Data sources Ovid Medline, Embase, EBM Review, Cochrane Central Register of Control Trials and the Cochrane Database of Systematic Reviews.

Study selection Randomised controlled trials or prospective cohort studies published in English with ≥10 patients and ≥6 months follow-up (the longest follow-up period was chosen in longitudinal studies which were published more than once). Experimental animal or in vitro studies were excluded.

Data extraction and synthesis Data on the primary outcome reduction in bleeding on probing (BOP) in implants treated surgically for peri-implantitis, and secondary outcomes pocket probing depth (PPD) and RBL (radiographic bone-loss) were extracted and meta-analysis conducted.

Results Sixteen papers met the inclusion criteria. Four treatment modalities to supplement mechanical debridement were identified: (1) apically repositioned flap, (2) chemical surface decontamination, (3) implantoplasty and (4) bone augmentation. Inconsistent results were evident which were dependent on several treatment-independent factors. No clinical benefits were identified for the additional use of surface decontamination, while limited evidence demonstrated improvement of clinical and radiographic outcomes after implantoplasty. The effect of bone augmentation appeared limited to 'filling' radiographic defects.

The meta-analysis was conducted using eight randomised clinical trials and two controlled prospective cohort studies. Meta-analysis demonstrated that implants treated with surface decontamination had SMD of -0.21 (95% CI: -1.70 to 1.27) for periodontal pocket reduction (PPD) reduction. Only one study reported the effect of implantoplasty on PPD, which shows a significant SMD of -3.33 (95% CI: -4.37 to -2.28 mm).

Bone augmentation with grafting materials and the additional use of membrane resulted in SMD of 0.15 mm (95% CI: -0.55 to 0.84 mm) and 0.30 mm (95% CI: -0.31 to 0.91 mm), respectively. In terms of RBL changes, the use of surface decontamination methods resulted in SMD of 0.54 mm (95% CI: -0.20 to 1.28 mm). Implants treated with implantoplasty had SMD of -3.38 (95% CI: -.43 to -2.33 mm). The SMD for RBL changes after the use of bone augmentation was -1.05 (95% CI: -1.80 to -0.31 mm). However, the additional use of membrane had SMD of -0.16 (95% CI: -0.56 to 0.24 mm.

Conclusions The outcomes of the currently available surgical interventions for peri-implantitis remain unpredictable. There is no reliable evidence to suggest which methods are the most effective. Further randomised controlled studies are needed to identify the best treatment methods.

数据来源： Ovid Medline，Embase，EBM评论，Cochrane中央对照试验注册和Cochrane系统评价数据库。

研究选择随机对照试验或前瞻性队列研究以英语发表，≥10位患者且随访≥6个月（在纵向研究中选择了最长的随访期，发表了不止一次）。排除实验动物或体外研究。

数据提取与综合提取有关因种植体周围炎而接受手术治疗的植入物中主要出血量（BOP）减少的数据，并提取次要结果口袋探测深度（PPD）和RBL（放射影像学的骨丢失）并进行荟萃分析。

结果符合入选标准的论文16篇。确定了四种补充机械清创的治疗方式：（1）根尖复位瓣，（2）化学表面去污，（3）植入物成形，和（4）骨增大。不一致的结果是明显的，这取决于几种与治疗无关的因素。没有发现额外使用表面去污的临床益处，而有限的证据表明植入后的临床和影像学结果有所改善。骨增大的作用似乎仅限于“填充”放射线照相缺陷。

荟萃分析使用八项随机临床试验和两项对照前瞻性队列研究进行。荟萃分析表明，经过表面去污处理的植入物的SMD为-0.21（95％CI：-1.70至1.27），可减少牙周袋（PPD）。只有一项研究报告了植入物对PPD的影响，显示出显着的SMD为-3.33（95％CI：-4.37至-2.28 mm）。

用接枝材料进行骨填充并额外使用膜可导致SMD分别为0.15毫米（95％CI：-0.55至0.84毫米）和0.30毫米（95％CI：-0.31至0.91毫米）。就RBL的变化而言，使用表面去污方法可导致SMD为0.54 mm（95％CI：-0.20至1.28 mm）。植入物治疗的植入物的SMD为-3.38（95％CI：-。43至-2.33 mm）。使用骨增强后RBL变化的SMD为-1.05（95％CI：-1.80至-0.31 mm）。但是，额外使用膜的SMD为-0.16（95％CI：-0.56至0.24 mm。

结论目前对植入物周围炎的外科手术治疗的结果仍然无法预测。没有可靠的证据表明哪种方法最有效。需要进一步的随机对照研究来确定最佳的治疗方法。