# Peri-Implantitis Therapy Using Surgical Methods:
## 3 Results
### Study Characteristics  
The characteristics of the research articles included are displayed in Table 1. Table 2 shows the results summary of the five studies. The total number of patients treated in thesestudies was 154. The follow-up period was two-five years. One study [25] compared the effectiveness of the addition of bone substitute material with (group 1) or without membrane (group 2) after surgical debridement. The results of the five-year follow-up demonstrated that both clinical and radiographic were improved. Moreover, no implants were lost owing to peri-implantitis progression. PPD was reduced by 3.0 \(\pm\) 2.4 mm and 3.3 \(\pm\) 2.09 in groups 1 and 2, respectively. Both groups demonstrated significant radiographic evidence of bone gain (\(p<0.001\)). The average defect fill measured by an oral radiologist at year 5 was 1.3 mm (SD 1.4 mm) and 1.1 mm (SD 1.2 mm) in groups 1 and 2, respectively (mean diff; 0.4 95% CI 0.3, 1.2, \(p=0.24\)). Both groups demonstrated a decrease in BoP. At baseline, the suppuration occurred in 19.9% and 22.7% of implants in groups 1 and 2, respectively, while at five years post-surgery, the implants in both groups did not show suppuration. According to the results of this study [25], both therapeutic approaches caused stable conditions. In addition, it was found that the use of a membrane does not improve the outcome. A similar study performed by [PERSON] et al. [31] used deproteinized bovine bone mineral containing 10% collagen (DBBMC) combined with enamel matrix derivative (EMD) and doxycycline powder in the regeneration of bone defects due to peri-implantitis. The results demonstrated that while the mean PPD and bone loss at the baseline were 8.9 \(\pm\) 1.9 mm and 6.92 \(\pm\)1.26 mm, respectively, these values were reduced significantly to 3.55 \(\pm\) 0.50 mm and 2.85 \(\pm\) 0.73 mm at 12 months, 3.50 \(\pm\) 0.50 and 2.62 \(\pm\) 0.80 mm at 24 months, and 3.50 \(\pm\) 0.50 mm and 2.60 \(\pm\) 0.73 mm at 36 months, respectively. In addition, it was found that 56.6% of the implants were successfully treated after 36 months. According to the results of this study, using a mixture of DBBMC, EMD, and doxycycline is a promising approach for the regenerative treatment of peri-implantitis. [PERSON] et al. [32] compared various combinations of open flap debridement (OFD), citric acid decontamination (CAD), subepithelial connective tissue graft (SCTG), and implantablety to determine the most effective treatment combination. They divided patients into three groups and the groups received the treatments as follow: group 1: OFD and CAD; group 2: OFD, CAD, and SCTG; and group 3: OFD, CAD, and implantablety. The results demonstrated that all therapies (OFD, CAD, SCTG, and implantablely) were effective in managing peri-implantitis in 50%, 60%, and 62.5% of implants for groups 1, 2, and 3, respectively, with 91.30% overall survival rate of the implant after three-year follow-up; however, SCTG caused the highest keratinized mucosa width by \(\sim\)42.7%. Furthermore, the results demonstrated that the treatment modalities were all effective in decreasing the progression of crestal bone loss by \(\sim\)8.9% in groups 1 and 2, respectively, and by \(\sim\)13.5% in group 3. According to the results of this study [32], all therapies were found effective for the treatment of peri-implantitis; however, SCTG demonstrated the highest efficacy in achieving the biggest keratinized mucosa width. Overall, a combination of surgical therapies with mechanical and chemical decontamination could be efficient in treating peri-implantitis [32]. Moreover, the effectiveness of osteoplasty, implantablety, and the apically positioned flap was investigated by [PERSON] et al. [33]. The results of this study [33] demonstrated that after two years, no implants were lost and the mean PPD decreased from 8.7 to 3.3 mm, and the stability of bone level was kept in 92.5% of the implants. Also, at the final period of assessment, plaque was observed in 32.5% of patients.