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Gkioka M, Rausch-Fan X. Antimicrobial Effects of Metal Coatings or Physical, Chemical Modifications of Titanium Dental Implant Surfaces for Prevention of Peri-Implantitis: A Systematic Review of In Vivo Studies. Antibiotics (Basel) 2024; 13:908. [PMID: 39335082 PMCID: PMC11428254 DOI: 10.3390/antibiotics13090908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/08/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Introduction: Peri-implantitis poses a significant challenge for implant dentistry due to its association with bacterial colonization on implant surfaces and the complexity of its management. This systematic review aims to assess evidence from in vivo studies regarding the antimicrobial efficacy of titanium (Ti) dental implant surfaces following physical/chemical modifications or the application of various metal element coatings in preventing bacterial growth associated with peri-implantitis. Materials and Methods: A literature review was conducted across four scientific databases (PubMed, Embase, Scopus, Web of Science), encompassing in vivo studies published between 2013 and 2024, and 18 reports were included in the systematic review. Results: The findings suggest that titanium dental implant surfaces, following physical/chemical modifications and metal element coatings, exhibit antimicrobial effects against bacteria associated with peri-implantitis in humans and various animal models. Conclusions: The reviewed studies indicated a reduction in bacterial colonization, diminished biofilm formation, and decreased signs of inflammation in the peri-implant tissues, which provides evidence that physical/chemical alterations on titanium dental implant surfaces or metal element coatings, like silver (Ag), zinc (Zn), magnesium (Mg), and copper (Cu), demonstrate antimicrobial properties in in vivo studies. However, caution is warranted when translating findings to clinical practice due to methodological disparities and high bias risks. Further larger-scale clinical trials are imperative to assess their long-term efficacy and validate their clinical applicability.
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Affiliation(s)
- Maria Gkioka
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, Vaud University Hospital Center, 1005 Lausanne, Switzerland
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
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Hart I, Wells C, Tsigarida A, Bezerra B. Effectiveness of mechanical and chemical decontamination methods for the treatment of dental implant surfaces affected by peri-implantitis: A systematic review and meta-analysis. Clin Exp Dent Res 2024; 10:e839. [PMID: 38345466 PMCID: PMC10847712 DOI: 10.1002/cre2.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently eliminate bacterial biofilms. MATERIAL AND METHODS A systematic search was conducted in four electronic databases between January 1, 2010 and October 31, 2022. The search strategy followed the PICOS format and included only in vitro studies completed on either dental implant or titanium disk samples. The assessed outcome variable consisted of the most effective method(s)-chemical or mechanical- removing bacterial biofilm from titanium surfaces. A meta-analysis was conducted, and data was summarized through single- and multi-level random effects model (p < .05). RESULTS The initial search resulted in 5260 articles after the removal of duplicates. After assessment by title, abstract, and full-text review, a total of 13 articles met the inclusion criteria for this review. Different decontamination methods were assessed, including both mechanical and chemical, with the most common method across studies being chlorhexidine (CHX). Significant heterogeneity was noted across the included studies. The meta-analyses only identified a significant difference in biofilm reduction when CHX treatment was compared against PBS. The remaining comparisons did not identify significant differences between the various decontamination methods. CONCLUSIONS The present results do not demonstrate that one method of decontamination is superior in eliminating bacterial biofilm from titanium disk and implant surfaces.
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Affiliation(s)
- Iain Hart
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Christine Wells
- Statistical Methods and Data AnalyticsUCLA Office of Advanced Research ComputingLos AngelesCaliforniaUSA
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Beatriz Bezerra
- Section of Periodontics, Division of Regenerative and Reconstructive SciencesUCLA School of DentistryLos AngelesCaliforniaUSA
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Peng X, Guo X, Zhou Y. The Efficacy of Ten Different Adjunctive Measures in Patients with Nonsurgically Treated Peri-Implant Disease: A Network Meta-Analysis of Randomized Controlled Trials. Photobiomodul Photomed Laser Surg 2024; 42:99-124. [PMID: 38294889 DOI: 10.1089/photob.2023.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Objective: This study aimed to evaluate the impact of 10 adjunctive measures on non-surgical therapy outcomes for peri-implant disease. Methods: We formulated the study question and keywords following the Population, Intervention, Comparator, Outcome framework. Randomized controlled trials were identified through searches in PubMed, Embase, the Cochrane Library, and the Web of Science. Two researchers assessed the quality of included literature according to the Cochrane Risk of Bias Assessment Tool. Data analysis and ranking were performed using Stata 15.0 software. Results: This study, involving 51 pieces of literature and 2660 samples, conducted a network meta-analysis (NMA), which revealed that photodynamic therapy (PDT) significantly reduced probing pocket depth values in patients with peri-implant mucositis (SUCRA = 96.3%) and peri-implantitis (SUCRA = 96.7%). In addition, it showed an improvement in bleeding on probing (BOP) values for peri-implantitis (SUCRA = 91.6%). Furthermore, diode lasers improved BOP values for peri-implant mucositis (SUCRA = 76.5%). Conclusions: According to the NMA results and the surface under the cumulative ranking curve (SUCRA), PDT and diode laser outperform other adjuncts in peri-implant disease.
