Laser Treatment of Peri-Implantitis: A Systematic Review of Radiographic Outcomes.

Miriam Ting,Andre Paes Batista Da Silva,Andre Paes Batista Da Silva,Jon B Suzuki,Jon B Suzuki,Jon B Suzuki,Leela Subhashini C Alluri,John G Sulewski

doi:10.3390/dj10020020

Abstract

(1) Background: This systematic review aimed to evaluate the effects of laser therapy on radiographic bone level (RBL) changes in peri-implantitis defects. (2) Methods: A literature search with defined inclusion criteria was performed. PubMed, Web of Science, Cochrane Library, and Google Scholar were searched through September 2020. The evaluated primary outcomes were RBL changes. In studies that reported RBL data, corresponding secondary clinical outcomes were probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL). (3) Results: Thirteen articles were selected for data extraction and risk of bias assessment. Eight studies showed evidence of RBL gain in the laser groups compared to baseline, but did not report the statistical significance. Eight of these 13 studies reported comparisons to control. Five of the eight studies did not show RBL gain in the laser groups compared to control. In the laser groups compared to baseline, 11 of 13 reported reduced PD, and 6 of 13 reported significantly reduced BOP. Compared to the control, eight of the eight reported reduction of PD, and three of six reported significantly reduced BOP. Statistical significance was not consistently reported. (4) Conclusions: Within the limits of this systematic review, laser treatment may promote bone gain in peri-implantitis defects, may reduce BOP and PDs, and may be comparable to mechanical therapy. However, definitive conclusions can only be made with statistically significant data, which were found lacking in the currently available studies. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42020207972.

Highlights

The increasing usage of implants to rehabilitate the edentulous alveolar ridge has led to the higher frequency of peri-implant diseases, classified as peri-implant mucositis or peri-implantitis [1,2]
The aim of this review is to systematically evaluate the effect of high-intensity laser therapy on peri-implantitis defects by assessing the bone changes using radiographic methods
What is the radiographic osseous response in peri-implant defects after laser-assisted peri-implantitis treatment? The following were addressed in this focus question (PICOS): Participants: humans diagnosed with peri-implantitis; Interventions: laser-assisted periimplantitis therapy; Comparisons: treated sites vs. control/baseline; Outcomes: (1) primary: radiographic bone level (RBL) changes, (2) secondary: clinical attachment level (CAL), bleeding on probing (BOP), probing depth (PD); and Study design: descriptive studies

Summary

Introduction

The increasing usage of implants to rehabilitate the edentulous alveolar ridge has led to the higher frequency of peri-implant diseases, classified as peri-implant mucositis or peri-implantitis [1,2]. Peri-implant mucositis is a reversible inflammatory lesion that occurs in the soft tissues surrounding the endosseous dental implants [3]. Untreated peri-implant mucositis develops a radiographic progressive bone loss around the osseointegrated implant, resulting in peri-implantitis [4,5]. The progression of peri-implantitis is non-linear and accelerating; it manifests as a circumferential pattern of bone loss apical to the implant platform [5]. The weighted mean prevalence of peri-implantitis has been estimated at 22% [6]. The primary etiology of peri-implant diseases is microbial biofilm [5]

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