In summary, the number of studies and the in part contradictory results make a conclusive evaluation of the ‘ideal peri-implantitis therapy’ difficult.
As the simplest instrument, prevention with recall examinations at short intervals should be given the highest priority. Various risk factors regarding the patient and the treating dentist must be taken into account here. As well as smoking status, poor oral hygiene and comorbidities (e.g. periodontitis, systemic infectious diseases, bone diseases), the dentist must pay attention to possible factors such as remaining teeth, cementitis, choice of implant, bone status, familiarity with the handling of dental implants and recall examinations at short intervals.
For non-surgical therapy, combinations of mechanical debridement with metal curettes and airpowder abrasive systems (e.g. hydroxyapatite + tricalcium phosphate) in particular must be considered promising. These measures can be supplemented by systemic antibiotic combination therapies. Laser or photodynamic therapy has produced less promising results and should primarily be used in a supportive role or in less advanced cases.
Based on the non-surgical therapy, surgical approaches add to the therapy regime with resective and regenerative procedures. The bone substitute materials used here (e.g. BEGO OSS or BEGO Collagen Membrane) can be considered good materials that are almost equivalent to autologous bone substitute.
In the absence of guidelines, the CIST protocol must be considered a definitive guide whereby scrupulous incorporation of all existing risk factors must be considered.
The ideal peri-implantitis therapy must therefore be considered a multifactorial therapy regime that occasionally must draw on individually tailored treatment models in order to accommodate the diversity of the multifactorial genesis, therapy options and study results.