Efficacy of Antimicrobial Photodynamic Therapy as an Adjunctive to Mechanical Debridement in the Treatment of Peri-implant Diseases: A Randomized Controlled Clinical Trial

Abstract

Introduction:The purpose of the present study was to assess the clinical effects of antimicrobial photodynamic therapy (PDT) after closed surface scaling in the treatment of peri-implant diseases. Methods: Ten patients with a total of 15 pairs of dental implants, showing clinical and radiographic signs of peri-implant diseases, were included in this study. In each patient, one implant randomly served as control implant and the other served as test implant. The control implants were treated with closed surface scaling only and the test implants received additionally PDT, using light with a wavelength of 630 nm and intensity of 2000 mw/cm 2 for 120 seconds after application of photosensitizer in peri-implant sulcus. Clinical parameters were evaluated before and 1.5 and 3 months after treatment. Results: Statistical analysis showed significant differences in probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and gingival index (GI) at each time point between the two groups. There were no statistically significant changes with respect to any of the parameters in the control group. Complete resolution of BOP at 3 months was achieved in 100% of test implants. At 1.5 and 3 months, there were significant differences in the mean probing depth and CAL gain measurements at implants in the test group. Conclusion: The present study revealed that adjunctive use of PDT following closed surface scaling could lead to clinical improvement of peri-implant diseases. Further studies are necessary to confirm our results. Keywords: clinical trial; dental implant; mechanical debridement; peri-implantitis; photodynamic therapy Please cite this article as follows: Karimi MR, Hasani A, Khosroshahian S. Efficacy of antimicrobial photodynamic therapy as an adjunctive to mechanical debridement in the treatment of peri-implant diseases: a randomized controlled clinical trial.

Adjunctive photodynamic therapy improves the outcomes of peri‐implantitis: a randomized controlled trial

“…In the present study, no AE was observed in any patient of the two groups. This is in agreement with the reported safety profile of PVD . Nevertheless, once again, due to the wide choice of lasers and photosensitizers available on the market, different combinations should be explored to determine the safety profile of each one.…”

“…As observed in the control group and as supported by the literature, mechanical cleaning and rinsing can control peri‐implantitis to some extent, but the outcomes are unsatisfying in many patients. Clinical trials showed that PDT after surface scaling improved the outcomes of patients with peri‐implantitis . PDT combined with some forms of mechanical debridement can be used for the management of peri‐implantitis.…”

“…PDT is used to treat acne, wet age‐related macular degeneration, psoriasis, herpes and cancers . Antimicrobial PDT has been suggested as an adjunct to mechanical debridement in the management of peri‐implantitis and to improve periodontal probing depth (PD), plaque index (PLI) around the implant, sulcular bleeding index (SBI) and clinical attachment loss (CAL) …”

“Inhibitory effect of Brazilian red propolis on Candida biofilms developed on titanium surfaces”

“…Different treatment protocols for peri-implantitis have been studied, including chemical and mechanical intervention strategies [10,25,26]. Considering the increasing use of natural products, we have show that Brazilian red propolis hydroalcoholic extract have inhibitory effect on mono-species biofilms of Candida albicans and co-culture biofilms of C. albicans and C. glabrata developed on titanium surfaces.…”

“…The presence of those microorganisms, in association with deficient hygiene, can induce a harmful microenvironment, in which the multispecies communities can release toxins and by-products that makes treatment unsuccessful [8]. Therefore, some clinical procedures have been proposed, including abrasive therapies with air, water, sodium bicarbonate, citric acid, plastic curettes scraping, ultrasonic cleansing, among others [9,10]. However, none of those methods have obtained satisfactory results [8].…”