Emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases.

Peri-implant diseases are dysbiosis-mediated inflammatory disorders that occur in susceptible hosts. Antimicrobials and immunomodulatory agents therefore might be pertinent as adjunctive measures in the treatment of such disorders. The aim of this narrative review was to examine the existing evidence and assess the effectiveness of emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. An electronic search in the PubMed library was carried out to identify traditional and emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. A narrative review was conducted to shed light on the role of these approaches to prevent and treat peri-implant diseases. The use of traditional locally delivered antimicrobials as an adjunct to the nonsurgical or surgical treatment of peri-implant diseases has been shown to be safe and effective to a certain extent. Nevertheless, the body of evidence is limited, which precludes the drawing of firm conclusions/recommendations on their daily use for the treatment of these disorders. Likewise, the existing evidence on traditional immunomodulatory approaches is scarce, and so firm conclusions/recommendations on their daily use for the treatment of these disorders cannot be made. Among the emerging antimicrobials and immunomodulatory strategies, argon plasma and lasers seem to offer benefits for the prevention and treatment of peri-implant diseases, respectively. Significant advances have been made in the understanding and potential of novel locally delivered and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. Nevertheless, their clinical application is still limited by a lack of control over the bioactivity afforded by the known delivery systems and the scarcity of consistent nonclinical and clinical data. Awareness must be raised on the part of the industry to develop feasible agents/tools to enhance the efficacy of preventive and therapeutic strategies.