Non-Cochrane · intervention · PM42254058
Risk-based efficacy of systemic and local antibiotics in nonsurgical treatment of peri-implantitis: A systematic review and meta-analysis.
Faramarzi Masoumeh, Pourkaveh Sajjad, Shirmohammadi Adileh, et al. · Journal of advanced periodontology & implant dentistry · 2026 · PubMed · doi:10.34172/japid.026.3971
Findings
Population Adults with peri-implantitis
4 findings
| Systemic or local antibiotics adjunctive to nonsurgical debridement | Nonsurgical mechanical debridement alone | Probing depth (PD) reduction Overall (all antibiotics) | SMD -0.666 [-1.014, -0.318] GRADE not reported 6 studies · 325 participants |
| Systemic amoxicillin plus metronidazole adjunctive to nonsurgical debridement | Nonsurgical mechanical debridement alone | Probing depth (PD) reduction Systemic amoxicillin + metronidazole (AMX+MTZ) | SMD -1.033 [-1.836, -0.230] GRADE not reported 4 studies · 179 participants |
| Local metronidazole-minocycline ointment adjunctive to nonsurgical debridement | Nonsurgical mechanical debridement alone | Probing depth (PD) reduction Local metronidazole-minocycline (Local) | SMD -0.448 [-0.895, -0.002] GRADE not reported 1 study · 114 participants |
| Systemic metronidazole alone adjunctive to nonsurgical debridement | Nonsurgical mechanical debridement alone | Probing depth (PD) reduction Systemic metronidazole (Systemic MTZ) | SMD -0.977 [-1.747, -0.206] GRADE not reported 1 study · 32 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Ahmed 2020 The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis… PMID:33157330 | 2020 | 1 other review | Probing depth (PD) reduction | not extracted yet |
| Blanco 2022 Adjunctive benefits of systemic metronidazole on non-surgical treatment of peri-implantitis. A randomized placebo-controlled clinical trial. PMID:34713471 | 2022 | 1 other review | Probing depth (PD) reduction | not extracted yet |
| De Waal 2021 Systemic antibiotic therapy as an adjunct to non-surgical peri-implantitis treatment: A single-blind RCT. PMID:33939193 | 2021 | 1 other review | Probing depth (PD) reduction | not extracted yet |
| Polymeri 2022 Non-surgical peri-implantitis treatment with or without systemic antibiotics: a randomized controlled clinical trial. PMID:35238084 | 2022 | 1 other review | Probing depth (PD) reduction | not extracted yet |
| Shibli 2019 Microbiological and clinical effects of adjunctive systemic metronidazole and amoxicillin in the non-surgical treatment of… PMID:31576959 | 2019 | 1 other review | Probing depth (PD) reduction | not extracted yet |
| Park 2021 Adjunctive use of metronidazole-minocycline ointment in the nonsurgical treatment of peri-implantitis: A multicenter randomized controlled… PMID:34139047 | 2021 | this review only | Probing depth (PD) reduction | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with peri-implantitis | Patients with peri-implantitis (n=325 randomized across 6 RCTs, including one trial in type 2 diabetes) |
| Intervention | Adjunctive systemic or local antibiotics | Systemic amoxicillin plus metronidazole (4 RCTs); systemic metronidazole (1 RCT); local metronidazole-minocycline ointment (1 RCT) |
| Comparison | Nonsurgical mechanical debridement alone | Mechanical debridement alone or with placebo |
| Outcomes | PD reduction, BOP, CAL | PD, BOP, CAL, microbiological counts, adverse events; PD pooled |
| Study designs | RCTs | RCTs (n=6) |
| Timing | Not specified | 12 weeks to 12 months |
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 | Partial Yes | Partial Yes | 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: N/A | NRSI: N/A · RCT: Partial Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | 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 |