TY - JOUR
T1 - Efficacy of growth factors for the treatment of peri-implant diseases
T2 - a systematic review and meta-analysis
AU - Khouly, Ismael
AU - Pardiñas-López, Simon
AU - Ruff, Ryan Richard
AU - Strauss, Franz Josef
N1 - Funding Information:
Drs. Pardiñas-López and Strauss declare that they have no conflict of interest. Dr. Ruff reports grants from NIH, and Dr. Khouly from OsteoScience Foundation, Sweden and Martina SpA and Dentsply Sirona, during the conduct of the review. The review was self-funded by the authors.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objectives: The aim of this study was to conduct a systematic review and meta-analysis on the efficacy of growth factors (GF) on clinical outcomes after treatment (surgical/non-surgical) of peri-implant diseases (peri-implant mucositis and peri-implantitis). Materials and methods: A protocol was developed to answer the following focused question: Is there any difference for the use of GF for treatment of peri-implant diseases versus comparative GF treatment or without GF? Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected based on eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was probing depth (PD) and bleeding on probing (BOP) reduction along with changes in vertical defect depth (VDD). Changes in clinical attachment level, gingival recession, and plaque index, among others, were studied as secondary outcomes. Based on primary outcomes, random-effects meta-analysis was conducted. Results: A total of five RCTs were included. GF enhance the reduction of PD (standardized mean difference (SMD) = − 1.28; 95% confidence interval (CI) − 1.75, − 0.79; p = < 0.0001) and BOP (SMD = − 1.23; 95% CI − 1.70, − 0.76; p = < 0.0001) in the management of peri-implant mucositis. For the treatment of peri-implantitis, the use of GF yielded to significantly greater improvement in VDD (SMD = 0.68; 95% CI 0.22, 1.14; p = 0.004); however, there were no significant differences in terms of PD (SMD = 0.08; 95% CI − 1.08, 1.26; p = 0.887) and BOP (SMD = 0.211; 95% CI − 0.20, 0.63; p = 0.317). The overall risk of bias of the included studies was low to unclear. Conclusion: The results of the present systematic review suggest that the addition of GF might enhance the outcomes in the treatment of peri-implant mucositis. However, there is a lack of evidence for supporting additional benefit of GF managing peri-implantitis. Clinical relevance: Within the limitations of the current systematic review and based on the meta-analyses, (1) the addition of GF for the treatment peri-implant mucositis might be associated with better outcomes in terms of PD and BOP, and (2) an additional benefit of GF for the treatment peri-implantitis could not be determined on the basis of the selected evidence.
AB - Objectives: The aim of this study was to conduct a systematic review and meta-analysis on the efficacy of growth factors (GF) on clinical outcomes after treatment (surgical/non-surgical) of peri-implant diseases (peri-implant mucositis and peri-implantitis). Materials and methods: A protocol was developed to answer the following focused question: Is there any difference for the use of GF for treatment of peri-implant diseases versus comparative GF treatment or without GF? Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected based on eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was probing depth (PD) and bleeding on probing (BOP) reduction along with changes in vertical defect depth (VDD). Changes in clinical attachment level, gingival recession, and plaque index, among others, were studied as secondary outcomes. Based on primary outcomes, random-effects meta-analysis was conducted. Results: A total of five RCTs were included. GF enhance the reduction of PD (standardized mean difference (SMD) = − 1.28; 95% confidence interval (CI) − 1.75, − 0.79; p = < 0.0001) and BOP (SMD = − 1.23; 95% CI − 1.70, − 0.76; p = < 0.0001) in the management of peri-implant mucositis. For the treatment of peri-implantitis, the use of GF yielded to significantly greater improvement in VDD (SMD = 0.68; 95% CI 0.22, 1.14; p = 0.004); however, there were no significant differences in terms of PD (SMD = 0.08; 95% CI − 1.08, 1.26; p = 0.887) and BOP (SMD = 0.211; 95% CI − 0.20, 0.63; p = 0.317). The overall risk of bias of the included studies was low to unclear. Conclusion: The results of the present systematic review suggest that the addition of GF might enhance the outcomes in the treatment of peri-implant mucositis. However, there is a lack of evidence for supporting additional benefit of GF managing peri-implantitis. Clinical relevance: Within the limitations of the current systematic review and based on the meta-analyses, (1) the addition of GF for the treatment peri-implant mucositis might be associated with better outcomes in terms of PD and BOP, and (2) an additional benefit of GF for the treatment peri-implantitis could not be determined on the basis of the selected evidence.
KW - Growth factors
KW - Peri-implant diseases
KW - Peri-implant mucositis
KW - Peri-implantitis
KW - Humans
KW - Dental Implants
KW - Stomatitis/drug therapy
KW - Peri-Implantitis/drug therapy
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U2 - 10.1007/s00784-020-03240-5
DO - 10.1007/s00784-020-03240-5
M3 - Review article
C2 - 32418012
AN - SCOPUS:85084799411
SN - 1432-6981
VL - 24
SP - 2141
EP - 2161
JO - Clinical Oral Investigations
JF - Clinical Oral Investigations
IS - 7
ER -