BACKGROUND AND OBJECTIVES: Peri-implant mucositis (PiM) is a reversible inflammatory condition that may progress to peri-implantitis if untreated. Professional mechanical plaque removal (PMPR) is the standard therapy, although complete resolution is not always achieved. This review aimed to evaluate the effectiveness of chemical and pharmacological adjunctive therapies to PMPR in PiM management. MATERIALS AND METHODS: A literature search was conducted in PubMed and Scopus up to March 2025. Randomized controlled trials (RCTs) including adult patients with PiM, reporting bleeding on probing (BoP) changes, and with a minimum follow-up of 3 months were included. Nine RCTs (414 patients) were qualitatively analyzed. RESULTS: PMPR alone resulted in significant reductions in BoP and probing depth (PD), but complete disease resolution was inconsistent. Adjunctive therapies, including chlorhexidine, local antibiotics, sodium hypochlorite, probiotics, and bioactive agents, showed intra-group improvements. However, additional benefits over PMPR alone were limited and often not statistically significant. Study heterogeneity in diagnostic criteria, outcome definitions, and treatment protocols limited comparability. CONCLUSIONS: PMPR remains the gold standard for PiM treatment. Adjunctive therapies may provide additional clinical benefits in selected cases, but their routine use is not supported by consistent evidence. Standardized RCTs with long-term follow-up are needed.
Mauriello et al. (Tue,) studied this question.