Comparative Effectiveness Research of Adjunctive Methods in Controlling Peri-Implant Mucositis Intervention A Systematic Review Analysis

Introduction and Objective: Peri-implant mucositis is a very common condition affecting the gingival tissue around dental implants. It is an inflammation of the tissues, characterized by bleeding on probing around the implant. This condition is the initial step of a more severe condition called peri-implantitis, which is very difficult to treat. With increased number of implant placements in patients, the length of time each dental implant is supposed to serve, and the price of replacing the implant after failure, the importance of maintaining a healthy tissue around implants has become a fundamental issue. Mechanical debridement is the proposed treatment of peri-implant mucositis, which may be accompanied by adjunctive methods to increase the efficacy of treatment. These options include but are not limited to photodynamic therapy, chlorhexidine, antibiotics, etc. Due to the importance and prevalence of peri-implant mucositis, the establishment of a treatment protocol is called for. If the addition of adjunctive treatments reduces the inflammation, they can be added to the mechanical debridement approach. Since there are multiple adjunctive methods, there is a need to conduct a comparative effectiveness research to provide scientific information regarding the best option. The aim of this study is to find out whether addition of adjunctive methods to mechanical debridement improves the results of controlling peri-implant mucositis. This improvement can be measured by bleeding on probing scores before and after the intervention.Methods: Search for systematic reviews, observational studies, and randomized clinical trials studies was done using the National Library of Medicine-PubMed, Cochrane library, the American Dental Association (ADA) web Library, and hand search. The relevance of the identified systematic reviews and clinical trials studies to the study and PICOTS questions was assessed using the inclusion and exclusion criteria. The quality of evidence was achieved using the CONSORT-2010 checklist instrument. Results: Three out of five randomized clinical trials were considered as high quality studies. We were unable to perform a Meta-analysis due to the heterogeneity in the methods and results of the retained articles.Conclusion: Based on the results of the three retained randomized clinical trials, chlorhexidine might or might not reduce the bleeding on probing scores around dental implants and antibiotics showed no short term differences