Lasers in Peri-implantitis Treatment

The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n=10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n=10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA).

The inclusion criteria for patients to participate in the study, indicating the existence of peri-implantitis are based on the most recent case definition of peri-implantitis, i.e.:Probing depths of ≥6 mm,Bone levels ≥3 mm apical of the most coronal portion of the intraosseous part of the implant, andthe simultaneous presence of bleeding on probing and/or suppurationImplants should be loaded for >12 months.As exclusion criteria were set :A severe systematic disease of patients by which a surgical procedure cannot be performed (e.g., bleeding disorders, uncontrolled diabetes mellitus, etc.),treatment of peri-implantitis within the previous 12 months,antibiotic intake in the last three months before treatment andprosthetic loading of implants > 12 months.In addition, peri-implantitis lesions indicated for regeneration (3-walled, craters were excluded from the study and were treated accordingly).