Deep Intrabony Defects Research Articles

Non-incised papillae surgical approach (NIPSA): A new technique for the treatment of deep intrabony defect: A case report

Non-incised papillae surgical approach (NIPSA): A new technique for the treatment of deep intrabony defect: A case report

The flapless approach with and without enamel matrix derivatives for the treatment of intrabony defects: A randomized controlled clinical trial.

To compare the clinical and radiographic outcomes of flapless procedure alone or in combination with enamel matrix derivatives (EMD) in the treatment of deep intrabony defects. Forty-six patients re-evaluated after non-surgical therapy were randomly assigned to the test (flapless with EMD) or control group (flapless alone). Clinical measurements were recorded pre-surgery and at 6 and 12 months after surgery, and radiographic measurements were taken pre-surgery and after 12 months. Forty-six patients completed the study. Improvements were observed in both groups at 12 months for mean clinical attachment level (CAL) gain, with significant differences between test (3.9 ± 1.1 mm) and control groups (3.0 ± 1.2) (p = .017). Probing pocket depth (PPD) reduction (4.0 ± 0.7 vs. 3.3 ± 1.4 mm) was also near to statistical significance (p = .051). Also, more sites achieved successful composite outcome measure (final PPD ≤ 4 mm and CAL gain ≥3 mm) for the regenerative treatment in the flapless + EMD group (82.6% vs. 52.2%; p = .028). In terms of radiographic outcomes, EMD yielded a greater defect bone fill than flapless treatment alone (3.0 ± 1.0 mm vs. 1.8 ± 1.5 mm; p < .001). The additional application of EMD during the flapless procedure for intrabony defects slightly improved clinical and radiographic outcomes. gov identification number: NCT05456555.

Rejuvenation of bone volume with CGF and i-PRF in intra-osseous defects.

The risk of further periodontal breakdown increases with a deep intrabony defect. Non-surgical periodontal therapy could pose a challenge and surgical intervention is mainly required to manage the defect. Autologous platelet concentrates such as Injectable platelet rich fibrin (i-PRF) and concentrated growth factor (CGF) may improve surgical outcome due to its enrichment with growth factors. Total of 04 patients involved in this study. After conventional flap debridement of intrabony defects, CGF is placed in 2 patients and the other 2 patients received i-PRF in their respective intrabony defects. Volumetric analysis was done pre-operative and 6 months post operatively in both the groups. Bone volume is significantly increased in both CGF and i-PRF group but higher in CGF group when compared to i-PRF group has high regenerative and reconstructive growth factors which helps aids in early and high bone fill when compared to i-PRF.

Treatment of Deep Intrabony Defect with Buccal Gingival Recession using Connective Tissue Graft Combined with Enamel Matrix Derivative and Bone Graft: case reports

&lt;p&gt;It is a challenging situation for clinicians in managing deep non-contained intrabony de&amp;not;fects associated simultaneously with soft tissue recession nowadays. Besides, prevention of post-operative gingival recession is one of treatment goals for ideal regenerative surgery as well. The case reports tended to achieve periodontal regeneration and root coverage in teeth affected with both deep intrabony defects and the buccal gingival recession using the concept of connective tissue (CTG) wall technique combined with enamel matrix derivative (EMD) and bone graft materials. The surgeries involved a single flap approach (SFA) and augmentation of soft tissue, attempting to minimize post-operative gingival recession, by suturing the CTG on the inner surface of coronally advanced flap (CAF) as a barrier wall for the coronal portion of the bone defect. The bony defects were filled with allograft and/or xenograft as a space mak&amp;not;ing scaffold and followed by primary closure of wound. Significant probing depth (PD) reduc&amp;not;tion, clinical attachment level (CAL) gain and improvement in the level of gingiva margin were noticed after 7- and 11- months follow-up respectively. Comparisons of pre-operative and different periods of radiographic images demonstrated that the bone defects were indeed filled. It can be concluded that the CTG does support the bone regeneration and overlying soft tissue flap stability within the periods of observation. This surgical approach provides an alter-native aid on the clinical outcome of bone healing and root coverage simultaneously in deep intrabony defects.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study

IntroductionCarbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). MethodsA single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. ResultsThe postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. ConclusionsThe clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.

