Non-Cochrane · intervention · PM41892788
Regenerative Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis.
Fuerst Gabor, Ali Shko Atta, Rausch-Fan Xiaohui, et al. · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14030180
Findings
Population Patients with peri-implantitis
30 findings
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Bleeding on probing (BOP) Follow-up as reported by included studies · All arms pooled | Pooled mean change -1.33 [-1.65, -1.01] GRADE not reported 8 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Suppuration (SUP) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change -1.25 [-1.68, -0.82] GRADE not reported 4 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Clinical attachment level (CAL) Follow-up as reported by included studies · Regenerative vs OFD, test of group differences | Test of group differences: Qb(1) = 0.00, p = 0.96 GRADE not reported 7 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Bleeding on probing (BOP) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change -1.61 [-2.24, -0.98] GRADE not reported 8 studies |
| Open flap debridement | None | Radiographic bone level (RBL) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change -0.57 [-0.77, -0.38] GRADE not reported 6 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Radiographic bone level (RBL) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change -1.53 [-1.99, -1.08] GRADE not reported 11 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Mucosal recession (REC) Follow-up as reported by included studies · Regenerative vs OFD, test of group differences | Test of group differences: Qb(1) = 2.17, p = 0.14 GRADE not reported 4 studies |
| Regenerative surgical treatment (bone graft, GBR, PRF, HA) | Open flap debridement (OFD) | Bleeding on probing (BOP) Test of group differences: regenerative vs OFD | Test of group differences Q = 2.24, p = 0.13; no between-group effect estimate or CI reported GRADE not reported 8 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Mucosal recession (REC) Follow-up as reported by included studies · All arms pooled | Pooled mean change 0.37 [0.16, 0.57] GRADE not reported 4 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Probing pocket depth (PPD) Follow-up as reported by included studies · All arms pooled | Pooled mean change -1.87 [-2.16, -1.58] GRADE not reported 11 studies |
| Regenerative surgical treatment (bone graft, GBR, PRF, HA) | Open flap debridement (OFD) | Radiographic bone level (RBL) Test of group differences: regenerative vs OFD | Test of group differences Q = 14.61, p < 0.001 (Results; plot shows p = 0.00); no between-group effect estimate or CI reported GRADE not reported 11 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Radiographic bone level (RBL) Follow-up as reported by included studies · All arms pooled | Pooled mean change -1.25 [-1.62, -0.88] GRADE not reported 11 studies |
| Open flap debridement | None | Mucosal recession (REC) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change 0.55 [0.34, 0.76] GRADE not reported 2 studies |
| Open flap debridement | None | Probing pocket depth (PPD) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change -1.84 [-2.23, -1.45] GRADE not reported 7 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Clinical attachment level (CAL) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change -1.52 [-1.95, -1.09] GRADE not reported 7 studies |
| Regenerative surgical treatment (bone graft, GBR, PRF, HA) | Open flap debridement (OFD) | Suppuration (SUP) Test of group differences: regenerative vs OFD | Test of group differences Q = 0.64, p = 0.42; no between-group effect estimate or CI reported GRADE not reported 5 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Suppuration (SUP) Follow-up as reported by included studies · All arms pooled | Pooled mean change -1.14 [-1.44, -0.83] GRADE not reported 5 studies |
| Open flap debridement | None | Clinical attachment level (CAL) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change -1.49 [-2.6, -0.38] GRADE not reported 2 studies |
| Regenerative surgical treatment (bone graft, GBR, PRF, HA) | Open flap debridement (OFD) | Probing pocket depth (PPD) Test of group differences: regenerative vs OFD | Test of group differences Q = 0.08, p = 0.77; no between-group effect estimate or CI reported GRADE not reported 11 studies |
| Open flap debridement | None | Suppuration (SUP) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change -0.98 [-1.47, -0.49] GRADE not reported 2 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Clinical attachment level (CAL) Follow-up as reported by included studies · All arms pooled | Pooled mean change -1.51 [-1.89, -1.14] GRADE not reported 7 studies |
