Efficacy of Er,Cr:YSGG Laser Application in Nonsurgical Treatment of Peri-implantitis: A Human Randomized Controlled Trial.

This investigation was designed to evaluate the efficacy of an erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser (laser group) compared to conventional mechanical debridement (control group) in the treatment of peri-implantitis. In a double-blinded, randomized, controlled clinical trial, 32 patients with 88 implants with peri-implantitis were randomly assigned to either group. Statistical analyses were performed at 9 months for both groups. The laser-treated group showed a statistically significant reduction in probing depth (PD) compared to the control group (P = .04), but no statistically significant differences were observed for clinical attachment level gain (P = .29) or reduction of bleeding on probing (P = .09). In the subgroup analysis, mandibular single implants with screw-retained restorations treated with Er,Cr:YSGG demonstrated a statistically significant decrease in PD (P < .05) compared to all other groups. A complete resolution of peri-implantitis was achieved in 21% of implants in the test group and 5% of implants in the control group. Er,Cr:YSGG laser is an efficacious therapeutic tool to treat peri-implantitis, achieving greater PD reduction than conventional mechanical debridement alone. Er,Cr:YSGG laser also showed increased benefits in the treatment of mandibular, screw-retained, and single-unit implants compared to the sole use of conventional mechanical debridement.

Erbium-doped: yttrium-aluminum-garnet (Er:YAG) versus scaling and root planing for the treatment of periodontal disease: A single-blinded split-mouth randomized clinical trial.

BACKGROUND: This randomized, controlled clinical trial aimed to compare the differences in periodontal clinical outcomes, duration of the procedure, and patient's experience between conventional scaling and root planing and erbium-doped: yttrium-aluminum-garnet (Er:YAG) in the treatment of generalized moderate to severe chronic periodontitis or generalized Stages II or III, and Grade B periodontitis based on the Centers for Disease Control (CDC), American Academy of Periodontology (AAP), and European Federation of Periodontology (EFP) definitions. METHODS: Thirty subjects were initially recruited. In a split-mouth fashion, right and left sides were randomly allocated into two treatment arms: conventional scaling and root planing (C-SRP) versus laser-assisted scaling and root planing (L-SRP). A blinded examiner recorded clinical measurements at baseline and 3 months. Duration of the procedure was also recorded for each visit, and the patient's experience was assessed with a questionnaire at baseline, 1, and 3 months. RESULTS: The final sample consisted of 26 subjects. Both treatments resulted in overall improvement, but no significant differences were found between modalities for clinical attachment gain or probing depth reduction. The duration of the procedure was approximately half for L-SRP, and postoperative sensitivity was greater in C-SRP. CONCLUSIONS: The low-energy protocol with Er:YAG (50 mJ) used for the non-surgical treatment of moderate-severe chronic or Stage II-III, Grade B periodontitis performed in this study population was a treatment modality that yielded similar clinical improvements when compared to conventional scaling and root planing.

SEM Evaluation of the Effects of Laser-Mediated Implant Surface Decontamination: An In Situ Human Pilot Study.

Successful treatment of peri-implantitis requires decontamination of implant surfaces exposed to biofilms and byproducts of tissue inflammation. In this regard, dental lasers may provide a clinical benefit. While the inherent characteristics of specific laser wavelengths may damage titanium implant surfaces, in vitro and animal studies have shown that damage to the target surface can be avoided with the selection of appropriate laser parameters. In this in situ human study, five hopeless implants were irradiated, each by one of the following lasers: Nd:YAG (1,064 nm), Er,Cr:YSGG (2,780 nm), Er:YAG (2,940 nm), CO2 (9,300 nm), and CO2 (10,600 nm) at their recommended settings. All implants were then removed and examined under scanning electron microscopy for the presence of residual bacteria and to assess the extent of damage to the implant surface. An additional implant (implant no. six) was irradiated and evaluated by the Limulus Amebocyte Lysate test for the presence of residual lipopolysaccharide endotoxin. The results showed that while there were localized areas of heat-related damage to an implant surface following laser irradiation, residual bacteria were rarely noted. Additionally, the Limulus Amebocyte Lysate test indicated a nearly complete removal of endotoxin. With the use of appropriate settings, all current dental lasers can be utilized for implant surface decontamination in a human.

Efficacy of Removal of Residual Dental Cement by Laser, Ultrasonic Scalers, and Titanium Curette: An In Vitro Study.

The purpose of this study was to conduct an in vitro evaluation of the efficacy of six dental lasers, two ultrasonic scalers, and a titanium curette in the removal of dental cement from the surface of an implant. The study used a total of 39 dental implants, representing three different surface textures. The implants were divided into 13 groups with one of each of the three surface textures in a group. A standardized amount of modified resin dental cement was applied to the implant surface. Each test instrument was used as a monotherapy. Additionally, three of the lasers were used as part of a dual therapy in conjunction with the piezo ultrasonic scaler. Laser irradiation was limited to 2 minutes. Following treatment, implants were graded visually and by scanning electron microscopy (SEM) for the presence of unremoved cement and concomitant damage, if any, to the implant surface. The results showed that no treatment removed all residual cement from any of the three implant surfaces, although specific protocols appeared more effective than others. Implant surface damage was frequently observed, both visually and by SEM, and appeared to result from laser irradiation and the use of ultrasonic scaling instruments.

Peri-Implant Disease, a Consensus for Treatment: A Case Study.

The aim of this case report was to find common treatment with the use of laser energy to treat failing implants. This article discusses definition of peri-implantitis and how-to diagnosis peri-implantitis. The article shows a case report of treatment with the use of two different lasers.