Concentrated Growth Factor as an alternative membrane material in periodontal regeneration: A case report

The risk of further periodontal breakdown increases with a deep intrabony defect. Non-surgical periodontal therapy could pose a challenge and surgical intervention is mainly required to manage the defect. Autologous platelet concentrates such as concentrated growth factor (CGF) may improve surgical outcome due to its enrichment with growth factors. Nevertheless, the outcomes of using CGF as a biomaterial in periodontal regenerative therapy is inconclusive. This case report describes the regenerative management of an intrabony defect on all the first molars of a 24-year-old Malay lady diagnosed with Generalised Periodontitis, Stage III, Grade C. A guided tissue regeneration strategy was utilised on all the first molars except on tooth 46, which was treated with xenografts and a biologic adjunct of CGF. Patient was recalled regularly every week up to two months following the procedure, followed by a three-month interval review. The results showed promising outcomes with an average of 4 mm probing pocket depth reduction and 79.1% radiographic bone fill for both regenerative strategies. The utilisation of biologic adjuncts such as CGF, could offer a viable alternative to collagen membrane in periodontal regeneration without compromising clinical results.

Efficacy of Guided Tissue Regeneration Using Frozen Radiation-Sterilized Allogenic Bone Graft as Bone Replacement Graft Compared with Deproteinized Bovine Bone Mineral in the Treatment of Periodontal Intra-Bony Defects: Randomized Controlled Trial

(1) Background: The aim of this study was to compare the clinical and radiographic outcomes of guided tissue regeneration (GTR) using two biomaterials as bone replacement grafts in the treatment of periodontal intra-bony defects. (2) Methods: Using a split-mouth design, 30 periodontal intra-bony defects were treated with either frozen radiation-sterilized allogenic bone grafts (FRSABG tests) or deproteinized bovine bone mineral (DBBM, controls) combined with a bioabsorbable collagen membrane in 15 patients. Clinical attachment level gains (CAL-G), probing pocket depth reductions (PPD-R), and radiographic changes in linear defect fill (LDF) were evaluated 12 months postoperatively. (3) Results: The CAL, PPD, and LDF values improved significantly in both groups 12 months after the surgery. However, in the test group, the PPD-R and LDF values were significantly higher compared to the controls (PPD-R 4.66 mm versus 3.57 mm, p = 0.0429; LDF 5.22 mm versus 4.33, p = 0.0478, respectively). Regression analysis showed that baseline CAL was a significant predictor for PPD-R (p = 0.0434), while the baseline radiographic angle was a predictor for CAL-G (p = 0.0026) and LDF (p = 0.064). (4) Conclusions: Both replacement grafts when used for GTR with a bioabsorbable collagen membrane yielded successful clinical benefits in teeth with deep intra-bony defects 12 months postoperatively. The use of FRSABG significantly enhanced PPD reduction and LDF.

SURGICAL TREATMENT OF PERIODONTAL BONE DEFECTS THROUGH THE APPLICATION OF THE “SINGLE FLAP APPROACH” TECHNIQUE AND BIOMATERIALS

The introduction and application of ad hoc- flap designs for accessing even deep intrabony defects has led to a significant improvement in reconstructive outcomes after the use of guided tissue regeneration (GTR, Guided Tissue Regeneration) or enamel matrix derivatives (EMD). Although the additional beneficial effects of GTR and EMD are now known, in association with open curettage alone, the improvements in surgical techniques, in particular the introduction of new papilla preservation procedures, have resulted in a progressive increase in clinical attachment gain achievable with open curettage alone. The Single Flap Approach (SFA) is a simplified surgical procedure specifically designed for the treatment of periodontal bone defects. The key principle of this procedure consists in the elevation of a single mucoperiosteal access flap (buccal or oral), preserving the integrity of the interproximal supracrustal soft tissues. The article, in addition to the the oretical research and studies to date on the advantages of this surgical technique, brings in a detailed analysis the clinical case treated by the authors, analyzing the entire procedure step by step. Scientific research and their application in clinical cases have shown that SFA allows to minimize the trauma of the interproximal soft tissues by bringing reduced recession after surgery.

POST DENTAL AND ORAL – MAXILLOFACIAL IMPLANT NEUROPATHY OF TRIGEMINAL NERVE

The introduction and application of ad hoc- flap designs for accessing even deep intrabony defects has led to a significant improvement in reconstructive outcomes after the use of guided tissue regeneration (GTR, Guided Tissue Regeneration) or enamel matrix derivatives (EMD). Although the additional beneficial effects of GTR and EMD are now known, in association with open curettage alone, the improvements in surgical techniques, in particular the introduction of new papilla preservation procedures, have resulted in a progressive increase in clinical attachment gain achievable with open curettage alone. The Single Flap Approach (SFA) is a simplified surgical procedure specifically designed for the treatment of periodontal bone defects. The key principle of this procedure consists in the elevation of a single mucoperiosteal access flap (buccal or oral), preserving the integrity of the interproximal supracrustal soft tissues. The article, in addition to the the oretical research and studies to date on the advantages of this surgical technique, brings in a detailed analysis the clinical case treated by the authors, analyzing the entire procedure step by step. Scientific research and their application in clinical cases have shown that SFA allows to minimize the trauma of the interproximal soft tissues by bringing reduced recession after surgery.

