Biomaterials for resolution of peri‐implantitis: Consensus report of Workgroup 2 of the IADR Implantology Research Group Best Evidence Consensus Symposium on Peri‐Implant Disease and Its Treatment

Peri-implantitis is a destructive disease affecting tissues around dental implants. We studied whether adding reconstructive biomaterials (i.e., biomaterials used to improve the likelihood of new bone formation or bone defect fill) to surgical treatments improves the clinical condition, meaning no further bone loss, probing pocket depths (PPD) ≤5 mm, and no bleeding on probing (BOP). We reviewed randomized controlled trials (RCTs) comparing surgery with biomaterials to surgery alone with at least 12 months of follow-up. The main outcomes measured were PPD reduction, absence of BOP, and radiographic defect level (RDL). Secondary outcomes included RDL change, buccal mucosal recession (REC), and patient-related outcomes (PROMs). Seven studies with 402 patients and 405 implants were analyzed. Due to variations in outcome reporting, it was challenging to compare the effectiveness of treatments. However, some individual analyses showed a small improvement in PPD and BOP with biomaterials. For RDL reduction, biomaterials showed better results, but with significant variability. REC also improved slightly with biomaterials. The analysis also suggested that using hydrogen peroxide, but not rotary titanium brushes, for implant cleaning could positively affect bone levels. The study concluded that adding biomaterials to surgical treatment does not definitively improve peri-implantitis resolution, possibly due to other factors like implant surface treatments. This study emphasized the need for standardized reporting and considering these factors in future research.