Abstract
Aim
To answer the following PICO question: In systemically healthy humans with peri-implant mucositis (PiM), what is the efficacy of patient-performed or administered (by prescription) measures used adjunctively to submarginal instrumentation, as compared to submarginal instrumentation alone or combined with a negative control, in terms of reducing bleeding on probing (BOP), in randomized controlled clinical trials (RCTs) with at least 3-month follow-up?
Material and methods
Three databases were searched until April 2022. Weighted mean differences (WMD) with 95% confidence intervals (CIs) and predictive intervals were calculated.
Results
16 parallel RCTs corresponding to 14 studies with low/moderate risk of bias were included. Test groups showed greater reductions in BOP (%) than control groups (nstudies=16; npatients=650; WMD=14.25%; 95% CI [9.06; 19.45]; p<0.001; I2=98.7%). The greatest WMD in BOP reductions (%) were obtained by antiseptics (ns=5; np=229; WMD=22.72%; 95% CI [19.40; 26.04]; p<0.001; I2=94.8%), followed by probiotics (ns=6; np=260; WMD=12.11%; 95% CI [3.20; 21.03]; p=0.008; I2=93.3%), and systemic antibiotics (ns=3; np=101; WMD=5.97%; 95% CI [1.34; 10.59]; p=0.012; I2=58.1%). Disease resolution was scarcely reported (n=6).
Conclusions
Significant clinical improvements can be obtained when professional submarginal instrumentation is combined with patient-performed or administered (by prescription) adjunctive measures, although a complete disease resolution may not be achieved.
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