| Open flap debridement | None | Bleeding on probing (BOP) Follow-up as reported by included studies · Control arms (OFD) pooled | Pooled mean change -1.11 [-1.31, -0.91] GRADE not reported 6 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Mucosal recession (REC) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change 0.29 [0.02, 0.56] GRADE not reported 4 studies |
| Regenerative surgery (bone graft, GBR, PRF, HA) | Open flap debridement | Probing pocket depth (PPD) Follow-up as reported by included studies · Test arms (regenerative) pooled | Pooled mean change -1.93 [-2.34, -1.51] GRADE not reported 11 studies |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Mucosal recession (REC) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: p = 0.86 GRADE not reported Studies not reported |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Radiographic bone level (RBL) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: p > 0.05 GRADE not reported Studies not reported |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Clinical attachment level (CAL) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: p = 0.58 GRADE not reported Studies not reported |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Bleeding on probing (BOP) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: p = 0.72 GRADE not reported Studies not reported |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Probing pocket depth (PPD) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: no significant difference (p not reported) GRADE not reported Studies not reported |
| Guided bone regeneration, platelet-rich fibrin or hyaluronic acid with grafting | Bone grafting alone | Suppuration (SUP) Follow-up as reported by included studies · Second meta-analysis | Second meta-analysis: p = 0.35 GRADE not reported Studies not reported |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Andersen 2017 Porous titanium granules in the treatment of peri-implant osseous defects-a 7-year follow-up study. PMID:29199392 | 2017 | this review only | not stated | not extracted yet |
| Derks 2022 Reconstructive surgical therapy of peri-implantitis: A multicenter randomized controlled clinical trial. PMID:35804491 | 2022 | this review only | not stated | not extracted yet |
| Heitz-Mayfield 2023 Surgical peri-implantitis treatment with and without guided bone regeneration. A randomized controlled trial. PMID:37382408 | 2023 | this review only | not stated | not extracted yet |
| Jepsen 2016 Reconstruction of Peri-implant Osseous Defects: A Multicenter Randomized Trial. PMID:26450511 | 2016 | this review only | not stated | not extracted yet |
| Monje 2022 Significance of barrier membrane on the reconstructive therapy of peri-implantitis: A randomized controlled trial. PMID:36399349 | 2023 | this review only | not stated | not extracted yet |
| Rakasevic 2023 Reconstructive Peri-Implantitis Therapy by Using Bovine Bone Substitute with or without Hyaluronic Acid: A Randomized Clinical Controlled… PMID:36976073 | 2023 | this review only | not stated | not extracted yet |
| Ramanauskaite 2018 Clinical outcomes following surgical treatment of peri-implantitis at grafted and non-grafted implant sites: a retrospective analysis. PMID:30090967 | 2018 | this review only | not stated | not extracted yet |
| Renvert 2018 Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute-a randomized clinical trial. PMID:30003583 | 2018 | this review only | not stated | not extracted yet |
| Renvert 2021 Surgical treatment of peri-implantitis with or without a deproteinized bovine bone mineral and a native bilayer collagen membrane: A… PMID:34169551 | 2021 | this review only | not stated | not extracted yet |
| Roos-Jansaker 2007 Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort study. PMID:17555414 | 2007 | this review only | not stated | not extracted yet |
| Sun 2021 Effects of platelet-rich fibrin combined with guided bone regeneration in the reconstruction of peri-implantitis bone defect. PMID:34377334 | 2021 | this review only | not stated | not extracted yet |
| Wang 2023 Stability of peri-implantitis surgical reconstructive therapy-a (> 2 years) follow-up of a randomized clinical trial. PMID:38147180 | 2023 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with peri-implantitis | Patients with peri-implantitis (n=12 studies) |
| Intervention | Surgical regenerative treatments (GBR, PRF, HA, bone grafting) | Bone graft, GBR, PRF, HA (n=12 studies) |
| Comparison | Open flap debridement (OFD), bone grafting (BG), GBR, PRF, HA | OFD; bone grafting alone |
| Outcomes | PPD, RBL, BOP (primary); SUP, REC, CAL (secondary) | RBL, PPD, BOP, SUP, REC, CAL |
| Study designs | Human studies with test and control group; English; peer-reviewed | RCTs and non-randomized studies (n=12) |
| Timing | Published 1993 to 2024; follow-up not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |