Although NST is always the first treatment approach in peri-implantitis management, its efficacy in promoting disease resolution is currently limited, especially in cases presenting advanced pathology and complex peri-implant defect configurations. It is becoming increasingly clear that successful NST does not only entail an effective biofilm removal, but it requires a multi-level approach where the peri-implant tissues are considered in close interrelation with the implant-abutment-prosthesis complex.
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Calciolari et al. (2026) studied this question.
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