The aim of the study was to investigate the effects of neodymium: yttrium aluminium garnet (Nd:YAG) (1064 nm) and erbium: yttrium aluminium garnet (Er:YAG) (2940 nm) laser energy on titanium when delivered with conventional optics (focusing handpieces or plain ended optical fibres) or with a conical tip. Machined and micro-roughened implant discs were subjected to laser irradiation under a variety of energy settings either dry (without water) or wet (with water). Samples were scanned using a 3D non-contact laser profilometer and analysed for surface roughness, volume of peaks and the maximum diameter of the ablated area. Conical tip designs when used with both lasers showed no surface effect at any power setting on both machined and micro-roughened implant surfaces, regardless of the irrigation condition. When used with conventional delivery systems, laser effects on titanium were dose related, and were more profound with the Nd:YAG than with the Er:YAG laser. High laser pulse energies caused surface fusion which reduced the roughness of micro-roughened titanium surfaces. Likewise, repeated pulses and higher power densities also caused greater surface modifications. The presence of water reduced the influence of laser irradiation on titanium. It may be concluded that conical fibres can reduce unwanted surface modification, and this may be relevant to clinical protocols for debridement or disinfection of titanium dental implants.

Despite the many treatment modalities offered to prevent or manage peri-implantitis, there is currently a lack of high-quality evidence that supports any approach being regarded as a gold standard. Given that methods such as hand scaling with metal instruments and ultrasonic scaling may damage the implant surfaces, it is important to identify methods that are inherently safe for the surface being treated, and this is where interest in the use of lasers as alternative or adjunctive methods has arisen. This article provides a summary of the different types of lasers that can be used for the management and prevention of peri-implantitis. It also presents novel results from our research team related to the profile and surface characteristics of implants after treatment with different laser types and using different laser parameters. This review looks at the factors that should be considered when using lasers for the management or prevention of peri-implantitis. In conclusion, it is extremely difficult to formulate a reliable comparison between the available studies in the literature due to the high variability in laser types, settings and techniques used in each study. The review highlights the need for standardised studies in this field in order to provide recommendations to clinicians that would allow a more predictable treatment outcome.