Access flap and pocket elimination surgery are effective procedures in the management of peri-implantitis suggests a recent study published in the Journal of Clinical Periodontology
Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an Osseointegrated implant in function.
A study was conducted to evaluate the efficacy of access flap and pocket elimination procedures in the surgical treatment of peri-implantitis.

Systematic electronic searches (Central/Medline/Embase) up to March 2022 were conducted to identify prospective clinical studies evaluating surgical therapy (access flap or pocket elimination procedures) of peri-implantitis. Primary outcome measures were reduction of probing depth (PD) and bleeding on probing (BOP). Risk of bias was evaluated according to study design. Meta-analysis and meta-regression were performed. Results were expressed as standardized mean effect with 95% confidence intervals (CI).
Results:
Evidence from studies directly comparing surgical with non-surgical therapy is lacking.
Based on pre-post data originating from 13 prospective patient cohorts, pronounced reductions of PD and BOP% as well as MBL gain were observed at evaluation time points ranging from 1 to 5 years. Wide prediction intervals suggested a high degree of heterogeneity.
Reduction of mean PD increased by 0.7 mm for every mm in increase of mean PD at baseline.
During follow-up period ranging from 1 to 5 years, disease recurrence occurred frequently and implant loss was not uncommon.
Access flap and pocket elimination surgery are effective procedures in the management of peri-implantitis, although rates of disease recurrence during 5 years were high. Treatment outcomes were affected by baseline conditions.
Reference:
Karolina Karlsson, Anna Trullenque-Eriksson, Cristiano Tomasi, Jan Derks. Efficacy of access flap and pocket elimination procedures in the management of peri-implantitis – a systematic review and meta-analysis. https://doi.org/10.1111/jcpe.13732
Keywords:
Journal of Clinical Periodontology, Karolina Karlsson ,Anna Trullenque-Eriksson, Cristiano Tomasi, Jan Derks, Efficacy, access, flap, pocket, elimination, procedures, management, peri-implantitis, systematic review, and meta-analysis