TINJAUAN ARTIKEL: PENGOBATAN NON BEDAH PERI-IMPLANTITIS
DOI:
https://doi.org/10.51878/knowledge.v5i2.5594Keywords:
Peri-implantitis, Antibiotik, Implan Gigi, Perawatan non-bedahAbstract
Dental implants are materials inserted into the jawbone that serve as supports for restorations, resembling natural teeth. In addition to their aesthetic function, implants also play an important role in the rehabilitation of the stomatognathic system. Proper maintenance is essential for the long-term success of implant-based restorations. One of the common complications is peri-implantitis, a pathological condition characterized by inflammation of the peri-implant connective tissue and progressive loss of supporting bone. If left untreated, peri-implantitis can lead to implant failure. This study is a literature review aimed at evaluating the effectiveness of non-surgical treatment for peri-implantitis. Data were collected through a search on Google Scholar using relevant keywords, yielding 15,700 articles. After applying inclusion criteria, articles were selected that were published within the last five years (2020–2024), written in English, available in full text, and categorized as original research, reviews, or case reports. Findings from three case reports indicate that non-surgical approaches provide significant clinical improvements. In Case 1, after one year, probing depth reduced to 1.5–3 mm without bleeding. In Case 2, after six months, no signs of inflammation or further bone resorption were observed, with a 2.1 mm reduction in probing depth. In Case 3, after six months, inflammatory resolution was achieved, with probing depth reduced to 2 mm and increased bone level seen on radiographs. All patients demonstrated good oral hygiene, were non-smokers, and had no uncontrolled systemic diseases. Overall, non-surgical treatment for peri-implantitis can yield positive clinical outcomes in reducing probing depth and inflammation, especially in patients with good plaque control and stable systemic health.
ABSTRAK
Implan gigi merupakan bahan yang ditanam dalam tulang rahang dan berfungsi sebagai penyangga restorasi, dengan bentuk menyerupai gigi alami. Selain memiliki fungsi estetik, implan juga berperan dalam rehabilitasi sistem stomatognatik. Pemeliharaan yang optimal sangat penting untuk keberhasilan jangka panjang restorasi berbasis implan. Salah satu komplikasi yang dapat terjadi adalah peri-implantitis, yaitu kondisi patologis yang ditandai dengan peradangan jaringan ikat di sekitar implan dan kehilangan progresif tulang penyangga. Jika tidak ditangani, kondisi ini dapat menyebabkan kegagalan implan. Penelitian ini merupakan tinjauan pustaka (literature review) yang bertujuan untuk membahas efektivitas pengobatan non-bedah peri-implantitis. Data dikumpulkan melalui penelusuran di Google Scholar dengan kata kunci terkait, menghasilkan 15.700 artikel. Setelah dilakukan seleksi sesuai kriteria inklusi, dipilih artikel yang diterbitkan dalam lima tahun terakhir (2020–2024), berbahasa Inggris, teks lengkap, dan berupa original research, review, atau case report. Hasil dari tiga laporan kasus menunjukkan bahwa pendekatan non-bedah memberikan perbaikan klinis yang signifikan. Pada Kasus 1, setelah satu tahun, kedalaman probing berkurang menjadi 1,5–3 mm tanpa perdarahan. Pada Kasus 2, setelah enam bulan, tidak ditemukan tanda-tanda peradangan, dengan penurunan kedalaman probing sebesar 2,1 mm. Sedangkan pada Kasus 3, setelah enam bulan, terjadi resolusi inflamasi dengan kedalaman probing menjadi 2 mm dan peningkatan tingkat tulang berdasarkan radiograf. Semua pasien memiliki kebersihan mulut yang baik, tidak merokok, dan tidak memiliki penyakit sistemik yang tidak terkontrol. Secara keseluruhan, pengobatan non-bedah untuk peri-implantitis dapat memberikan hasil klinis yang positif dalam mengurangi kedalaman probing dan peradangan, terutama pada pasien dengan kontrol plak yang baik dan kondisi sistemik yang stabil.
References
Almersed, N., Abukhamud, R., Alwafi, A., Alharbi, A., Almasoud, M. A., & Aljohani, S. (2021). The use of non?surgical interventions in patients with peri?implantitis; a systematic review and meta?analysis. Oral Surgery, 14(2), 178–190.
Alqahtani, F., Alqhtani, N., Celur, S. L., Divakar, D. D., Al-Kheraif, A. A., & Alkhtani, F. (2020). Efficacy of low-level laser therapy as an adjunct to non-surgical mechanical debridement in the treatment of peri-implantitis. Journal of Oral Implantology.
Atieh, M. A., Alsrouji, S., Shaarawy, A., & El?Hag, S. (2022). Airflow for initial nonsurgical treatment of peri?implantitis: A systematic review and meta?analysis. Clinical Implant Dentistry and Related Research, 24(2), 196–210.
Barootchi, S., & Wang, H. L. (2021). Peri-implant diseases: Current understanding and management. Int J Oral Implantol (Berl), 14(3), 263–282.
