Current Protocols for the Treatment of Peri-implantitis

Purpose of Review: Peri-implant diseases are becoming a major problem in modern dentistry. A clear understanding of the pathogenesis of peri-implant diseases may provide key aspects for decision-making on their approach and obtaining predictable results. The purpose of the present article is to provide a narrative review of current protocols (2015–present) used for treatment of peri-implantitis. Recent Findings: Current evidence reflects the level of diagnostic and therapeutic complexity; and multifactorial effect of conditions associated with peri-implant mucositis and peri-implantitis. Non-surgical therapy, by means of mechanical detoxification with or without adjuncts, has proven somehow effective for the treatment of mild forms of peri-implantitis. Conversely, open flap mechanical debridement with resective and/or regenerative treatment modalities have been advocated more towards moderate-to-severe forms. There is a lack of evidence to support the use of adjuncts (e.g. systemic/locally-delivered antibiotics, antimicrobial mouth rinses, biologic agents, laser therapy, antimicrobial photodynamic therapy, soft tissue augmentation) with conventional mechanical therapy upon the long-term outcomes after the peri-implantitis treatment. Summary: Emerging long-term results found surgical outcomes after peri-implantitis therapy to remain unpredictable in arresting inflammation, but effective in preventing further bone destruction and implant loss. In the presence of further peri-implant breakdown, the need for rescue therapy and implant removal was observed in retrospective and prospective studies. To the present date, inconclusive evidence exists to support a gold standard protocol for an effective surgical implant detoxification.