Evaluation of the effect of Er,Cr:YSGG laser application on peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand and osteoprotegerin levels in the non-surgical treatment of peri-implantitis: A randomized clinical trial.

Abstract

This study aimed to investigate the effect of erbium, chromium doped:yttrium,scandium,gallium,garnet (Er,Cr:YSGG) laser application combined with non-surgical mechanical debridement (MD) on clinical parameters and peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) levels in the treatment of peri-implantitis. A total of 49 patients who underwent non-surgical treatment of peri-implantitis were randomly divided into two groups. The control group (n=26) received MD alone, while the laser group (n=23) received MD+Er,Cr:YSGG. The clinical parameters (bleeding on probing [BoP], gingival index [GI], plaque index [PI], probing depth [PD]), marginal bone loss (MBL), and biochemical parameters (RANKL and OPG) were measured at baseline (T0) and 6 months after treatment (T1). There was a statistically significant decrease in all the clinical parameters in both groups at T1 compared to T0 (p<0.05). The BoP, PD, MBL, and RANKL reductions were significantly higher in the laser group than in the control group (p=0.046, p=0.014, p=0.047, p=0.045, respectively). The OPG levels significantly increased at T1 in the laser group (p=0.01). The OPG/RANKL ratio increased significantly in both groups at T1, which favored the laser group (p=0.034). Although both treatment methods were influential in treating peri-implantitis, the laser group (MD+Er,Cr:YSGG) yielded more favorable results by reducing clinical inflammation and improving biochemical parameters. Based on these findings, Er,Cr:YSGG laser may be a beneficial adjunctive treatment in this patient group.