Keywords: AMSTAR, dental implant, evidence-based dentistry, Glenny, nonsurgical therapy, peri-implantitis, systematic review
Purpose: To summarize the methodologic quality and outcome measures from systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for the treatment of peri-implant diseases.
Materials and methods: Two review authors independently searched for systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for treatment of peri-implant diseases in three different databases: MEDLINE, Embase, and the Cochrane Library. In addition, journals with a high impact factor in the fields of periodontics, prosthodontics, oral maxillofacial surgery, and implant dentistry were analyzed for potential reviews. The search was implemented from January 2010 through August 2020. Eligible reviews were screened and assessed to determine the characteristics and outcome measures. Furthermore, two review authors independently evaluated the methodologic quality by using the AMSTAR tool and the checklist proposed by Glenny et al. The interrater agreement was assessed by using the Cohen kappa coefficient. The assessment of correlation between the findings of the AMSTAR tool and Glenny et al checklist was performed by using the Spearman correlation.
Results: Fifteen systematic reviews and 12 meta-analyses were evaluated based on the inclusion criteria. One review investigated the efficacy of growth factors and another investigated glycine powder air polishing, 5 evaluated the role of antimicrobial photodynamic therapy, 8 assessed the effect of laser therapy, and 13 compared the different nonsurgical therapies with the surgical therapies for the treatment of peri-implant diseases. The quality assessment score evaluated by the AMSTAR checklist ranged from 5 to 11 with a mean of 7.5 ± 1.8, whereas the score evaluated by the Glenny et al checklist ranged from 3 to 14 with a mean of 9.7 ± 2.8. Spearman correlation analysis between these two tools reported a high correlation (r = 0.91) that was statistically significant (P < .001).
Conclusion: The summarized evidence of this overview shows that the different nonsurgical therapies are effective for the treatment of peri-implant mucositis. The lack of sufficient long-term data involving large datasets results in their inconclusive efficacy in the treatment of peri-implantitis. However, the summary is determined from the moderate quality of evidence. Hence, future well-designed high-quality trials are encouraged to reassess the findings.