Effectiveness of nonsurgical therapy of peri‐implant mucositis: A systematic review

Abstract Objectives This systematic review intends to respond to the question: “How do clinical parameters change in implants affected by peri‐implant mucositis following different non‐surgical treatment approaches or no treatment in patients monitored for a minimum of six months?” Materials and Methods A search for randomized clinical trials (RCTs) or prospective controlled clinical studies (NRCT) in MEDLINE‐PubMed, Cochrane Central Register of Controlled Trials, and Web of Science was performed between May 2015 and April 2025. After a two‐step screening, data extraction and risk of bias (RoB) assessment were performed. A network meta‐analysis (NMA), incorporating multi‐arm RCTs, was planned. Results Twenty‐one studies (19 RCTs; 2 NRCTs; 1068 patients) were included. The treatments comprised curettes, (ultra)sonic scalers, air‐polishing, laser, antimicrobials, probiotics, and antibiotics, alone or in combination. Patient‐related systemic and local factors and operator‐related factors were sporadically reported and analyzed. To various extents all treatments resulted in a reduction in BOP. When reported, peri‐implant mucositis resolution was achieved in a subset of patients, ranging from 9% to 100% (only in one study group). Microbiological and immunological data and patient‐reported outcomes (PROs) were sparsely and heterogeneously reported. Only one‐third of the studies presented low RoB. Due to limited data available and heterogeneity in treatment protocols and outcomes among the included studies, a NMA could not be performed. Conclusions Within the limitations of this review, different nonsurgical treatment protocols, including mechanical debridement alone, all improved clinical parameters, whereas adjuncts yielded only minor improvements after 6 months. Standardized outcome sets and routine PROs are needed to improve comparability and decision‐making in future studies.