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Laser-assisted regenerative surgical therapy for peri-implantitis: A randomized controlled clinical trial.
Wang, Chin-Wei; Ashnagar, Sajjad; Gianfilippo, Riccardo Di; Arnett, Michelle; Kinney, Janet; Wang, Hom-Lay.
Affiliation
  • Wang CW; Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
  • Ashnagar S; Private practice, Dallas, Texas, USA.
  • Gianfilippo RD; Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
  • Arnett M; Division of Dental Hygiene, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA.
  • Kinney J; Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
  • Wang HL; Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
J Periodontol ; 92(3): 378-388, 2021 03.
Article in En | MEDLINE | ID: mdl-32761810
ABSTRACT

BACKGROUND:

Different surgical approaches have been proposed to treat peri-implantitis defects with limited effectiveness and predictability. Laser has been proposed as an effective tool to assist in bacterial decontamination and modulating peri-implant tissue inflammation. The aim of this pilot clinical trial was to evaluate the adjunctive benefits of ErYAG laser irradiation for regenerative surgical therapy of peri-implantitis-associated osseous defects.

METHODS:

Twenty-four patients diagnosed with peri-implantitis with a radiographic infrabony defect were randomized into two groups. Both test and control groups received the following treatment open flap mechanical debridement, supracrestal implantoplasty, bone grafting using a mixture of human allograft with demineralized bone matrix human allograft putty, and then covered with acellular dermal matrix membrane. The only difference in the test group was the adjunctive use of ErYAG laser to modulate and remove inflammatory tissue as well as to decontaminate the implant surface. Clinical assessments, including pocket depth (PD), clinical attachment level (CAL), and gingival index (GI) were performed by calibrated masked examiners for up to 6 months following surgery. Standardized radiographs were also taken to evaluate linear bone gain and defect bone fill. Student t-tests were used to analyze those clinical parameters.

RESULTS:

Both groups showed significant reductions in PD, GI, and CAL gain overtime. The test group demonstrated significantly higher PD reductions at the site level compared to the control group (2.65 ± 2.14 versus 1.85 ± 1.71 mm; test versus control, P = 0.014). There were no statistical differences found in CAL gain (1.90 ± 2.28 versus 1.47 ± 1.76 mm; test versus control), GI reduction (-1.14 ± 1.15 versus -1.04 ± 0.89; test versus control), radiographic linear bone gain (1.27 ± 1.14 versus 1.08 ± 1.04 mm; test versus control) or proportional defect size reduction (- 24.46 ± 19.00% versus -15.19 ± 23.56%; test versus control). There was a positive trend for test patients on PD reduction and CAL gain found in narrow infrabony defects. Major membrane exposure negatively impaired the overall treatment outcome of CAL gain (2.47 ± 1.84 versus 1.03 ± 1.48 mm; no/minor versus major exposure, P = 0.051) and PD reduction in the test group (-3.63 ± 2.11 versus -1.66 ± 1.26 mm, P = 0.049).

CONCLUSION:

This pilot study indicated using laser irradiation during peri-implantitis regenerative therapy may aid in better probing PD reduction. Nonetheless, a larger sample size and longer follow-up is needed to confirm if ErYAG laser irradiation provides additional clinical benefits for peri-implantitis regenerative therapy (Clinicaltrials.gov NCT03127228).
Subject(s)
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Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_energeticas Main subject: Low-Level Light Therapy / Laser Therapy / Peri-Implantitis Type of study: Clinical_trials / Prognostic_studies Language: En Journal: J Periodontol Year: 2021 Type: Article Affiliation country: United States

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_energeticas Main subject: Low-Level Light Therapy / Laser Therapy / Peri-Implantitis Type of study: Clinical_trials / Prognostic_studies Language: En Journal: J Periodontol Year: 2021 Type: Article Affiliation country: United States