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Affiliation(s)
- Xuepei Peng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingtong Guo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuwen Zhou
- Department of Stomatology, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
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Kong YQ, Dong XX, Zhao JZ, An PG, Li YZ, Ma R, Tang YJ, Liu J, Cheng ML, Li Q. The Use of 810 and 1064 nm Lasers on Dental Implants: In Vitro Analysis of Temperature, Surface Alterations, and Biological Behavior in Human Gingival Fibroblasts. Photobiomodul Photomed Laser Surg 2023; 41:644-654. [PMID: 37638820 DOI: 10.1089/photob.2023.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Objective: The primary objective of this study was to evaluate the safety of 810 and 1064 nm laser treatment on dental implants. Background: Peri-implantitis is a challenge for clinicians and researchers. Methods: A pig mandible model was used to evaluate temperature increases during laser irradiation. Surface alterations on processed pure titanium discs were analyzed via scanning electron microscopy and measurement of surface contact angles. Processed titanium discs were cocultured in vitro with human gingival fibroblasts; subsequently, cell proliferation was measured. Results: The maximum temperature and time to reach each threshold were comparable. No surface alterations were detected after 810 nm laser irradiation, whereas surface cracks were observed after 1064 nm laser irradiation under the parameter setting of 31.84 W/cm2. Compared with unaltered processed pure titanium discs, the proliferation of human gingival fibroblasts was significantly greater on altered processed pure titanium discs. Conclusions: The use of either 810 or 1064 nm laser treatments may increase the risk of thermal damage in terms of increased temperature if the parameter setting is not warranted. In addition, the use of 1064 nm laser treatment could lead to changes in pure titanium discs that do not negatively affect cell proliferation. Further investigations of laser-assisted therapy are necessary to improve guidelines concerning the treatment of peri-implantitis. Clinical trial registration number: 2021-P2-098-01.
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Affiliation(s)
- Ya-Qun Kong
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Xi Dong
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ji-Zhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pu-Gen An
- Department of Maxillofacial Surgery, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | - Yi-Zhou Li
- Department of Stomatology, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Rui Ma
- Second Outpatient Department of Peking University School of Stomatology, Beijing, China
| | - You-Jia Tang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Juan Liu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Meng-Lin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qian Li
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Lee JS, Son K, Hwang SM, Son YT, Kim YG, Suh JY, Hwang JH, Kwon SM, Lee JH, Kim HD, Lee KB, Lee JM. Effect of Electrocautery and Laser Treatment on the Composition and Morphology of Surface-Modified Titanium Implants. Bioengineering (Basel) 2023; 10:1251. [PMID: 38002374 PMCID: PMC10669704 DOI: 10.3390/bioengineering10111251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
The purpose of this study was to investigate the effects of different peri-implantitis treatment methods (Er,Cr:YSGG laser, diode laser, and electrocautery) on various titanium implant surfaces: machined; sandblasted, large-grit, and acid-etched; and femtosecond laser-treated surfaces. Grade 4 titanium (Ti) disks, with a diameter of 10 mm and a thickness of 1 mm, were fabricated and treated using the aforementioned techniques. Subsequently, each treated group of disks underwent different peri-implantitis treatment methods: Er,Cr:YSGG laser (Biolase, Inc., Foothill Ranch, CA, USA), diode laser (Biolase, Inc., Foothill Ranch, CA, USA), and electrocautery (Ellman, Hicksville, NY, USA). Scanning electron microscopy, energy-dispersive X-ray spectroscopy, and wettability were used to characterize the chemical compositions and surfaces of the treated titanium surfaces. Significant changes in surface roughness were observed in both the electrocautery (Sa value of machined surface = 0.469, SLA surface = 1.569, femtosecond laser surface = 1.741, and p = 0.025) and Er,Cr:YSGG laser (Ra value of machined surface = 1.034, SLA surface = 1.380, femtosecond laser surface = 1.437, and p = 0.025) groups. On femtosecond laser-treated titanium implant surfaces, all three treatment methods significantly reduced the surface contact angle (control = 82.2°, diode laser = 74.3°, Er,Cr:YSGG laser = 73.8°, electrocautery = 76.2°, and p = 0.039). Overall, Er,Cr:YSGG laser and electrocautery treatments significantly altered the surface roughness of titanium implant surfaces. As a result of surface composition after different peri-implantitis treatment methods, relative to the diode laser and electrocautery, the Er,Cr:YSGG laser increased oxygen concentration. The most dramatic change was observed after Er:Cr;YSGG laser treatment, urging caution for clinical applications. Changes in surface composition and wettability were observed but were not statistically significant. Further research is needed to understand the biological implications of these peri-implantitis treatment methods.
