A literature search was conducted using MEDLINE through the PubMed database of the US National Library of Medicine using studies up to 2011. Studies on the microbiology of
peri-implantitis lesions were hand selected.
RESULTS AND CONCLUSIONS: Two studies on the use of systemically administered
antibiotics in the treatment of
peri-implantitis were identified. Both studies involved a case series without controls. Five studies on locally delivered
antibiotics were found. In all cases, local
antibiotics were used in conjunction with mechanical
debridement and chemical disinfection with
antimicrobial agents such as
chlorhexidine digluconate or
hydrogen peroxide. The additional effects of local
antibiotics were noted in all studies but were in general moderate. This may in part be due to the selection of patients with advanced deep pockets and advanced bone loss. The current available scientific information on the use of locally or systemically administered
antibiotics is insufficient to allow any firm specific recommendations for the use of these drugs. Local application of
minocycline or
doxycycline as an adjunct to mechanical
debridement and irrigation with an
antimicrobial agent may be effective in moderately deep lesions. Surgical access by full-thickness flap surgery in deeper lesions is probably necessary to halt the progression of bone loss. No sound scientific basis is available for the use of systemic
antibiotics. There is an urgent need for randomised clinical trials on the use of
antibiotics in the treatment of
peri-implantitis. Proper periodontal infection control in dentate patients before implants are installed and frequent supportive implant care represent effective measures to reduce the risk of future
infections and their complications around oral implants.