The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review

The purpose of this umbrella review was to gather and summarize the data from published systematic reviews (SRs) that compared non-surgical mechanical debridement (NSMD) with and without the use of adjunctive treatments on the management of peri-implant mucositis (PIM).

A protocol was developed and registered in PROSPERO (CRD42021254350) before the systematic search for the SRs. Seven electronic databases, including Cochrane Library, Embase (via Ovid), MEDLINE (via Pubmed), Proquest, Prospero, Scopus and Web of Science, were searched for published reviews. The search for unpublished and informally published reviews was further attempted in the last four databases. The methodological quality of the included reviews was assessed using AMSTAR 2.

Twelve included SRs assessed clinical studies published between 2014 and 2020, including a total of seventeen primary clinical trials. All SRs summarized data from individual studies and provided a narrative conclusion regarding the effectiveness of the adjunctive treatments. Only six SRs performed a meta-analysis (MA) of additional benefits of the adjunctive therapy for PIM, with results indicating no significant difference between the different treatment modalities. The overall confidence was adjudged ranging from critically low to low using AMSTAR 2 and significant additional benefits of any adjunctive treatments in comparison with NSMD were not apparent.

Overall, the reviewed evidence did not support the use of adjunctive treatments for improvement of clinical outcomes in PM management as compared to NSMD alone.