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 - P

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Biomaterials used during surgical treatment for peri-implantitis aim to reconstruct bony defects and support soft tissue healing, but evidence is unclear if they enhance disease resolution.
A systematic review and meta-analysis of 7 RCTs (402 patients, 405 implants) found wide variations in outcome reporting, preventing quantitative comparison of peri-implantitis resolution between intervention (surgery with biomaterials) and comparison (surgery alone) groups.
Individual meta-analyses showed a weighted mean difference (WMD) in probing pocket depth (PPD) reduction of 0.28 mm and a relative risk (RR) for absence of bleeding on probing (BOP) of 1.11 for biomaterials over access flap alone, both with confidence intervals including no effect.
For radiographic defect level (RDL) reduction, a WMD of 1.08 mm favored biomaterials, but with significant heterogeneity (I2: 85%), and buccal mucosal recession (REC) showed a WMD of -0.38 mm, also favoring biomaterials.
Heterogeneity analysis indicated that hydrogen peroxide, but not rotary titanium brushes, used as an adjunct for implant surface debridement positively affected RDL outcomes.
Current evidence suggests biomaterials may not definitively enhance peri-implantitis resolution, possibly due to factors like implant surface treatments, highlighting the need for standardized outcome reporting and control of such variables in future research.

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