{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:30:43Z","timestamp":1791646243088,"version":"4.3.4"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["62171077"],"award-info":[{"award-number":["62171077"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.<\/jats:p>","DOI":"10.1371\/journal.pone.0305342","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:30:53Z","timestamp":1723642253000},"page":"e0305342","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Yingjie","family":"Bai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengao","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingshuai","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7735-6810","authenticated-orcid":true,"given":"Weiyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guowu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"issue":"3","key":"pone.0305342.ref001","first-page":"263","volume":"14","author":"S. Barootchi","year":"2021","journal-title":"Peri-implant diseases: Current understanding and management"},{"key":"pone.0305342.ref002","first-page":"S158","article-title":"Peri\u2010implant health and disease","volume":"42","author":"J. Derks","year":"2015","journal-title":"A systematic review of current epidemiology"},{"issue":"3","key":"pone.0305342.ref003","volume":"7","author":"M. Padial-Molina","year":"2016","journal-title":"Microbial profiles and detection techniques in peri-implant diseases: a systematic review."},{"issue":"3","key":"pone.0305342.ref004","first-page":"241","volume":"90","author":"S.K. Harrel","year":"2019","journal-title":"Titanium particles generated during ultrasonic scaling of implants."},{"issue":"6","key":"pone.0305342.ref005","first-page":"283","volume":"32","author":"Z. 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Romeo","year":"2016","journal-title":"The antimicrobial photodynamic therapy in the treatment of peri-implantitis"},{"issue":"3","key":"pone.0305342.ref010","first-page":"160","volume":"30","author":"M. Makhlouf","year":"2012","journal-title":"Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis."},{"issue":"5","key":"pone.0305342.ref011","first-page":"872","volume":"52","author":"F. Pamuk","year":"2017","journal-title":"The effect of low\u2010level laser therapy as an adjunct to non\u2010surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor\u2010beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non\u2010smoking chronic periodontitis patients: A split\u2010mouth, randomized control study."},{"issue":"5","key":"pone.0305342.ref012","first-page":"526","volume":"46","author":"F. Alqahtani","year":"2020","journal-title":"Efficacy of Nonsurgical Mechanical Debridement With and Without adjunct low-level laser therapy in the treatment of Peri-Implantitis: a randomized controlled trial."},{"issue":"4","key":"pone.0305342.ref013","first-page":"293","volume":"47","author":"F. Schwarz","year":"2016","journal-title":"Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis."},{"issue":"7","key":"pone.0305342.ref014","first-page":"1845","volume":"11","author":"J. Xu","year":"2023","journal-title":"The Potential Value of Probiotics after Dental Implant Placement."},{"key":"pone.0305342.ref015","first-page":"105906","volume":"88","author":"M.J. Page","year":"2021","journal-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews"},{"issue":"Suppl 20","key":"pone.0305342.ref016","first-page":"S246","article-title":"Peri-implantitis.","volume":"45","author":"F. 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Abduljabbar","year":"2017","journal-title":"Effect of Nd: YAG laser-assisted non-surgical mechanical debridement on clinical and radiographic peri-implant inflammatory parameters in patients with peri-implant disease"},{"issue":"2","key":"pone.0305342.ref021","first-page":"389","volume":"30","author":"M.H. Al-Askar","year":"2022","journal-title":"Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis."},{"key":"pone.0305342.ref022","first-page":"101750","volume":"30","author":"T. 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Ar\u0131san","year":"2015","journal-title":"Photomed Laser Surg"},{"issue":"1","key":"pone.0305342.ref025","first-page":"15","article-title":"Adjunctive benefits of systemic metronidazole on non\u2010surgical treatment of peri\u2010implantitis.","volume":"49","author":"C. Blanco","year":"2022","journal-title":"A randomized placebo\u2010controlled clinical trial."