Supportive Peri‐Implant Care and Adjunctive Therapies in Peri‐Implant Disease Control: A Systematic Review and Meta‐Analysis

Objectives To evaluate supportive peri‐implant care and adjunctive therapies across primary prevention and maintenance, secondary prevention and recurrence control, and active non‐surgical and surgical treatment of peri‐implant diseases. Materials and Methods This PRISMA‐compliant systematic review and meta‐analysis searched PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library to March 15, 2026. Randomized controlled trials and observational studies assessing supportive peri‐implant care, active treatment, adjunctive therapies, and post‐treatment maintenance were included. Outcomes were stratified by clinical domain. Results Thirty‐four unique studies, reported in 35 publications, were included in the qualitative synthesis; four contributed to meta‐analysis. Regular maintenance, plaque control, and patient adherence were consistently associated with better peri‐implant outcomes, whereas residual deep peri‐implant pockets were linked to recurrence or progression after treatment. Adjunctive chlorhexidine did not significantly improve probing depth reduction versus mechanical debridement (MD = 0.02 mm; 95% CI: −0.19 to 0.24; p = 0.82; I 2 = 0%). An exploratory pooled analysis of device‐based adjuncts showed no significant additional probing depth improvement, although clinical heterogeneity limits interpretation. Conclusions Supportive peri‐implant care, patient adherence, and structured maintenance are central to both prevention and long‐term stability after treatment. Most adjunctive therapies provide limited or inconsistent additional benefit over mechanical biofilm control, although selected non‐surgical protocols may improve outcomes in specific settings. Clinicians should implement individualized supportive care with regular professional biofilm control, reinforcement of patient‐performed oral hygiene, and risk‐based recall intervals, reserving adjunctive therapies for selected indications.