While the careful administration of non-surgical therapy can promote routine oral hygiene and healthy periodontal tissues, and significantly improve the starting point of the surgical therapy stage, the use of systemic AMX plus MTZ is no good as an adjunct therapy to non-surgical therapy for peri-implantitis, as found from a study published in Journal of Clinical Periodontology.

This randomized controlled trial by Yvonne C M De Waal et al. assessed the clinical efficacy of the combination of AMX and MTZ when used as an adjunctive to non-surgical peri-implantitis.

Overall, 62 patients with peri-implantitis were included. They were allocated to obtain full-mouth mechanical debridement and decontamination combined with antibiotic therapy of AMX and MTZ (test group) or chlorhexidine (controls) alone.

Alteration in bleeding score from starting (T0) to after 3 months (T3) was the primary outcome. Plaque, suppuration, probing pocket depths, clinical attachment level, bone level, microbiology, adverse events, and requirement for extra surgery were the secondary endpoints. Fifty-seven patients with 122 implants finished the three-month follow-up. Significant clinical improvements in both peri-implant and periodontal parameters were found in the groups at 3 months.

For any of the secondary or primary endpoints, no considerable differences were witnessed between the groups. AMX plus MTZ does not improve microbiological and clinical outcomes of non-surgical therapy, study authors concluded.