Adjunctive Systemic Metronidazole to Nonsurgical Therapy of Peri-implantitis with Intrabony Defects: A Retrospective Case Series Study

Int J Oral Maxillofac Implants. 2019 Sep/Oct;34(5):1237-1245. doi: 10.11607/jomi.7343.


Purpose: To show the clinical and radiographic results of intrabony peri-implantitis lesions treated nonsurgically with adjunctive systemic metronidazole with a mean follow-up of 50 months.

Materials and methods: Subjects diagnosed with peri-implantitis (probing depth ≥ 5 mm with concomitant bleeding on probing and/or suppuration) with radiographic evidence of intrabony defects > 2 mm were included in this study. Implants affected received one session of nonsurgical mechanical debridement with ultrasonic and steel curettes. Systemic metronidazole was immediately prescribed for 7 days. Clinical and radiographic variables were registered at baseline and at the end of follow-up.

Results: Eighteen patients and 25 implants were included in this investigation. At baseline, the mean radiographic bone level and intrabony component were 4.52 ± 2.14 mm and 3.93 ± 1.51 mm, respectively. After a mean follow-up of 54 (range: 12 to 108) months, the mean radiographic bone level reduction was 2.6 ± 0.21 mm, and the intrabony component reduction was 2.85 ± 0.37 mm (P < .05). A mean probing depth reduction of 4.66 ± 1.33 mm was observed (P < .05).

Conclusion: Within the limits of this study, nonsurgical treatment of peri-implantitis with the adjunctive administration of systemic metronidazole has shown potential effectiveness in terms of probing depth and radiographic defect reduction after a mean follow-up of 54 months.

MeSH terms

  • Anti-Infective Agents* / administration & dosage
  • Humans
  • Metronidazole* / administration & dosage
  • Peri-Implantitis*
  • Periodontal Index
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome


  • Anti-Infective Agents
  • Metronidazole