Cement-or screw-retained implant-supported prostheses and peri-implant disease

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This review comparing the incidence of peri-implant disease with cement- and screw-retained prostheses included 6 RCTs. The findings suggest no difference in level of peri-implant disease with cement- or screw retained prosthesis. However, the studies are small none of them are at low risk of bias. Consequently the findings should be interpreted cautiously.

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Supportive care to prevent recurrence or progression of peri-implantitis

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This review of whether supportive care is effective in preventing recurrence or progression of peri-implantitis included 15 studies. However none of the included studies was specifically designed to test supportive care regimens so there is a need for new well conducted and reported randomised trials of appropraite size and duration to provide better quality evidence.

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Smoking and the incidence of peri-implantitis

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This review of the influence of smoking on the incidence of peri-implantitis included 6 prospective cohort studies involving a total of 762 patients. The findings suggest an increased patient-level risk of peri-implantitis in smokers risk ratio = 2.08 (95%CI; 1.17 to 3.71.

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Peri-implantitis – adjunctive measures to non-surgical peri-implant therapy

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This review of the effectiveness of patient-performed or administered adjunctive measures to non-surgical peri-implantitis therapy included 9 RCTs. A wide range of interventions were tested but the studies were mainly small with only one being at low risk of bias. Consequently addition high quality well conducted studies are needed on both the prevention and treatment of peri-implant disease.

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Peri-implantitis – surgical treatment methods

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This review comparing the effectiveness of different surgical methods for peri-implantitis included 13 parallel group RCTs. However, a wide variety of interventions were tested and the studies were generally small providing very low certainty evidence. Consequently additional high quality well reported studies are needed.

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Peri-implant mucositis – patient performed adjunctive measures

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This review of patient-performed or administered measures used adjunctively to submarginal instrumentation for the management of peri-implant mucositis included 14 studies. The findings indicated that adjunctive measures reduced probing depth, bleeding on probing and plaque level reductions at 3 months and were in favour of adjunctive measures, which were plaque.

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Peri-implant mucositis – non-surgical treatments

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This review of the effectiveness of professional mechanical/physical treatment of peri-implant mucositis included 5 RCTs. None of the included RCTs was at low risk of bias so there is little evidence to recommend one treatment of combination of treatment. Additional high quality well reported studies are needed.

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Peri-implantitis – efficacy of different bone reconstructive therapies

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This review of the efficacy of different bone reconstructive therapies for peri-implantitis compared to access flap surgery at 12 months or longer. included 18 studies with 12 RCTs contributing to the meta-analyses. The findings suggest that compared with access flap surgery reconstructive surgery does not offer significant improvements at 12 months but the evidence is of low certainty.

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Peri-implantitis – How common is it?

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This review aiming to estimate the overall prevalence of peri-implantitis included 57 studies (18 cross-sectional,18 longitudinal, 17 cohort studies, 3 RCTs and 1 case-control). Meta-analysis found an ooverall patient level prevalence of 20% (95%CI; 16.6 to 23.7%). However most of the studies used convenience samples and there was a marked heterogeneity in the diagnostic criteria used so the findings should be viewed cautiously.

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Peri-implantitis – Surgical treatment with or without adjunctive graft material

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This review of the surgical treatment of peri-implantitis alone or in combination with adjunctive graft material included 5 small RCTs. The findings suggest improvements in marginal bone level (MBL) with graft material but the findings should be interpreted very cautiously because of the limited amount and quality of the evidence.

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