Efficacy of systemic use of antibiotics as an adjunct to non-surgical treatment of peri-implantitis: a meta-analysis of randomized controlled trials.

OBJECTIVES: The role of antibiotics as an adjunct to non-surgical peri-implantitis treatment approaches has not reach a consensus. This meta-analysis aimed to review the adjunctive effect of systemic use of metronidazole and amoxicillin in patients with peri-implantitis.

METHOD AND MATERIALS: PubMed, Embase, and the Cochrane library were searched for randomized controlled trials (RCTs) published from inception to January 2023.

RESULTS: A total of 5 clinical trials with a total of 211 patients were included in our analyses. No significant difference was found in the reduction of probing pocket depth (PD) at 3- and 6-month follow-up (3-month: WMD=-0.336, 95%CI: -0.966, 0.233, p=0.231; 6-month: WMD=-0.533, 95%CI: -1.654, 0.587, p=0.351). Statistically significance was found at 12-month follow-up: WMD=-1.327, 95%CI: -1.803, -0.852, p<0.001) between the treatment group and control. And the combined results indicated the difference in reduction of bleeding on probing (BOP), plaque score (PI), and bone level (BL) at 6-month follow-up were significant (p<0.05).

CONCLUSION: Our study demonstrated that the adjunctive use of systemic metronidazole and amoxicillin did not significantly improve PD compared to non-surgical treatment alone, and should not be routinely recommended. However, the significant reduction in BOP, PI, and BL at 6-month may indicate potential effect for treating peri-implantitis.