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Journal of Zhejiang University SCIENCE B
ISSN 1673-1581(Print), 1862-1783(Online), Monthly
2025 Vol.26 No.2 P.145-157
Efficacy of adjunctive systemic or local antibiotic therapy in peri-implantitis: a systematic review and meta-analysis of randomized controlled clinical trials
Abstract: This systematic review and meta-analysis considered the results of randomized controlled clinical trials (RCTs) to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis. Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria. A meta-analysis was performed to evaluate the weighted mean differences in survival rate (SR) and changes in pocket probing depth (PPD), bone level (BL), and clinical attachment level (CAL). The study cohorts were defined as antibiotic and control groups with subgroups for analysis. Seven studies including 309 patients (390 implants) were considered. Within the limitations of this review, patients in the antibiotic groups exhibited significant improvements in PPD. Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL. It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis, whether through surgical or non-surgical approaches, and also shows moderate performance regarding BL and CAL. Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics, careful clinical judgment is still necessary.
Key words: Peri-implantitis; Dental implant; Oral medicine; Microbiology; Disease management; Meta-analysis
浙江大学医学院附属口腔医院,浙江大学口腔医学院,浙江省口腔疾病临床医学研究中心,浙江省口腔生物医学研究重点实验室,浙江大学癌症研究院,口腔生物材料与器械浙江省工程研究中心,中国杭州市,310000
摘要:本文通过对随机对照临床试验(RCT)结果进行综述和荟萃(meta)分析,评估全身或局部辅助使用抗生素在种植体周围炎治疗中的疗效。两名研究人员分别独立从三个电子数据库中,筛选符合所有纳入和排除标准的RCT结果的相关文献,并采用meta分析评估种植体留存率(SR)、种植体周袋探诊深度(PPD)、牙槽骨水平(BL)和临床附着水平(CAL)变化的加权平均差异。本文将研究组定义为抗生素组和对照组,并进行亚组分析。最终,7项研究被纳入,包括309例患者(390个种植体)。结果显示,抗生素组的患者在PPD方面表现出显著的改善;亚组分析表明,全身使用抗生素或在非手术治疗中使用抗生素不会显著改变BL。在本综述的研究范围内,无论是通过手术还是非手术方式,辅助使用抗生素都可以改善种植体周围炎治疗中的PPD和SR,在BL和CAL方面也表现出一定程度的效果,但考虑到对照组中缺乏新技术的应用以及目前对抗生素潜在风险的评估受限,医生在临床工作中仍需谨慎选择。
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DOI:
10.1631/jzus.B2300730
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On-line Access:
2025-02-26
Received:
2023-10-18
Revision Accepted:
2024-04-01
Crosschecked:
2025-02-27