Host modulation therapy as an adjunct in peri-implantitis treatment

Terapi modulasi inang sebagai terapi tambahan dalam penanganan peri-implanitis

Abstract

Peri-implantitis is an inflammatory condition surrounding dental implants that often persists following mechanical debridement. Host modulation therapy (HMT) targets the destructive host response and has been proposed as an adjunctive therapy; however, its role remains unclear. In accordance with PRISMA 2020, a search was conducted in PubMed, ScienceDirect, the Cochrane Library and Google Scholar for human studies (2015–2025) evaluating HMT as an adjunct to peri-implantitis therapy. Methodological quality was assessed using the Joanna Briggs Institute checklist. The protocol was registered with PROSPERO (CRD420261322132). Seven studies (four RCTs, one retrospective cohort, one retrospective comparative study, one case series; 579 participants) were in-cluded. Three HMT approaches were tested: topical tetracyclines (doxycycline gel, minocycline microspheres/ointment, tetracycline fibres), systemic sub-anti-microbial dose doxycycline (SDD), and the probiotic Lactobacillus reuteri. Topical tetracyclines demonstrated the most consistent short-term improvements in probing depth, bleeding on probing, plaque, suppuration, and pro-inflammatory biomarkers. SDD was associated with long-term peri-implant stability in one case series, whilst probiotics only reduced the plaque index. It was concluded that adjunctive HMT, particularly topical doxycycline and minocycline, provides short-term clinical benefits in peri-implantitis.