The systemic impact of non‐surgical treatment of peri‐implantitis with or without adjunctive systemic metronidazole: Secondary analysis of a randomized clinical trial.

Objectives: The aim of this study was to evaluate the systemic effect of non‐surgical peri‐implantitis treatment (NSPIT) with or without the administration of systemic metronidazole. Methods: In this secondary analysis from a previously published clinical trial (NCT03564301), peri‐implantitis patients were randomized into two groups: test, receiving NSPIT plus 500 mg of oral systemic metronidazole three times a day for 7 days (n = 10); and control group, receiving NSPIT plus placebo (n = 11). Serum samples were obtained at baseline, 3 and 6 months after therapy to determine levels of inflammatory biomarkers, lipid fractions and complete blood counts. Results: Both treatment modalities produced improvements in clinical and radiographic parameters. After 6 months from NSPIT, a substantial reduction in C‐reactive protein (6.9 mg/dL; 95% CI: 3.7 to 9.9, p <.001) and low‐density lipoprotein cholesterol (21.8 mg/dL; 95% CI: −6.9 to 50.5, p =.013) as well as a modest increase in neutrophils counts (0.4 × 103/μL; 95% CI: −0.4 to 1.1, p =.010) was observed in the control group while the test group showed a significant reduction of TNF‐α (110.1; 95% CI: 38.9 to 181.4, p =.004). Conclusions: NSPIT showed a short‐term beneficial systemic effect regardless of adjunctive use of systemic metronidazole. [ABSTRACT FROM AUTHOR]