Berglundh, T., Armitage, G., Araujo, M. G., Avila-Ortiz, G., Blanco, J., Camargo, P. M., Chen, S., Cochran, D., Derks, J., Figuero, E., Hämmerle, C. H. F., Heitz-Mayfield, L. J. A., Huynh-Ba, G., Iacono, V., Koo, K.-T., Lambert, F., McCauley, L., Quirynen, M., Renvert, S., & Zitzmann, N. (2018). Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology, 45(S286–S291).
Chang, H.-Y., Chou, Y.-H., Lee, M.-S., Lu, S.-H., & Lu, C.-W. (2015). Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: A 5-year retrospective study after non-surgical treatment. Journal of Periodontal & Implant Science, 45(3), 82–93.
Cosgarea, R., Al?Nawas, B., Miron, R. J., & Jepsen, S. (2023). Efficacy of mechanical/physical approaches for implant surface decontamination in non?surgical submarginal instrumentation of peri?implantitis. A systematic review. Journal of Clinical Periodontology, 50(S2), 188–211.
Crespi, R., Capparè, P., Gherlone, E. F., & Ferrante, R. (2019). Nonsurgical treatment of peri-implantitis without eliminating granulation tissue: A 3-year study. Implant Dentistry, 28(1), 4–10.
Derks, J., Ichioka, Y., Dionigi, C., Trullenque?Eriksson, A., Berglundh, J., Tomasi, C., & Graziani, F. (2023). Prevention and management of peri?implant mucositis and peri?implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years. Journal of Clinical Periodontology, 50(S2), 55–66.
Diachkova, E., Corbella, S., Taschieri, S., & Tarasenko, S. (2020). Nonsurgical treatment of peri-implantitis: Case series. Dentistry Journal, 8(3), 78.
Dos Santos Martin, B. G., Gomes De Lima, D. G., Ribeiro, V. S., de Oliveira, T. R., Carvas, J. F., & Dos Santos Filho, J. B. (2022). Surgical and nonsurgical treatment protocols for peri-implantitis: An overview of systematic reviews. International Journal of Oral & Maxillofacial Implants, 37(4).
Dreyer, H., Grischke, J., Tiede, C., Eberhard, J., Schweitzer, A., Toikkanen, S. E., Glockner, S., Krause, G., & Stiesch, M. (2018). Epidemiology and risk factors of peri-implantitis: A systematic review. Journal of Periodontal Research, 53, 657–681.
Ephros, H., Kim, S., & DeFalco, R. J. D. C. (2020). Peri-implantitis: Evaluation and management. Dental Clinics of North America, 64(2), 305–313.
Estefania, R., Ortiz-Vigón, A., Pato, L. M., & Zabalegui, I. (2019). One?year results of a nonsurgical treatment protocol for peri?implantitis. A retrospective case series. Clinical Oral Implants Research, 30(7), 702–712.
Grusovin, M. G., Giromini, L., & Del Fabbro, M. (2022). Antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis: A systematic review and meta-analysis. Antibiotics, 11(12), 1766.
Hhentenaar, D. F. M., Luterbach, P. V. R., de Jager, W., Jager, D. H., Wagener, F. A. D. T., & Slot, D. E. (2021). Biomarker levels in peri?implant crevicular fluid of healthy implants, untreated and non?surgically treated implants with peri?implantitis. Journal of Clinical Periodontology, 48(4), 590–601.
Hussain, R. A., Miloro, M., & Cohen, J. B. (2021). An update on the treatment of periimplantitis. Dental Clinics, 65(1), 43–56.
John, G., Becker, J., Schwarz, F., & Happe, A. (2017). Non?surgical treatment of peri?implant mucositis and peri?implantitis at two?piece zirconium implants: A clinical follow?up observation after up to 3 years. Journal of Clinical Periodontology, 44(7), 756–761.
Karlsson, K., Derks, J., Håkansson, J., Wennström, J. L., Petzold, M., & Berglundh, T. (2019). Interventions for peri-implantitis and their effects on further bone loss: A retrospective analysis of a registry-based cohort. Journal of Clinical Periodontology, 46(8), 872–879.
Karlsson, K., Derks, J., Wennström, J. L., Petzold, M., & Berglundh, T. (2020). Occurrence and clustering of complications in implant dentistry. Clinical Oral Implants Research, 31(10), 1002–1009.
Karring, E. S., Stavropoulos, A., Ellegaard, B., & Karring, T. (2005). Treatment of peri-implantitis by the VectorR system. A pilot study. Clinical Oral Implants Research, 16(3), 288–293.
Khan, A., Kotsailidi, E. A., Javed, F., & Corbella, S. (2020). Management of peri-implantitis lesions without the use of systemic antibiotics: A systematic review. Dentistry Journal, 8(3), 106.
Khoury, F., Keeve, P. L., Ramanauskaite, A., Schwarz, F., Koo, K., Sculean, A., & Romanos, G. (2019). Surgical treatment of peri-implantitis—Consensus report of working group 4. International Dental Journal, 69(S1), 18–22.
Koo, K.-T., Lee, Y.-S., Suk, J.-H., Kim, S.-M., Lee, J.-H., & Kim, T.-I. (2019). Implant surface decontamination by surgical treatment of periimplantitis: A literature review. Implant Dentistry, 28(2), 173–176.
