Effect of Different Laser Wavelengths on Periodontopathogens in Peri-Implantitis: A Review of In Vivo Studies

Abstract

Nowadays, many studies are examining the effectiveness of dental lasers in the treatment of peri-implantitis; however, most of them only report periodontal parameter changes. The authors of this review tried to address the question: “What is the effect of different laser wavelengths on oral bacteria that cause peri-implantitis?” An electronic search of PubMed and Cochrane Central Register of Controlled Trials was performed. The following search terms were used: (peri-implantitis OR periimplantitis) OR/AND (microbial OR microbiologic) AND (laser OR Er:YAG OR erbium OR diode OR Nd:YAG OR neodymium-doped OR Er,Cr:YSGG OR chromium-doped). Initially, 212 studies were identified. After screening the titles and abstracts and excluding studies according to predefined inclusion criteria, seven publications were included in the review. Three studies about the effect of aPDT (antimicrobial photodynamic therapy) reported a decrease in the different bacterial strains associated with peri-implantitis, e.g., A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. denticola, T. forsythia, F. nucleatum, and C. rectus. Two studies showed that the high-power diode laser may have some effect on peri-implant pathogens. Two articles about the Er:YAG laser reported a lowering in the count of oral pathogens; however, it was hard to determine if this was due to the use of the laser. aPDT has the ability to decrease the count of peri-implant pathogens, whereas Er:YAG laser application shows no significant effect on oral bacteria in the long term.

Exploring the use of pulsed erbium lasers to retrieve a zirconia crown from a zirconia implant abutment

“…Pulsed erbium lasers are generally high-power lasers that can perform a wide range of functions, such as skin resurfacing and soft tissue de-epithelialization, [20] ablative and non-ablative, [21] vaporizing soft tissue as means of bacterial control, [22][23][24] and in cosmetic surgery to removal of skin epidermis to accelerated healing and reduce scars [22,25]. This study proposed that erbium pulsed lasers such as Er:YAG with 2940 nm wavelength and Er,Cr:YSGG with 2780 nm wavelength can be used to remove a zirconia crown off a zirconia implant abutment.…”

Q-Switch Nd:YAG Laser-Assisted Decontamination of Implant Surface

“…Moreover, the pathogenic bacteria associated with periimplantitis are more complex than those found under healthy peri-implant conditions and more diverse than those of periodontitis [7]. Therefore, the presence of pathogenic microorganisms is fundamental for the development of periimplantitis [8]. In addition, risk factors such as smoking (i.e., the greatest risk factor), genetics (i.e., the familial history of periodontitis), lack of compliance and poor oral hygiene, systematic disease, iatrogenic causes, soft tissue defects or poor-quality soft tissue at the area of implantation and others are associated with the appearance of peri-implantitis [9].…”

Er:YAG Laser Irradiation Reduces Microbial Viability When Used in Combination with Irrigation with Sodium Hypochlorite, Chlorhexidine, and Hydrogen Peroxide

“…Combination therapies of an Er:YAG laser and a dilute oxidative solution appear to be more effective and could be implemented into non-surgical periodontal therapy as a non-invasive treatment facilitating a decrease in the bacterial viability. The Er:YAG laser has also been used for treatment of peri-implantitis with similar exposure settings [20,53]. Clinical applications should be explored and studied to examine our in vitro findings and study the efficiency of these protocols in treatment of periodontitis and peri-implantitis.…”

“…Lasers have been used for decades in various fields of dentistry, including periodontal and peri-implant therapy [17][18][19][20][21][22][23][24]. High-power lasers such as the erbium-doped yttrium aluminum garnet (Er:YAG) with a wavelength of 2940 nm are especially useful for ablation, vaporization, and disinfection, and also demonstrate beneficial biological effects, including the promotion of tissue regeneration, photobiomodulation, enhanced wound healing, and overall improved clinical outcomes on the host [16,23].…”