Efficacy of Erbium:YAG Laser for Regenerative Surgical Treatment of Peri-implantitis: Clinical, Microbiological, and Biomarker Analyses.

This paper reports on a study undertaken to ascertain the efficacy of the erbium:YAG laser (EYL) for peri-implantitis treatment. A total of 12 patients with bone loss resulting from peri-implantitis were involved in this study. The treatment protocol consisted of using the EYL for implant surface debridement and deproteinized bovine bone mineral (DBBM) for bone grafting. The following parameters were analyzed: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), bone levels (BLs), and the lipopolysaccharide levels before and after debridement with the EYL. This study found a statistically significant improvement in PPD, CAL, BOP, and BL at 3 and 12 months postoperative. Furthermore, a statistically significant decrease in implant-surface LPS levels was observed following debridement with the EYL. These findings show that using the EYL for debridement in peri-implantitis cases is effective in decreasing LPS levels. Moreover, after partial reconstruction with DBBM grafting, BLs were restored for at least 12 months. It was shown in one case that BLs had remained stable over 6 years, which also attests to the efficacy of this treatment. The combined use of EYL and DBBM could be effective for regenerative surgical peri-implantitis treatment.

Effectiveness of an erbium-doped: yttrium, aluminum and garnet laser for treatment of peri-implant disease: Clinical, microbiological, and biochemical marker analyses.

BACKGROUND: The effectiveness of an erbium-doped: yttrium, aluminum and garnet (Er: YAG) laser (EYL) for the treatment of peri-implant disease (PID) remains unclear. The aim of this study was to compare non-surgical EYL therapy for PID with locally delivered minocycline hydrochloride (MC) ointment therapy by evaluating clinical, microbiological, and biochemical markers. MATERIAL AND METHODS: Thirty-seven patients with PID were randomly assigned to either the EYL group (n = 18) or the MC group (n = 19). The clinical, microbiological, and biochemical markers at baseline and at 1 and 3 months after treatment were compared between the two groups. Subgingival plaque and peri-implant crevicular fluid (PICF) were collected from the diseased pockets. RESULTS: In the EYL group, probing pocket depth (PPD) was significantly decreased after treatment when compared with baseline. On the other hand, in the MC group, there was no significant decrease in PPD after treatment. Specific bacteria associated with PID were not determined. The counts of both Gram-positive and -negative species did not significantly decrease in the EYL group at 3 months after treatment. In the MC group, the counts of almost all bacterial species were significantly decreased after treatment. Biochemical marker analysis of PICF revealed significantly lower levels of metalloproteinase (MMP)-9 in the EYL group, as compared with the MC group at 3 months after treatment (p= 0.009). CONCLUSIONS: Non-surgical therapy with an EYL for PID was clinically effective, with decreased MMP-9 levels in PICF, which may lead to reduced peri-implant tissue destruction. Key words:Er: YAG laser; peri-implant disease; biomarker; peri-implant crevicular fluid.

Innovative regeneration technology to solve peri-implantitis by Er:YAG laser based on the microbiologic diagnosis: a case series.

Peri-implantitis is an emerging problem, and corrective therapy requires a method for decontaminating the complex surface structure of the implant body and sterilizing the surrounding tissue. The erbium:yttrium-aluminum-garnet (Er:YAG) laser has proven to effectively allow tissue to regenerate when used for peri-implantitis. The power of the Er:YAG laser is absorbed by a water molecule; therefore, its target neither rises in temperature nor carbonizes. An antibacterial remedy based on the bacteriologic diagnosis, followed by debridement and sterilization of the implant surface and peri-implant tissues by Er:YAG laser is efficacious for peri-implantitis treatment. The aim of this report was to present the effectiveness of the Er:YAG laser for peri-implant bone regeneration. This case series of two patients showed that antibiotic therapy reduced the bacterial amount from the peri-implantitis sites significantly and that Er:YAG laser therapy, along with the bone augmentation, enhanced bone regeneration in the peri-implant bony defects.

Use of Er:YAG laser to decontaminate infected dental implant surface in preparation for reestablishment of bone-to-implant contact.

The prevalence of peri-implantitis is of concern to all clinicians participating in implant dentistry. Peri-implant inflammation results in the loss of supporting bone for the implant that may or may not be accompanied by bleeding on probing and suppuration. Early diagnosis and intervention are mandated, but there is a paucity of evidence leading to the most effective therapy. There is agreement that one of the challenges in surgically treating peri-implant defects is the process of cleaning and decontaminating the implant surface, which may be contaminated by bacterial aggregates. This preclinical canine study investigates the erbium:yttrium-aluminum-garnet laser to decontaminate the complex rough surface of the implant by stripping the contaminated oxide layer for induction of hard and soft tissue adaptation to a compromised or failing implant. The results provide evidence of new bone-to-implant contact established at a level representative of the size of the defects. The soft tissues contain little or no evidence of inflammation, which can be interpreted as an arrest of the disease progression process. The results can be translated to a treatment goal of stabilizing the prognosis of an implant that has been compromised.