Combination Therapy with Connective Tissue Graft, Amelogenins, and Bone Substitutes for Treatment of Deep Intrabony Defects Associated with Gingival Recession: 1-Year Follow-up of 12 Cases.

Combined surgical procedures have been introduced that combine periodontal regenerative/reconstructive procedures in intrabony defects with a connective tissue graft to compensate for a deficient bone wall and limit soft tissue shrinkage, but little is known about the reproducibility of these advanced surgical techniques. This 12-case series applies a combined surgical procedure, combining amelogenins, bone substitutes, and connective tissue graft to treat deep intrabony defects associated with gingival recession. Twelve deep intrabony defects with a mean clinical attachment loss of 9.9 ± 2.1 mm, mean probing depth (PPD) of 7.8 ± 1.5 mm, mean recession of the tip of the interdental papilla (TP) of 2.1 ± 1.5 mm, and mean buccal recession (REC) of 2.3 ± 1.8 mm were treated. At 1 year, the average attachment gain was 5.1 ± 1.8 mm (P < .001), the residual PPD was 2.9 ± 0.7 mm (P < .001), no change was observed in the TP (-0.4 ± 0.8 mm, P = .078), and the REC slightly decreased to 1.7 ± 1.5 mm (P = .047). These results suggest that the proposed technique led to predictable clinical outcomes that support regeneration while maintaining or improving the position of the soft tissue margin for the interdental and buccal aspects in deep intrabony defects associated with gingival recession.

Periodontal regenerative treatment with connective tissue grafts in deep intrabony defect and gingival recession in the maxillary canine: a case report with 3-year follow-up

Periodontal regenerative treatment with connective tissue grafts in deep intrabony defect and gingival recession in the maxillary canine: a case report with 3-year follow-up

The apically incised coronally advanced surgical technique (AICAST) for periodontal regeneration in isolated defects: a case series.

The aim of this retrospective case series was to report the performance up to 5 years of an innovative surgical design (the apically incised coronally advanced surgical technique [AICAST]) for the regenerative treatment of one- or two-walled intrabony periodontal lesions. After completion of standard step I to II periodontal therapy, nine isolated periodontal defects were treated through AICAST. The following clinical outcome measurements were collected before the surgical intervention and at the last available follow-up: probing pocket depth (PPD), recession depth (REC), and clinical attachment level (CAL). Periapical radiographs of the treated teeth were also taken at baseline and at the last available follow-up (18 months or 5 years postoperatively). A mean (± standard deviation) PPD reduction of 6.05 ± 1.76 mm (P < .01), REC reduction of 1.15 ± 1.97 mm (P = .119), and CAL gain of 7.20 ± 2.13 mm (P < .01) were attained when comparing preoperative results with the last follow-up visit. CAL gain of 6 mm or more was reached in eight out of nine treated cases (88.9%), with a residual PPD of 2 to 3 mm in all the cases. Complete radiographic fill of the intrabony component was present in all the defects, while detectable suprabony radiographic filling was identified in two cases. AICAST represents an innovative surgical design for the treatment of deep intrabony defects and the eventual reduction of the associated gingival recessions. Preliminary results show good performance in terms of clinical attachment gains and maintenance of the marginal tissues.

Treatment of Intrabony Defects with a Combination of Hyaluronic Acid and Deproteinized Porcine Bone Mineral.

Background: this study evaluates the clinical outcomes of a novel approach in treating deep intrabony defects utilizing papilla preservation techniques with a combination of hyaluronic acid (HA) and deproteinized porcine bone mineral. Methods: 23 patients with 27 intrabony defects were treated with a combination of HA and deproteinized porcine bone mineral. Clinical attachment level (CAL), pocket probing depth (PPD), gingival recession (REC) were recorded at baseline and 6 months after the surgery. Results: At 6 months, there was a significant CAL gain of 3.65 ± 1.67 mm (p < 0.001) with a PPD reduction of 4.54 ± 1.65 mm (p < 0.001), which was associated with an increase in gingival recession (0.89 ± 0.59 mm, p < 0.001). The percentage of pocket resolution based on a PPD ≤4 mm was 92.6% and the failure rate based on a PPD of 5 mm was 7.4%. Conclusions: the present findings indicate that applying a combined HA and xenograft approach in deep intrabony defects provides clinically relevant CAL gains and PPD reductions compared to baseline values and is a valid new approach in treating intrabony defects.

