Surgical treatment of Periimplantitis: Literature review.

Surgical treatment of Periimplantitis: Literature review.

SUMMARY

Objective: The objective of this study was to describe in a narrative review, the efficacy and indications of surgical therapy in the treatment of peri-implantitis.

Method: A narrative review was conducted through a literature search in the following electronic databases: PubMed, EBSCO, Cochrane, Google Scholar, as well as a manual search of the articles published in the "Journal of Periodontology" for availability in our library, and the literature cited in the selected studies. To develop the theoretical framework was used as support material in the area of ​​periodontics books. Electronic search for the following key words were used: "periimplantitis", "therapy", "treatment", "SURGERY" and "SURGICAL PROCEDURES, OPERATIVE" and the Boolean operators AND and OR. To analyze the risk of bias in clinical trials bias the tone for the Cochrane Collaboration for reviews of interventions used.

Results: A total of 6,167 articles were cast, of which 343 were potentially relevant articles. Of these, 256 were dismissed for not meeting the inclusion and exclusion criteria; and 65 did not answer the research question. Finally reduced to a total of 22 articles were included in this review.

Conclusion: more clinical evidence is needed in the scientific literature to determine the efficacy and indications of surgical treatment for the treatment of peri-implantitis.

I. INTRODUCTION

Dental implants have been used successfully in partial and total edentulous patients, however, the rise in installation also correlates to an increase in peri-implant disease.

The peri-implantitis is defined as inflammation of the mucosa surrounding the implant, accompanied by loss of supporting tissues. As for treatment, the first thing is to treat risk factors, such as periodontal disease throughout, then start therapy of peri-implantitis. (1)

Although, initially, it was thought that the treatment would As with other periodontal diseases, it has been found that both its etiology and pathogenesis are different, therefore, their treatment, must also be different.

The objectives of treatment are directed to the removal of the etiological factors, eliminate inflammation of soft tissues and disinfection of the implant and regeneration of the lost bone tissue. Despite this, it has been seen that the non-surgical treatment is not sufficient to resolve pathology, being necessary to add the surgical therapy for the treatment of peri-implantitis. It is at this point that there is no general consensus on the efficacy and indications on the implementation of this treatment.

The objective of this narrative review is to answer the following research question: What is the efficacy and indications of surgical treatment of peri-implantitis ?.

II. OBJECTIVES

General objective:

• The overall objective of this study is to describe a narrative review, the efficacy and indications of surgical therapy in the treatment of peri-implantitis.

Specific objectives:

1. Describe the peri-implantitis.

2. Describe the surgical treatment of peri-implantitis and the techniques currently used.

3. Describe the efficacy of surgical therapy for the treatment of peri-implantitis, by evaluating periodontal parameters.

4. Describe the indications for surgical therapy for the treatment of peri-implantitis.

III. METHOD

A narrative review was conducted through a literature search in the following electronic databases: PubMed, EBSCO, Cochrane, Google Scholar, as well as a manual search of the articles published in the "Journal of Periodontology" available on our library, and the literature cited in the selected studies. To develop the theoretical framework utilizaronlibros the area of ​​periodontics as support materials.

Electronic search for the following key words were used: "periimplantitis", "therapy", "treatment", "SURGERY" and "SURGICAL PROCEDURES, OPERATIVE" and the Boolean operators AND and OR.

publications written in English and Spanish, published from 2005 onwards, who have completed their studies in humans and were available in full-text journals and databases subscribed by the central library "José Enrique Diez" of were selected Universidad de los Andes.

RCTs were selected; non-randomized trials; systematic reviews; Case-control studies, descriptive, and case reports, only human. On the other hand, expert opinions and letters to the editor excluded.

The level of scientific evidence of the studies was performed using the following proposal made by the Centre for Evidence-Based Medicine (EMBC) Oxford (2).

Table 1: Levels of Evidence (EMBC) (2)

Level of evidence Type of study

1a Systematic review of randomized clinical trials, with homogeneity.

1b Randomized controlled trial with narrow confidence interval.

1c Clinic Practice ("all or none") (*).

The 2nd systematic review of cohort studies, with homogeneity.

2b Study cohort or randomized clinical trial of low quality (**).

2c Outcomes Research (***), ecological studies.

3a Systematic review of case-control studies, with homogeneity.

3b Study of cases and controls.

4 Case series or cohort and case-control studies of low quality (****).

5 Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles (*****).

Table 2: Grades of recommendation (EMBC) (2)

Grade of Recommendation Level of Evidence

A Level 1 Surveys.

B 2-3 level studies, or extrapolation of level 1 studies.

C Studies Level 4, or extrapolation from studies of level 2-3.

D Studies Level 5, or inconclusive studies of any level.

The extrapolation applies when our clinical scenario has important differences from the original study situation.

Table 3: Meaning of the degrees of recommendation (2)

Meaning degrees recommendation

A Strongly recommended

B Recommendation pro

C Recommendation friendly but inconclusive.

D Not recommended or disapprove.

The quality evaluation was performed by reporting the following guidelines:

• Questionnaire CONSORT for RCTs (3).

• TREND Questionnaire for non-randomized clinical trials (4).

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