},{"issue":"5","key":"pone.0305342.ref026","first-page":"439","article-title":"Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial.","volume":"42","author":"A. B\u00fcchter","year":"2004"},{"issue":"3","key":"pone.0305342.ref027","first-page":"378","article-title":"Clinical and microbiological evaluation of the effect of Lactobacillus reuteri in the treatment of mucositis and peri\u2010implantitis: A triple\u2010blind randomized clinical trial.","volume":"53","author":"M. Galofr\u00e9","year":"2018"},{"issue":"1","key":"pone.0305342.ref028","article-title":"Efficacy of Er, Cr: YSGG Laser Application in Nonsurgical Treatment of Peri-implantitis: A Human Randomized Controlled Trial.","volume":"43","author":"P. Kang","year":"2023"},{"issue":"12","key":"pone.0305342.ref029","first-page":"1198","article-title":"Treatment of peri\u2010implantitis using multiple applications of chlorhexidine chips: a double\u2010blind, randomized multi\u2010centre clinical trial.","volume":"39","author":"E.E. Machtei","year":"2012"},{"issue":"1","key":"pone.0305342.ref030","first-page":"11","article-title":"Repeated delivery of chlorhexidine chips for the treatment of peri\u2010implantitis: A multicenter, randomized, comparative clinical trial.","volume":"92","author":"E.E. Machtei","year":"2021"},{"issue":"10","key":"pone.0305342.ref031","first-page":"1268","article-title":"Short\u2010term comparison of two non\u2010surgical treatment modalities of peri\u2010implantitis: Clinical and microbiological outcomes in a two\u2010factorial randomized controlled trial.","volume":"47","author":"M. Merli","year":"2020"},{"issue":"4","key":"pone.0305342.ref032","first-page":"543","article-title":"Adjunctive use of metronidazole\u2010minocycline ointment in the nonsurgical treatment of peri\u2010implantitis: A multicenter randomized controlled trial.","volume":"23","author":"S.H. Park","year":"2021"},{"issue":"5","key":"pone.0305342.ref033","first-page":"548","article-title":"Non\u2010surgical peri\u2010implantitis treatment with or without systemic antibiotics: a randomized controlled clinical trial.","volume":"33","author":"A. Polymeri","year":"2022"},{"issue":"9","key":"pone.0305342.ref034","first-page":"900","article-title":"Non\u2010surgical mechanical therapy of peri\u2010implantitis with or without repeated adjunctive diode laser application.","volume":"33","author":"A. Roccuzzo","year":"2022","journal-title":"A 6\u2010month double\u2010blinded randomized clinical trial."},{"issue":"1","key":"pone.0305342.ref035","first-page":"43","article-title":"Treatment of peri\u2010implantitis: Clinical outcome of chloramine as an adjunctive to non\u2010surgical therapy, a randomized clinical trial.","volume":"28","author":"A.M. Roos\u2010Jans\u00e5ker","year":"2017"},{"issue":"1","key":"pone.0305342.ref036","first-page":"240","article-title":"Non-surgical treatment of peri-implantitis with and without erythritol air-polishing a 12-month randomized controlled trial.","volume":"23","author":"A. Selimovi\u0107","year":"2023"},{"key":"pone.0305342.ref037","first-page":"e080","volume":"33","author":"J.A. Shibli","year":"2019","journal-title":"Microbiological and clinical effects of adjunctive systemic metronidazole and amoxicillin in the non-surgical treatment of peri-implantitis: 1 year follow-up"},{"issue":"4","key":"pone.0305342.ref038","first-page":"563","article-title":"Laser-assisted therapy for the treatment of peri-implantitis. Part I. clinical outcomes","volume":"41","author":"G. Strauss","year":"2021"},{"key":"pone.0305342.ref039","first-page":"169","volume":"34","author":"L. Wang","year":"2019","journal-title":"Low-level laser irradiation modulates the proliferation and the osteogenic differentiation of bone marrow mesenchymal stem cells under healthy and inflammatory condition"},{"issue":"5","key":"pone.0305342.ref040","first-page":"471","article-title":"Effect of photobiomodulation after non\u2010surgical mechanical debridement on cortisol levels in the peri\u2010implant sulcular fluid among patients with peri\u2010implant mucositis.","volume":"38","author":"A.A. Alhumaidan","year":"2022"},{"issue":"2","key":"pone.0305342.ref041","first-page":"99","article-title":"Efficacy of antibiotic versus probiotics as adjuncts to mechanical debridement for the treatment of peri-implant mucositis.","volume":"48","author":"F. Alqahtani","year":"2022"},{"key":"pone.0305342.ref042","first-page":"1729","article-title":"Efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in reducing inflammation around the teeth and implants: a randomized clinical trial.","volume":"25","author":"J. Bollain","year":"2021"},{"issue":"5","key":"pone.0305342.ref043","first-page":"897","article-title":"Short\u2010term efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E on peri\u2010implant mucositis: A double\u2010blind, randomized, clinical trial.","volume":"56","author":"J. Gonz\u00e1lez\u2010Serrano","year":"2021"},{"issue":"1","key":"pone.0305342.ref044","first-page":"60","article-title":"Probiotic supplements and debridement of peri-implant mucositis: a randomized controlled trial.","volume":"74","author":"H. Hallstr\u00f6m","year":"2016"},{"issue":"6","key":"pone.0305342.ref045","first-page":"574","article-title":"Systemic antibiotics and debridement of peri\u2010implant mucositis.","volume":"39","author":"H. Hallstr\u00f6m","year":"2012","journal-title":"A randomized clinical trial."