Kotsailidi, E. A., Michelogiannakis, D., Al-Zawawi, A. S., & Javed, F. (2020). Surgical or non-surgical treatment of peri-implantitis—what is the verdict? Surgery in Practice and Science, 1, 100010.
Lafaurie, G. I., Sabogal, M. A., Castillo, D. M., Rincón, M. V., Gómez, L. A., Lesmes, Y. A., & Chambrone, L. (2017). Microbiome and microbial biofilm profiles of peri-implantitis: A systematic review. Journal of Periodontology, 88(10), 1066–1089.
Lang, N. P., Salvi, G. E., & Sculean, A. (2019). Nonsurgical therapy for teeth and implants—When and why? Periodontology 2000, 79(1), 15–21.
Linares, A., Sanz?Sánchez, I., Dopico, J., Molina, A., Blanco, J., & Montero, E. (2023). Efficacy of adjunctive measures in the non?surgical treatment of peri?implantitis: A systematic review. Journal of Clinical Periodontology, 50(S2), 224–243.
Mahato, N., Wu, X., & Wang, L. (2016). Management of peri-implantitis: A systematic review, 2010–2015. SpringerPlus, 5, 1–9.
Maló, P., Rangert, B., & Nobre, M. D. A. (2003). “All-on-Four” immediate-function concept with Brånemark System® implants for completely edentulous mandibles: A retrospective clinical study. Clinical Implant Dentistry and Related Research, 5(1), 2–9.
Merli, M., Merli, L. A., Mariotti, G., Nieri, M., & Papi, P. (2020). Short?term comparison of two non?surgical treatment modalities of peri?implantitis: Clinical and microbiological outcomes in a two?factorial randomized controlled trial. Journal of Clinical Periodontology, 47(10), 1268–1280.
Muthukuru, M., Zainvi, A., Esplugues, E. O., & Flemmig, T. F. (2012). Non?surgical therapy for the management of peri?implantitis: A systematic review. Clinical Oral Implants Research, 23(S6), 77–83.
Nart, J., Mesa, F., Molla, G., Ortés, A., Vilarassa, J., & Santos, A. (2020). Non-surgical therapeutic outcomes of peri-implantitis: 12-month results. Clinical Oral Investigations, 24(2), 675–682.
Persson, G. R., Samuelsson, E., Lindahl, C., & Renvert, S. (2010). Mechanical non-surgical treatment of peri-implantitis: A single-blinded randomized longitudinal clinical study. II. Microbiological results. Journal of Clinical Periodontology, 37(6), 563–573.
Polymeri, A., Fickl, S., & Pukrop, B. (2022). Non?surgical peri?implantitis treatment with or without systemic antibiotics: A randomized controlled clinical trial. Clinical Oral Implants Research, 33(5), 548–557.
Roccuzzo, A., De Ry, S. P., Sculean, A., Roccuzzo, M., & Salvi, G. E. (2020). Current approaches for the non-surgical management of peri-implant diseases. Current Oral Health Reports, 7, 274–282.
Rokaya, D., Srimaneepong, V., Wisitrasameewon, W., Humagain, M., & Thunyakitpisal, P. (2020). Peri-implantitis update: Risk indicators, diagnosis, and treatment. European Journal of Dentistry, 14(04), 672–682.
Roncati, M., Barattelli, S., & Zecchin, E. (2015). Nonsurgical periodontal management of iatrogenic peri-implantitis: A clinical report. Journal of Biological Regulators & Homeostatic Agents, 29(3), 164–169.
Roos?Jansaker, A. M., Almhojd, U. S., & Jansson, H. (2017). Treatment of peri?implantitis: Clinical outcome of chloramine as an adjunctive to non?surgical therapy, a randomized clinical trial. Clinical Oral Implants Research, 28(1), 43–48.
Schou, S., Berglundh, T., & Lang, N. P. (2004). Surgical treatment of peri-implantitis. International Journal of Oral & Maxillofacial Implants, 19(1), 140–149.
Schwarz, F., Sculean, A., Rothamel, D., Schwenzer, K., Georg, T., & Becker, J. (2005). Clinical evaluation of an Er: YAG laser for nonsurgical treatment of peri?implantitis: A pilot study. Clinical Oral Implants Research, 16(1), 44–52.
Vilarassa, J., Ortés, A., Molla, G., & Nart, J. (2023). Outcome indicators of non-surgical therapy of peri-implantitis: A prospective case series analysis. Clinical Oral Investigations, 27(6), 3125–3138.
Wagner, T. P., Fontes, C. S., Dantas, A. A., & Fontes, F. L. (2021). Surgical and non-surgical debridement for the treatment of peri-implantitis: A two-center 12-month randomized trial. Clinical Oral Investigations, 25(10), 5723–5733.
Wang, C.-W., Renvert, S., & Wang, H.-L. (2019). Nonsurgical treatment of periimplantitis. Implant Dentistry, 28(2), 155–160.
Wennström, J. L., Dahlén, G., & Ramberg, P. (2011). Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. Journal of Clinical Periodontology, 38(9), 820–827.
