What do systematic reviews say?

Air-abrasive / Vector system debridement vs Manual debridement (carbon fibre curettes)

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  6 months
  No statistically significant difference for PPD; data not usable.
  1 study · 11 participants
  GRADE not reported

Metronidazole gel 25% (local antibiotic) vs Ultrasonic debridement

Metronidazole gel 25% (local antibiotic) showed no clear difference in change in probing pocket depth compared with ultrasonic debridement; GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  12 weeks
  After 12 weeks there was no statistically significant difference in PPD changes.
  1 study · 27 participants
  GRADE not reported

Mechanical debridement with titanium curettes vs Ultrasonic debridement

Mechanical debridement with titanium curettes showed no clear difference in change in probing pocket depth compared with mechanical debridement with ultrasonic device; GRADE not reported.

• Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants 2010 · Cochrane All outcomes

  6 months
  MD -0.40 [-1.14, 0.34]
  1 study · 31 participants
  GRADE not reported

Mechanical debridement plus topical minocycline vs Mechanical debridement plus chlorhexidine gel

Mechanical debridement plus topical minocycline showed no clear difference in change in probing pocket depth compared with mechanical debridement plus chlorhexidine gel; GRADE not reported.

• Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants 2010 · Cochrane All outcomes

  12 months
  MD 0.30 [-0.17, 0.77]
  1 study · 32 participants
  GRADE not reported

Phosphoric etching (acid) gel vs Mechanical debridement and polishing

Phosphoric etching (acid) gel showed no clear difference in change in probing pocket depth compared with mechanical debridement and polishing; GRADE not reported.

• Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants 2010 · Cochrane All outcomes

  5 months
  MD 0.28 [-1.97, 2.53]
  1 study · 16 participants
  GRADE not reported

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Metal-free implant abutments (zirconia) showed no clear difference in implant probing pocket depth (PPD) compared with metal implant abutments (titanium); GRADE not reported.

• Metal‐free materials for fixed prosthodontic restorations 2017 · Cochrane All outcomes

  12 months
  MD -0.22 [-0.60, 0.16]
  2 studies · 47 participants
  GRADE not reported

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox) added to manual debridement vs Manual debridement plus chlorhexidine irrigation/gel

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox)… led to higher change in probing pocket depth (PPD) compared with manual debridement with chlorhexidine (no antibiotic); GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  4 months (18 weeks)
  MD 0.59 [0.39, 0.79]
  1 study · 28 participants
  GRADE not reported

Mechanical debridement plus topical minocycline vs Mechanical debridement plus chlorhexidine gel

Mechanical debridement plus topical minocycline showed no clear difference in change in probing pocket depth (worst sites) compared with mechanical debridement plus chlorhexidine gel; GRADE not reported.

• Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants 2010 · Cochrane All outcomes

  12 months
  MD 0.40 [-0.28, 1.08]
  1 study · 32 participants
  GRADE not reported