Regeneration of deep intrabony periodontal defects with enamel matrix derivative: A case report

A clinical case of treatment of two severe intrabony defects on the aesthetic zone is reported and followed for one year. The biomaterial of choice was enamel matrix derivative (Emdogain®; Straumann™) alone with a preservation papilla flap and a minimally invasive surgical technique. After surgical treatment, the patient was kept in a supportive periodontal therapy programme with 6-month interval between appointments. In the one year after surgery appointment, clinical and radiographic changes were observed, showing periodontal health and stability.

Periodontal regenerative therapy in patients with type 2 diabetes using minimally invasive surgical technique with enamel matrix derivative under 3-year observation: A prospective cohort study.

Information regarding periodontal regenerative therapy in patients with diabetes mellitus (DM) is limited. This pilot study compared the regenerative outcomes of minimally invasive periodontal surgery using enamel matrix derivative (EMD) between DM and non-DM patients. This prospective study included deep intrabony defects in patients with or without type 2 DM. Minimally invasive surgical technique (MIST) or modified MIST (M-MIST) using EMD, without bone graft materials, was performed. Periodontal examination and intraoral radiography were performed at baseline, 6 months, and 1 and 3 years after surgery. Ten sites of 10 subjects in the DM group, and 20 sites of 18 subjects in non-DM group were evaluated (mean age; 67.5 ± 7.6 and 63.1 ± 9.7, respectively). Probing depth significantly decreased from 7.1 ± 1.6 and 7.0 ± 1.3mm to 2.2 ± 0.9 and 2.3 ± 1.1mm at the 1-year examination in the DM and non-DM groups, respectively. Clinical attachment level (CAL) gain and radiographical defect fill at the 3-year examination were 3.8 ± 1.1mm and 58.3% ± 10.4%, respectively, in the DM group, and 4.1 ± 1.1mm and 65.5% ± 18.8%, respectively, in the non-DM group, showing no significant differences between the groups. Multiple regression analysis showed no significant association of CAL gain with DM or age after adjustments for relevant confounders. This is the first documented study of successful periodontal tissue regeneration in patients with DM. Minimally invasive surgery combined with EMD yielded significant clinical attachment gain and bone fill in the DM and non-DM groups at comparable levels.

Periodontal regeneration: is it still a goal in clinical periodontology?

In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.

Reconstructive surgical treatment of isolated deep intrabony defects with guided tissue regeneration using entire papilla preservation technique: A prospective case series.

The aim of this prospective study is to evaluate the clinical applicability of the entire papilla preservation (EPP) technique in the regenerative treatment of isolated deep intrabony defects using native collagen membrane and bone grafting materials. Fifteen healthy and non-smoker patients (nine males and six females; mean age: 47.73 ± 12.18; range 21 to 63 years) with one isolated deep intrabony defect each (baseline probing depth (PD): 9.03 ± 1.62mm; clinical attachment level (CAL): 11.16 ± 1.81mm) were treated with guided tissue regeneration. Surgical access to the defect was provided by a single buccal vertical incision with an interdental tunneling flap. Following the granulation tissue removal, intrabony defect was filled with bone substitutes. A collagen barrier was trimmed and placed under the intact defect-associated papilla with palatal positioning suture. Microsurgical sutures were used for primary closure. At 1week, healing of the 15 sites was uneventful. During the study, all sites showed 100% primary closure rate. At 1-year follow-up, an average CAL gain of 5.86 ± 1.28mm (P<0.0001), PD reduction of 6.1 ± 1.47mm (P<0.0001), and minimal increase in gingival recession of 0.23 ± 0.62mm (P=0.168) were observed. This novel surgical technique, that keeps the interdental papilla intact, seems promising to provide optimal biomaterial protection and healing conditions, even when a collagen barrier and bone substitutes are applied.

Regenerative surgery versus access flap for the treatment of intra-bony periodontal defects: A systematic review and meta-analysis.

