Nonsurgical Treatment Effective in Early Peri-Implantitis, suggests study

A new research published in the journal of the Nature Scientific Reports found nonsurgical mechanical instrumentation, with or without adjunctive therapies, can lead to meaningful short-term improvements in early peri-implantitis. While adjunctive approaches such as glycine powder air abrasion may provide additional clinical benefits, they do not demonstrate clear overall superiority when compared to standard nonsurgical treatment alone.

This randomized, assessor-blinded, multi-arm trial evaluated 80 implants across 26 patients diagnosed with early peri-implantitis. This study compared five different treatment strategies, like the mechanical instrumentation alone, mechanical instrumentation combined with chlorhexidine irrigation, ozone application, or glycine powder air abrasion, and glycine powder air abrasion used as a standalone therapy.

Over a period of 6-months, this study tracked key indicators of peri-implant health, which included probing pocket depth, bleeding on probing, and modified plaque index. Measurements were taken at baseline, 3 months, and 6 months, with results analyzed using statistical models that accounted for patient-level clustering.

All 5 treatment approaches led to significant improvements in clinical parameters over time, which suggests that nonsurgical interventions can effectively manage early-stage peri-implantitis in the short term.

Among the tested methods, the combination of mechanical instrumentation and glycine powder air abrasion showed the greatest numerical improvements across all measured outcomes. The patients in this group experienced the most notable reductions in pocket depth, bleeding, and plaque accumulation. However, these gains were not statistically significant when compared with the other treatment groups.

While glycine powder air abrasion may enhance the effects of standard mechanical cleaning, it cannot yet be considered definitively superior based on current evidence. Similarly, adjunctive treatments such as chlorhexidine irrigation and ozone therapy also demonstrated benefits, but none stood out as a clear frontrunner.

The study illuminates the complexity of peri-implantitis management and the ongoing uncertainty surrounding optimal treatment strategies. Biofilm disruption remains central to care, and mechanical instrumentation continues to play a foundational role. Adjunctive therapies may provide incremental improvements, but their added value appears to vary and may depend on individual patient factors.

Overall, the findings of this study emphasize that the results are limited to early peri-implantitis and short-term outcomes. Longer follow-up periods and larger patient populations will be required to determine whether any of these approaches can deliver sustained benefits or prevent disease progression more effectively.

Source:

Eraydin-Tufek, N., Ozcan, G., & Isler, S. C. (2026). Efficacy of different nonsurgical treatments for peri-implantitis: a multi-arm randomized controlled clinical trial. Scientific Reports, 1–11. https://doi.org/10.1038/s41598-026-50332-5