Does submarginal instrumentation before surgical management of peri-implantitis offer added benefit?

Current treatment for peri-implantitis starts with behavioural intervention and supragingival instrumentation followed by non-surgical submarginal instrumentation. In severe forms, surgical therapy is often required. Various authors have questioned the value of submarginal instrumentation and opted to use only supragingival instrumentation before surgical treatment.

Research published by Mario Romandini et al. in the Journal of Clinical Periodontology Volume 49, issue 12 (December 2022), and summarised as JCP Digest 108 aimed to evaluate the effects of non-surgical submarginal instrumentation before surgical treatment of peri-implantitis.

The study was a randomised multi-centre trial with 21 patients per treatment group. Treatment success (no implant loss, no bone loss) was achieved in 26.9 of all study implants, with marginally better but not statistically significant results for the test group (33.3 test vs 21.4% control.)

Researchers found that no added benefit was demonstrated in performing submarginal instrumentation six weeks before the surgical treatment of peri-implantitis. They also found that patient discomfort, treatment duration and costs can potentially be reduced by avoiding submarginal instrumentation before surgical therapy for peri-implantitis. Nevertheless, the authors caution that further studies with larger populations are required to establish definitive conclusions. The research was summarised for JCP Digest by postgraduate students at the Dublin Dental University Hospital, Trinity College, Dublin, Ireland.

Read JCP Digest

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