Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.

This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polish...

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Main Authors: Yingjie Bai, Shengao Qin, Bingshuai Lu, Weiyi Wang, Guowu Ma
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0305342
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author Yingjie Bai
Shengao Qin
Bingshuai Lu
Weiyi Wang
Guowu Ma
author_facet Yingjie Bai
Shengao Qin
Bingshuai Lu
Weiyi Wang
Guowu Ma
author_sort Yingjie Bai
collection DOAJ
description This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.
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spelling doaj-art-e8901fcf296a451796017f6c3225ff552025-02-05T05:32:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01198e030534210.1371/journal.pone.0305342Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.Yingjie BaiShengao QinBingshuai LuWeiyi WangGuowu MaThis network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.https://doi.org/10.1371/journal.pone.0305342
spellingShingle Yingjie Bai
Shengao Qin
Bingshuai Lu
Weiyi Wang
Guowu Ma
Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
PLoS ONE
title Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
title_full Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
title_fullStr Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
title_full_unstemmed Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
title_short Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.
title_sort comparison of the efficacy of seven non surgical methods combined with mechanical debridement in peri implantitis and peri implant mucositis a network meta analysis
url https://doi.org/10.1371/journal.pone.0305342
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