},{"issue":"3","key":"pone.0305342.ref046","first-page":"237","article-title":"Anti\u2010infective treatment of peri\u2010implant mucositis: a randomised controlled clinical trial.","volume":"22","author":"L.J. Heitz\u2010Mayfield","year":"2011"},{"key":"pone.0305342.ref047","first-page":"1971","article-title":"Anti-infective therapy of peri-implant mucositis with adjunctive delivery of a sodium hypochlorite gel: a 6-month randomized triple-blind controlled clinical trial.","volume":"24","author":"V. Iorio-Siciliano","year":"2020"},{"issue":"6","key":"pone.0305342.ref048","first-page":"683","article-title":"Effect of glycine powder air\u2010polishing as an adjunct in the treatment of peri\u2010implant mucositis: a pilot clinical trial.","volume":"25","author":"Y.J. Ji","year":"2014"},{"issue":"5","key":"pone.0305342.ref049","first-page":"269","article-title":"One-year clinical outcomes following non-surgical treatment of peri-implant mucositis with adjunctive diode laser application.","volume":"69","author":"G.M. Mariani","year":"2020"},{"issue":"11","key":"pone.0305342.ref050","first-page":"1305","article-title":"Efficacy of 0.12% chlorhexidine gluconate for non\u2010surgical treatment of peri\u2010implant mucositis.","volume":"87","author":"K.M. Menezes","year":"2016"},{"issue":"1","key":"pone.0305342.ref051","first-page":"e13","article-title":"Clinical effect of diode laser on peri-implant tissues during non-surgical peri-implant mucositis therapy: Randomized controlled clinical study.","volume":"12","author":"R. S\u00e1nchez-Martos","year":"2020"},{"issue":"3","key":"pone.0305342.ref052","first-page":"144","article-title":"Effectiveness of orally administered probiotic Lactobacillus reuteri in patients with peri-implant mucositis: a prospective clinical study.","volume":"13","author":"F. Signorino","year":"2021"},{"issue":"1","key":"pone.0305342.ref053","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/jre.12361","article-title":"The effectiveness of low-level laser therapy as an adjunct to non-surgical periodontal treatment: a meta-analysis.","volume":"52","author":"C. Ren","year":"2017","journal-title":"J Periodontal Res"},{"issue":"1","key":"pone.0305342.ref054","first-page":"1","article-title":"Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis.","volume":"23","author":"L. Barbato","year":"2023"},{"issue":"5","key":"pone.0305342.ref055","first-page":"348","article-title":"Proposed guidelines for American Dental Association acceptance of products for professional, non-surgical treatment of adult periodontitis.","volume":"29","author":"P. Imrey","year":"1994","journal-title":"Task Force on Design and Analysis in Dental and Oral Research"},{"issue":"Suppl 26","key":"pone.0305342.ref056","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jcpe.13823","article-title":"Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline.","volume":"50","author":"D. Herrera","year":"2023","journal-title":"J Clin Periodontol"},{"issue":"2","key":"pone.0305342.ref057","first-page":"e161","volume":"25","author":"A. Vives-Soler","year":"2020","journal-title":"Effect of probiotics as a complement to non-surgical periodontal therapy in chronic periodontitis: a systematic review"},{"issue":"6","key":"pone.0305342.ref058","first-page":"775","article-title":"The effect of orally administered probiotic Lactobacillus reuteri\u2010containing tablets in peri\u2010implant mucositis: a double\u2010blind randomized controlled trial.","volume":"50","author":"A. Flichy\u2010Fern\u00e1ndez","year":"2015"},{"key":"pone.0305342.ref059","author":"V.H. Matsubara","year":"2022","journal-title":"Probiotic Bifidobacteria in Managing Periodontal Disease: A Systematic Review"},{"issue":"4","key":"pone.0305342.ref060","first-page":"658","volume":"16","author":"G. Reid","year":"2003","journal-title":"Potential uses of probiotics in clinical practice."},{"issue":"6","key":"pone.0305342.ref061","first-page":"912","volume":"25","author":"J. Lukic","year":"2017","journal-title":"Probiotics or pro\u2010healers: the role of beneficial bacteria in tissue repair."},{"key":"pone.0305342.ref062","first-page":"202","volume":"39","author":"M. Sanz","year":"2012","journal-title":"Clinical research on peri\u2010implant diseases: consensus report of W orking G roup 4"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:31:25Z","timestamp":1723642285000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305342"}},"subtitle":[],"editor":[{"given":"Peter","family":"Eickholz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,8,14]]},"references-count":62,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0305342","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,14]]}}}