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However, the benefits of these agents in treating peri\u2010implantitis are still debatable and demand further analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this review was to critically appraise the literature on the use of antibiotics to treat peri\u2010implantitis, with the ultimate goal of supporting evidence\u2010based clinical recommendations, defining gaps in knowledge and guiding future studies on this topic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematized literature search was conducted in MEDLINE\/PubMed and Cochrane Library databases for randomized clinical trials (RCTs) on patients with peri\u2010implantitis treated by mechanical debridement\u2010only or with adjunctive use of local or systemic antibiotics. Clinical and microbiological data were extracted from the RCTs included. The findings were critically reviewed, interpreted, and discussed. An overview of antibiotic\u2010loaded dental implant materials in peri\u2010implantitis treatment was also provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve RCTs testing local\/systemic antibiotics were included. Although not always statistically significant, all antibiotic\u2010treated groups had greater reductions in mean PD than those treated by mechanical debridement\u2010only. The only clinically relevant antibiotic protocol supported by one RCT with low risk of bias and long\u2010lasting benefits was systemic metronidazole (MTZ). Studies using ultrasonic debridement reported better outcomes. No RCTs to date have tested MTZ\u2010only or with amoxicillin (AMX) as adjuncts to open\u2010flap implant debridement. In vitro\/animal studies suggested that biomaterials with antimicrobial properties are promising to treat peri\u2010implantitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are insufficient data to support a particular evidence\u2010based antibiotic protocol to treat peri\u2010implantitis using surgical or nonsurgical therapy, but some conclusions may be drawn. Systemic MTZ adjunct to ultrasonic debridement is an effective protocol to improve the outcomes of nonsurgical treatment. Future studies should assess the clinical and microbiological effects of MTZ and MTZ\u2009+\u2009AMX as adjuncts to optimal nonsurgical implant decontamination protocols or open\u2010flap debridement. In addition, new locally delivered drugs and antibiotic\u2010loaded surfaces should be assessed by RCTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cid.13239","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T02:04:45Z","timestamp":1688090685000},"page":"767-781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Unraveling the effectiveness of antibiotics for peri\u2010implantitis treatment: A scoping review"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2293-3392","authenticated-orcid":false,"given":"Magda","family":"Feres","sequence":"first","affiliation":[{"name":"Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"Department of Periodontology, Dental Research Division Guarulhos University (UnG)  S\u0101o Paulo Brazil"},{"name":"The Forsyth Institute  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Dental Research Division Guarulhos University (UnG)  S\u0101o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-6953","authenticated-orcid":false,"given":"Jo\u00e3o Gabriel S.","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Dental Research Division Guarulhos University (UnG)  S\u0101o Paulo Brazil"},{"name":"Research Division Dental Science School (Faculdade de Ci\u00eancias Odontol\u00f3gicas\u2014FCO)  Montes Claros Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martinna","family":"Bertolini","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Preventive Dentistry, School of Dental Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6391-9917","authenticated-orcid":false,"given":"Valentim A. 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