LAUSR

AIM To study in humans with peri-implant mucositis the efficacy of: Q1) mechanical/physical instrumentation over oral hygiene instruction alone; Q2) any single mode of mechanical/physical instrumentation over others; Q3) combinations of mechanical/physical instrumentation over single modes; Q4) repetitions of mechanical/physical instrumentation over single administration. MATERIALS AND METHODS Randomized clinical trials (RCTs) fulfilling specific inclusion criteria established to answer the four PICOS questions were included. A single search strategy encompassing the four questions was applied to four electronic databases. Two review authors independently screened the titles and abstracts, did full-text analysis, extracted the data from the published reports and performed the risk of bias assessment through the RoB2 tool of the Cochrane Collaboration. In case of disagreement, a third review author took the final decision. Treatment success (i.e., absence of bleeding on probing, BoP), BoP extent and BoP severity were considered as the implant-level outcomes of critical importance for the present review. RESULTS A total of five manuscripts reporting on five RCTs, involving 364 participants and 383 implants, were included. Overall, treatment success rates after mechanical/physical instrumentation ranged from 30.9% to 34.5% at 3-months and from 8.3% to 16.7% at 6-months. Reduction in BoP extent was 19.4% to 28.6% at 3 months, 27.2% to 30.5% at 6 months, and 31.8% to 35.1% at 12 months. Reduction in BoP severity was 0.3 to 0.5 at 3 months and 0.6 to 0.8 at 6 months. Q2 was addressed in two RCTs, reporting no differences between glycine powder air-polishing and ultrasonic, as well as between chitosan rotating brush and titanium curettes. Q3 was addressed by three RCTs, showing no added effect of glycine powder air-polishing over the use of ultrasonic and of diode laser over ultrasonic/curettes. No RCTs were identified to answer Q1 and Q4. CONCLUSIONS Several mechanical/physical instrumentation procedures including curettes, ultrasonics, lasers, rotating brushes and air-polishing are documented, however a beneficial effect over OHI alone or superiority over other procedures could not be demonstrated. Moreover, it remains unclear whether combinations of different procedures or their repetition over time may provide additional benefits. (CRD42022324382) This article is protected by copyright. All rights reserved.