Treatment of peri-implantitis: Non-surgical therapeutic approaches

Introduction The prevalence of peri-implant complications will increase as dental implant-retained prostheses become routine. Peri-implant diseases are present in two forms: peri-implant mucositis and peri-implantitis. Plaque-induced mucositis is a reversible inflammation of the peri-implant gingiva and responds satisfactorily to nonsurgical treatment. It is generally accepted that mucositis will eventually give rise to peri-implantitis, with inflammation encroaching on the alveolar support. Depending on the severity of the peri-implantitis lesion, surgical or nonsurgical procedures should be implemented. Based on the diagnosis, continuously made during recall visits, a maintenance system termed cumulative interceptive supportive therapy has been followed in this manuscript, further expanding the nonsurgical protocols, including the adjunctive use of the diode laser. Long-term maintenance care for high-risk groups is essential to reduce the risk of peri-implantitis. Informed consents for patients receiving implant treatment must include the need for such maintenance therapy. When surgical treatment is contraindicated or not accepted by the patient, it is essential to implement nonsurgical therapy, well aware, however, of unpredictable results. The aim of this methodology was to discuss the nonsurgical approaches of the treatment of peri-implantitis. Methodology Since it is universally accepted that peri-implantitis has a bacterial aetiology, decontamination of the implant surface is crucial. Based on the diagnosis, made during recall visits, a maintenance system called CIST has been followed in this manuscript, with minor adjustments and further expanding the nonsurgical protocols, including the adjunctive use of the diode laser. Conclusion This article presents a protocol for nonsurgical treatment of peri-implant defects using antimicrobials combined with a nonsurgical mechanical treatment and the adjunctive use of the diode laser.