Adjunctive systemic antibiotics fail to prevent additional surgical intervention after non-surgical peri-implantitis treatment: Study

The aim of this retrospective long-term follow-up of a 3-month RCT was to assess whether non-surgical peri-implantitis treatment with adjunctive systemic antibiotics influenced the need for additional surgical treatment. Patients enrolled in an aftercare programme following non-surgical peri-implantitis treatment with or without systemic amoxicillin and metronidazole, were analysed. Data had previously been collected pre-treatment (T0) and 3 months after treatment (T1) and were additionally collected during subsequent aftercare visits, until the final assessment (T2). Primary outcome was the need for additional surgical peri-implantitis therapy during the aftercare programme, analysed via Kaplan–Meier analysis and Cox regression.

Secondary outcomes involved clinical parameters, assessed using parametric and non-parametric tests. Results: Forty-five patients (22 AB− group, 23 AB+ group) were included. The mean follow-up time between T1 and T2 was 35.9 months (SD = 21.0). 73.9% of the AB+ group and 50.0% of the AB− group did not receive additional surgical therapy (log-rank test, p = .110). The adjusted Cox regression model did not provide a significant result for antibiotics (β = .441, 95% CI = 0.159–1.220, p = .115). Univariable regression analysis highlighted the influence of baseline peri-implant pocket depth on the need for surgical treatment (β = 1.446, 95% CI = 1.035–2.020, p = .031). Systemic amoxicillin and metronidazole administered during non-surgical peri-implantitis treatment do not seem to prevent the need for additional surgical therapy in the long term, during a structured aftercare programme.

Reference:

Hakkers, J., Vangsted, T. E., van Winkelhoff, A. J., & de Waal, Y. C. M. (2024). Do systemic amoxicillin and metronidazole during the non-surgical peri-implantitis treatment phase prevent the need for future surgical treatment? A retrospective long-term cohort study. Journal of Clinical Periodontology, 1–8. https://doi.org/10.1111/jcpe.14024