Long‐term surgical treatment outcomes of peri‐implantitis

Abstract Background To assess the long‐term results of the surgical treatment of peri‐implantitis by means of clinical, radiographic outcomes, and whenever possible, a composite definition of disease resolution. Furthermore, this review aimed at evaluating the prognostic indicators of long‐term disease recurrence. Methods A systematic screening was conducted to identify long‐term clinical studies (≥5 years) on the surgical therapy of peri‐implantitis. Data pertinent to study methodology, surgical intervention and clinical and radiographic outcomes were retrieved from the original studies. Qualitative assessment was performed. Results Overall, 17 long‐term studies were included in the qualitative synthesis. Due to the heterogeneity, quantitative analysis was not suggested. The mean disease resolution rate was 58.6%. The mean progressive bone loss arrestment (>1 mm) at the latest follow‐up following therapy was reached in 69.6%. Resolution of bleeding on probing at the latest follow‐up was achieved in 59.9%. The need for retreatment was deemed in 27.2% of the cases. Disease resolution following a second attempt was seldomly evaluated. The implant survival rate resulted in 88.6% (range: 75%–100%). The odds for disease recurrence following surgical treatment of peri‐implantitis were ∼8× higher when residual pathogenic pockets were present during follow‐up. Moreover, the extent of bone loss, the width (<2 mm) of keratinized mucosa following surgical treatment, and implant surface (modified) influenced disease recurrence. Conclusion The surgical treatment of peri‐implantitis yields to favorable outcomes in the long‐term. Data suggest that the long‐term disease resolution is ∼60% under supportive peri‐implant care, while ∼70% exhibit progressive bone loss arrestment. Hence, the need for retreatment is not infrequent. Residual pockets (≥6 mm) following surgical therapy and the advanced extent of bone loss imply a risk for disease recurrence. Clinical Relevance These findings suggest that the surgical treatment of peri‐implantitis is effective in the long‐term in patients enrolled in supportive peri‐implant therapy. However, its predictability can be interfered in scenarios exhibiting advanced lesions or in those that display residual deep pockets following therapy.