Adjunctive efficacy of diode laser in the treatment of peri‐implant mucositis with mechanical therapy: A randomized clinical trial

Abstract

Objectives Due to the inconclusive findings on the effect of laser therapy in the management of peri‐implant diseases, the aim of this study was to analyze the adjunctive clinical efficacy of 980‐nm diode laser (DL) irradiation in the treatment of peri‐implant mucositis with mechanical debridement. Material and methods Two hundred and twenty patients with one implant diagnosed with peri‐implant mucositis (probing depth [PD] ≥ 4 mm and bleeding on probing [BoP] [primary outcome]) were randomly allocated to test and control treatments. Patients in the control group (n = 110) received debridement using curettes and ultrasonic devices, while patients allocated in the test group (n = 110) received mechanical therapy in combination with DL irradiation (setting 980 nm, 2.5 W, 10 kHz, pw, 30 s). BoP, presence of plaque, and PD were recorded at baseline, 1 month, and 3 months after treatment. Results Both therapeutic modalities yielded similar clinical improvements with comparable reductions in the number of BoP‐positive sites, plaque scores, and PD values at 3 months (all p‐values > 0.05). Complete disease resolution was obtained in 38/110 (34.5%) implants in the test group compared with 34/110 (30.9%) implants in the control group at the end of the observation period. Conclusion Based on these results, the adjunct use of DL did not yield any statistically significant clinical benefit as compared to nonsurgical mechanical treatment alone in controlling peri‐implant inflammation at 3 months.

Clinical effect of diode laser on peri-implant tissues during non-surgical peri-implant mucositis therapy: Randomized controlled clinical study

“…However, at 3 months both study groups returned to present similar biofilm values. These results agree with those obtained by the Aimetti et al in 2019, which shows an improvement in the plaque index for both groups significantly (p <0.001) but without differences between them at the 3-month revaluation (14). The fact that both study groups improve plaque index values is mainly due to oral hygiene instructions offered by researchers to patients.…”

“…Nevertheless, at 3-month revaluation the measurements increased slightly, obtaining better results for the test group but without statistical differences. Authors such as Al-Amri et al and Aimetti et al obtained similar results in their studies (14,15). In these studies, as in ours, plaque indexes were balanced between both study groups, this increase in plaque index makes epithelial seal formation difficult, causing, despite the effect of the laser, slight changes in the probing pocket depth.…”

“…The decrease at 6 weeks seems to be due to the bio-stimulation effect of the diode laser, which by facilitating the formation of epithelial sealing reduces plaque retention. However, patients tend to demotivate over time, which results in a greater accumulation of biofilm in the revaluation at 3 months (14).…”

Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

“…PDT has also been reported to kill pathogenic microbes associated with the etiology of periodontal and peri-implant disease such as Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Prevotella intermedia, and Porphyromonas gingivalis (P. gingivalis) [49]. A total of 7 articles included in this study were about PDT, three of which were about peri-implant mucositis [14,17,19] and four were about peri-implantitis [13,16,20,41]. The follow-up time of three literatures on peri-implant mucositis was only three months, probably because in ammation had improved signi cantly within three months after treatment, and no longer observation time was required.…”

“…Summarizing the risk of bias for each study, only six studies were considered at low risk of bias [17,20,23,33,34,36], seven were at unclear risk [10,14,16,19,31,35,41], and ve studies were considered at high risk of bias [9,13,24,26,32]. Results of the quality assessment of RCTs are listed in Table 2, following the recommendations [44].…”