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Treatment included resective surgery and implant surface decontamination with adjunctive antibiotics or placebo. Primary outcomes were probing pocket depth (PPD) reduction and marginal bone level (MBL) stability. Secondary outcomes were treatment success (defined as PPD\u2009\u2264\u20095\u2009mm, bleeding on probing [BOP] \u2264\u20091site, absence of suppuration on probing [SOP] and absence of progressive bone loss of &gt;0.5\u2009mm), changes in BOP\/SOP, mucosal recession (REC), clinical attachment level (CAL), bacterial levels and adverse events. Outcomes were evaluated for up to 12\u2009months. The impact of potential prognostic indicators on treatment success was evaluated using multilevel logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 76 patients (104 implants) completed the study. All groups showed clinical and radiological improvements over time. Statistically significant differences were observed between groups for MBL stability (A\u2009=\u200997%, B\u2009=\u200989%, C\u2009=\u200976%), treatment success (A\u2009=\u200968%, B\u2009=\u200966%, C\u2009=\u200928%) and bacterial levels of <jats:italic>Aggregatibacter actinomycetemcomitans<\/jats:italic> and <jats:italic>Tannerella forsythia<\/jats:italic>, favouring antibiotics compared to placebo. Multiple regression identified antibiotic use as potential prognostic indicator for treatment success. Gastrointestinal disorders were the most reported adverse events in the antibiotic groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adjunctive systemic antibiotics resulted in additional improvements in MBL stability. However, the potential clinical benefits of antibiotics need to be carefully balanced against the risk of adverse events and possible antibiotic resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.13994","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T08:29:34Z","timestamp":1714724974000},"page":"981-996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Systemic antibiotics in the surgical treatment of peri\u2010implantitis: A randomized placebo\u2010controlled trial"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9634-8217","authenticated-orcid":false,"given":"Caroline","family":"Riben Grundstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Periodontology Specialist Clinic Kaniken, Public Dental Health Service  Uppsala Sweden"},{"name":"Department of Dental Medicine Karolinska Institutet  Huddinge 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