modified plaque index; NA = not available; OHI = oral hygiene instructions; PD = probing depth; PI = plaque index; RB = radiographic bone; RCT = randomized controlled trials; SD = standard deviation.