Clinical efficacy of antibiotics in the treatment of peri-implantitis

Authors


Correspondence to:

Dr Fawad Javed

Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration

3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University

60169 Riyadh 11545, Saudi Arabia.

Email: fawjav@gmail.com

Abstract

Objectives

The aim of the present study was to review the pertinent literature with reference to the clinical efficacy of antibiotics in the treatment of peri-implantitis.

Methods

To address the focused question ‘Are locally and systemically delivered antibiotics useful in the treatment of peri-implantitis?’ PubMed/Medline and Google-scholar databases were explored from 1992 until February 2013 using a combination of the following keywords: ‘antibiotic,’ ‘dental implant,’ ‘inflammation,’, ‘peri-implantitis’ and ‘treatment’. Letters to the editor, case-reports and unpublished data were excluded.

Results

Ten studies were included. In six studies, peri-implantitis was treated using a non-surgical approach (scaling and root planing), whereas in four studies, a surgical approach was adopted for treating peri-implantitis. In three studies systemic antibiotics were administered and in six studies locally delivered antibiotics were used for treatment. One study used the oral route for antibiotic delivery. In three studies, minocycline hydrochloride was locally delivered as an adjunctive therapy to non-surgical mechanical debridement of infected sites. Nine studies reported that traditional peri-implantitis treatment with adjunct antibiotic therapy reduces gingival bleeding, suppuration and peri-implant pocket depth. In one study, despite surgical debridement of infected sites and systemic antibiotic cover, nearly 40% of the implants failed to regain stability. There was no placebo or control group in eight out of the nine studies included.

Conclusion

The significance of adjunctive antibiotic therapy in the treatment of peri-implantitis remains debatable.

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