AUTHOR=Gardelis Panagiotis , Giannopoulou Catherine , Stavropoulos Andreas , Zekeridou Alkisti TITLE=Impact of implant surface modifications on long-term outcome of surgical peri-implantitis treatment: a systematic review JOURNAL=Frontiers in Dental Medicine VOLUME=Volume 6 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/dental-medicine/articles/10.3389/fdmed.2025.1661369 DOI=10.3389/fdmed.2025.1661369 ISSN=2673-4915 ABSTRACT=IntroductionPeri-implantitis is an inflammatory disease that compromises peri-implant tissues and supporting bone, potentially leading to implant loss. Although several surgical treatment strategies have been proposed, it remains unclear whether implant surface characteristics (smooth vs. rough) influence long-term treatment outcomes.MethodsA systematic review was conducted to evaluate clinical studies with a minimum follow-up of 3 years that assessed the outcomes of surgical treatment of peri-implantitis in relation to implant surface type. Data extraction focused on recurrence of peri-implantitis, implant survival, clinical parameters, radiographic outcomes, and the type of surgical approach used (reconstructive vs. non-reconstructive).ResultsSeventeen clinical studies were included. Outcomes varied according to implant surface characteristics. Rough (modified) surfaces were generally associated with a higher risk of recurrence of peri-implantitis and implant loss compared with smooth (machined/turned) surfaces. Reconstructive surgical approaches, especially those involving bone grafts and membranes, demonstrated more favorable outcomes compared with non-reconstructive approaches.DiscussionDespite observed trends, the certainty of the evidence remains low due to heterogeneity between studies, small sample sizes, and methodological limitations. Further well-designed long-term clinical trials are needed to clarify the role of implant surface characteristics in the long-term success of peri-implantitis surgical treatment.Systematic Review RegistrationPROSPERO (CRD420251129791).