Efficacy of Nonreconstructive Surgical Treatment of Peri-implantitis: An AAP/AO Systematic Review and Meta-analysis of Access Flap Versus Osseous Surgery Procedures.

This systematic review and meta-analysis evaluated the efficacy of two nonreconstructive surgical treatments—access flap surgery and osseous resective surgery—for managing peri-implantitis, a condition characterized by inflammation and bone loss around dental implants. Analyzing 15 randomized controlled trials with follow-ups up to 12 months, the study found no significant differences between the two techniques in reducing probing pocket depth (PPD) or bleeding on probing (BoP). However, flap surgery showed a slight advantage in preserving marginal bone levels (MBLs), with significantly less bone loss compared to osseous resective surgery at 6 and 12 months. The review also noted that smoking negatively affected BoP reduction and that patients with a history of periodontitis experienced slightly more marginal bone loss. Overall, both surgical approaches were effective in improving clinical parameters of peri-implantitis, but direct comparative studies remain limited, and further research considering defect morphology and diagnostic imaging is recommended.