HOME - Clinical cases - Implantology
 
 
13 September 2021

Laser-assisted surgical regenerative therapy for peri-implantitis

Lara Figini


Peri-implantitis has been defined as a “pathological condition” that occurs in the tissues around dental implants, characterized by inflammation of the peri-implant connective tissue and by progressive loss of the supporting bone beyond the initial physiological remodeling. The treatment of peri-implantitis is still considered unpredictable and currently there is no standardized protocol available to manage this problem. Guided bone regeneration (GBR) of intrabony defects for peri-implantitis has been documented as one of the most promising treatment modalities. One of the main challenges during the surgical approach in regeneration therapy is to achieve the best and most effective disinfection of the contaminated implant surface. There is currently no gold standard to adequately decontaminate the implant surface. The application of the laser, in particular the erbium laser, for example, has been studied for the treatment of peri-implantitis in vitro and in vivo with promising results.


Materials and methods
In a pilot clinical study, published on Journal of Periodontology, March 2021, the authors evaluated the additional benefits of Er: YAG laser irradiation in the regenerative surgical therapy of bone defects associated with peri-implantitis. Twenty-four patients with radiographic diagnosis of peri-implantitis and with an intraosseous defect were randomly assigned to one of two groups, test group and control group. Both the test group and the control group received the following treatment:

- mechanical cleaning with open flap,

- supracrestal implantoplasty,

- bone grafting using a mixture of human allograft with demineralized bovine matrix, then

- covering with acellular dermal matrix membrane.

The only difference between the two groups was that the Er: YAG laser was also used in the test group to modulate and remove inflammatory tissue and to decontaminate the implant surface. Pocket depth (PD), clinical attachment level (CAL), and gingival index (GI) were clinically assessed by blinded examiners up to 6 months after surgery. Standardized radiographs were also taken to assess gain and filling of the bone defect. Student's t-tests were used to analyze clinical parameters.


Results
Significant reductions in PD, GI, and CAL gain occurred over time in both groups. The test group demonstrated significantly higher PD reductions at the implant site than the control group (2.65 ± 2.14 versus 1.85 ± 1.71 mm; test versus control, P = 0.014). There were no statistical differences in CAL gain, GI reduction, radiographic linear bone gain, or proportional reduction in defect size. There was a positive trend for patients in the test group in narrow intrabony defects to PD reduction and CAL gain. Membrane exposure negatively compromised the overall treatment, the result of the CAL gain and the reduction of PD in the test group.


Conclusions
From the data of this pilot study, which must be confirmed in other similar studies, it can be concluded that the use of laser irradiation during the regenerative therapy of peri-implantitis can help in the reduction of PD periodontal pockets.



For additional information: Laser-assisted regenerative surgical therapy for peri-implantitis: A randomized controlled clinical trial


Related articles

When bone volume is insufficient for implant placement, bone regeneration techniques can be used or the insertion of particularly inclined implants or zygomatic implants. The survival of implants...


Dr. Bruce Smoler, DDS, FAGD, FICOI, of Michigan, has provided 100 implants to patients in 100 days using a robotic device that assists in surgery. Using the FDA-approved device, implants can be...


Authors: Marco Esposito, Hassan Maghaireh, Roberto Pistilli, Maria Gabriella Grusovin, Sang Taek Lee, Federico Gualini, Jacopo Buti

PURPOSE. To compare the effectiveness of identical implants with internal or external connections.MATERIALS AND METHODS. One hundred and twenty patients with any type of edentulism (single tooth,...


Authors: Marco Esposito, Carlo Barausse, Roberto Pistilli, Pierantonio Bellini, Jacopo Buti, Pietro Felice

PURPOSETo evaluate the effectiveness of immediately loaded 3 mm-diameter implants as an alternative to horizontal bone augmentation procedures to allow placement of implants with a conventional...


Placement of dental implants in the correct tridimensional position produces good results that are maintained over time.  However, some esthetic alterations may occur in the hard and soft...


Read more

Philips Avent, a mother, and childcare product corporation, has launched a new line of products, including an orthodontic-friendly pacifier. The new line is designed to aid in feeding babies and to...


Author: Giacomo Tarquini

Periodontitis is an inflammatory disease caused by the formation of a bacterial biofilm that, especially in predisposed subjects, may lead to periodontal ligament destruction and alveolar bone...


Independent dental implant and oral healthcare company, Keystone Dental Inc., completed a financing round that netted $25 million, led by investors, Nantahala, and joined by Accelmed and Migdal...


Dental caries and tooth wear remain an oral public health issue affecting nearly 100% of the adult population.  When the amount of lost tooth structure is important, often either a complete...


According to a recent report, Valuates Reports, a market analysis firm, has forecast the dental consumables market to grow at a CAGR of 3.9% between 2021 and 2027. The market is expected to reach...


 
 
 
 
 
 

Most popular

 
 

Events

 
 

Copyright © 2021 - All Rights Reserved
ISSN 2767-1178

Top