Clinical Efficacy of Minocycline Hydrochloride for the Treatment of Peri-Implant Disease: A Systematic Review With Meta-Analysis of Randomized Controlled Trials

This systematic review aimed to assess the clinical efficacy of the local application of minocycline hydrochloride for treating peri-implantitis. Four databases—PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure—were searched from their inception through December 2020. English and Chinese randomized controlled trials (RCTs) that compared minocycline hydrochloride with control regimes, including negative control, iodine solution or glycerin, and chlorhexidine, for patients with peri-implant diseases were retrieved. Three outcomes—plaque index (PLI), probing depth (PD), and sulcus bleeding index (SBI)—were assessed using meta-analysis based on the random-effects model. Fifteen RCTs were included in the present meta-analysis, and results suggested that minocycline hydrochloride significantly affected PLI, PD, or SBI reduction regardless of the type of comparator regime. However, subgroup analyses suggested that minocycline hydrochloride was not superior to chlorhexidine in terms of reduction of PLI (1 week: MD = −0.18, 95% CI = −0.55 to 0.20, P = .36; 4 weeks: MD = −0.08, 95% CI = −0.23 to 0.07, P = .28; 8 weeks: MD = −0.01, 95% CI = −0.18 to 0.16, P = .91) and PD (1 week: MD = 0.07, 95% CI = −0.27 to 0.41, P = .68; 4 weeks: MD = −0.10, 95% CI = −0.43 to 0.24, P = .58; 8 weeks: MD = −0.30, 95% CI = −0.68 to 0.08, P = .12), and minocycline hydrochloride was also not better than chlorhexidine regarding reduction of SBI at 1 week after treatment (MD = −0.10; 95% CI = −0.21 to 0.01; P = .08). This study concludes that minocycline hydrochloride as adjuvant therapy of nonsurgical treatment enhances the clinical results when compared to control regimes. However, the difference between minocycline hydrochloride and chlorhexidine should be further investigated by designing additional high-quality studies with large sample sizes.