The aim of this systematic review was to compare clinical, radiographic and patient-reported outcomes (PROMs) in intra-bony defects treated with regenerative surgery or access flap. A systematic review protocol was written following the PRISMA checklist. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) on regenerative treatment of deep intra-bony defects (≥3mm) with a follow-up of at least 12months. Primary outcome variables were probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain and tooth loss. Secondary outcome variables were Rec, radiographic bone gain, pocket "closure," PROMs and adverse events. Meta-analysis was carried out when possible. To evaluate treatment effect, odds ratios were combined for dichotomous data and mean differences for continuous data using a random-effect model. A total of 79 RCTs (88 articles) published from 1990 to 2019 and accounting for 3,042 patients and 3,612 intra-bony defects were included in this systematic review. Only 10 of included studies were rated at low risk of bias. A total of 13 meta-analyses were performed. All regenerative procedures provided adjunctive benefit in terms of CAL gain (1.34mm; 0.95-1.73) compared with open flap debridement alone. Both enamel matrix derivative (EMD) and guided tissue regeneration (GTR) were superior to OFD alone in improving CAL (1.27mm; 0.79-1.74mm and 1.43mm; 0.76-2.22, respectively), although with moderate-high heterogeneity. Among biomaterials, the addition of deproteinized bovine bone mineral (DBBM) improved the clinical outcomes of both GTR with resorbable barriers and EMD. Papillary preservation flaps enhanced the clinical outcomes. The strength of evidence was low to moderate. EMD or GTR in combination with papillary preservation flaps should be considered the treatment of choice for residual pockets with deep (≥3mm) intra-bony defects.

Tooth survival and clinical outcomes up to 26 years after guided tissue regeneration therapy in deep intra-bony defects: Follow-up investigation of three randomized clinical trials.

To investigate tooth survival and clinical long-term outcomes up to 26years following guided tissue regeneration (GTR) therapy in deep intra-bony defects. Patients from three prospective clinical split-mouth studies, which investigated the outcomes of GTR therapy, were re-evaluated 21-26years after surgery independent of the membrane type used, and tooth survival was assessed according to several site-specific and patient-related factors. About 50 patients contributing 102 defects were available for this long-term follow-up. After up to 26years (median 23.3years), 52.9% of the teeth were still in situ. The median survival of the extracted teeth was 13.8years. Patients with diabetes mellitus and/or smoking history lost significantly more teeth in the long term. Compared to the 1-year situation, there was no new median CAL loss after up to 26years in the teeth which were still in situ. Within the limitations of this study, our data show that more than 50% of the initially seriously diseased teeth were still in situ up to 26years following GTR therapy despite an overall limited adherence to SPT. In the majority of these teeth, the CAL gain 1year after GTR could be maintained over this long period.

Integrating CAD and 3D-Printing Techniques to Construct an In Vitro Laser Standard Treatment Platform for Evaluating the Effectiveness of Sterilization by Er:YAG Laser in Peri-Implant Intra-Bony Defects

This study established an in vitro model mimicking clinical peri-implant intra-bony defects. We investigated the effect of access limitation and the bactericidal effectiveness of erbium-doped yttrium, aluminum and garnet (Er:YAG) laser irradiation in shallow and deep peri-implant defects at different tooth positions. Reverse engineering, computer-aided design (CAD), and 3D-printing techniques were integrated to establish physical peri-implant intra-bony defect models at mandibular central incisor, first premolar, and first molar positions with shallow (2 mm depth) or deep (6 mm depth) defects and with 1.5 mm and 1.8 mm widths at the bottom and crestal portions of the alveolar process, respectively. Three-dimensional printed suites at the corresponding implant sites replaced experimental implant specimens for the investigation of bacterial adhesion in individuals. Dental implants with diameters of 3, 4 and 5 mm were utilized at the mandibular incisor, premolar, and molar positions, respectively. Bacterial adhesion of Gram (–) Escherichia coli on the exposed implant surfaces prior to sterilization was assessed. Sterilization with shallow and deep intra-bony defects was investigated by measuring the reduction of residual viable bacteria on implants after 60 s of irradiation with an Er:YAG laser. The adhesion rate of Gram (–) Escherichia coli on the investigated implant surfaces ranged from 1% to 3% (1.76 ± 1.25%, 2.19 ± 0.75% and 2.66 ± 1.26% for 3, 4, and 5 mm implants, respectively). With shallow peri-implant bony defects, the Er:YAG laser sterilization rates were 99.6 ± 0.5%, 99.3 ± 0.41% and 93.8 ± 7.65% at mandibular incisor, premolar, and molar positions, respectively. Similarly, sterilization rates in deep peri-implant defects were 99 ± 1.35%, 99.1 ± 0.98% and 97.14 ± 2.57%, respectively. A 3D-printed model with replaceable implant specimens mimicking human peri-implant intra-bony defects was established and tested in vitro. This investigation demonstrated effective sterilization using Er:YAG laser irradiation in both shallow and deep peri-implant intra-bony defects at different positions and diameters of dental implants.