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Affiliation(s)
- Jin-Seok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea; (J.-S.L.); (S.-M.H.); (Y.-G.K.); (J.-Y.S.)
| | - Keunbada Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Republic of Korea; (K.S.); (Y.-T.S.)
| | - Sung-Min Hwang
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea; (J.-S.L.); (S.-M.H.); (Y.-G.K.); (J.-Y.S.)
| | - Young-Tak Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Republic of Korea; (K.S.); (Y.-T.S.)
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Yong-Gun Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea; (J.-S.L.); (S.-M.H.); (Y.-G.K.); (J.-Y.S.)
| | - Jo-Young Suh
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea; (J.-S.L.); (S.-M.H.); (Y.-G.K.); (J.-Y.S.)
| | - Jun Ho Hwang
- Institute of Advanced Convergence Technology, Kyungpook National University, Daegu 41061, Republic of Korea; (J.H.H.); (S.-M.K.); (J.H.L.)
| | - Sung-Min Kwon
- Institute of Advanced Convergence Technology, Kyungpook National University, Daegu 41061, Republic of Korea; (J.H.H.); (S.-M.K.); (J.H.L.)
| | - Jong Hoon Lee
- Institute of Advanced Convergence Technology, Kyungpook National University, Daegu 41061, Republic of Korea; (J.H.H.); (S.-M.K.); (J.H.L.)
| | - Hyun Deok Kim
- School of Electronics Engineering, Kyungpook National University, Daegu 41566, Republic of Korea;
| | - Kyu-Bok Lee
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea; (J.-S.L.); (S.-M.H.); (Y.-G.K.); (J.-Y.S.)
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Altindal D, Alkan EA, Calisir M. Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis. J Periodontal Implant Sci 2023; 53:376-387. [PMID: 37038829 PMCID: PMC10627738 DOI: 10.5051/jpis.2203140157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/19/2022] [Accepted: 12/21/2022] [Indexed: 02/11/2023] Open
Abstract
PURPOSE Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI. METHODS Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1β [IL-1β] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1β levels were determined using the enzyme-linked immunosorbent assay method. RESULTS The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1β level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG. CONCLUSIONS The diode laser enabled improvements in clinical parameters in the peri-implant tissue. However, it did not reduce IL-1β levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.
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Affiliation(s)
- Dicle Altindal
- Department of Periodontology, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey.
| | - Eylem Ayhan Alkan
- Department of Periodontology, Faculty of Dentistry, Yildirim Beyazit University, Ankara, Turkey
| | - Metin Calisir
- Department of Periodontology, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
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Calce L, Hafeez M, Hou W, Romanos GE. Thermal Effects of 445-nm Diode Laser Irradiation on Titanium and Ceramic Implants. J ORAL IMPLANTOL 2023; 49:401-406. [PMID: 37527174 DOI: 10.1563/aaid-joi-d-22-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/13/2023] [Accepted: 06/01/2023] [Indexed: 08/03/2023]
Abstract
This study aimed to evaluate temperature changes in titanium and ceramic implants after using a 445-nm diode laser under different in vitro conditions. Titanium (Ti) and ceramic (Zr) dental implants were placed into a bone analog, and an intrabony defect was created at each implant. A 445-nm diode laser was used to irradiate the defects for 30 seconds, noncontact, at 2 W in continuous wave (c.w.) and pulsed mode. The experiment was done at room temperature (21.0 ± 1°C) and in a water bath (37.0 ± 1°C). Two thermocouple probes were used to record real-time temperature changes (°C) at the coronal part of the implant (Tc) and the apex (Ta). The temperature was recorded at time 0 (To) and after 30 seconds of irradiation (Tf). The average temperature change was calculated, and a descriptive analysis was conducted (P < .05). The Ti implant resulted in the highest ΔT values coronally (29.6°C) and apically (6.7°C) using continuous wave at 21°C. The Zr implant increased to 26.4°C coronally and 5.2°C apically. In the water bath, the coronal portion of the Ti and Zr implants rose to 14.2°C and 14.01°C, respectively, using continuous waves. The ΔT values for Ti were 11.9°C coronally and 1.7°C apically when placed in a water bath using pulsed mode. The lowest ΔT occurred on the Zr implant with ΔTc and ΔTa of 4.8°C and 0.78°C, respectively. Under in vitro conditions, the 445-nm diode laser in pulsed mode seems to be safe for use on ceramic implants and should be used with caution on titanium implants.
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Affiliation(s)
- Loredana Calce
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Maryam Hafeez
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, New York
| | - Georgios E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
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Pergolini D, Palaia G, De Angelis R, Rocchetti F, Podda GM, Tenore G, Del Vecchio A, Relucenti M, Romeo U. SEM Evaluation of Thermal Effects Produced by a 445 nm Laser on Implant Surfaces. Dent J (Basel) 2023; 11:148. [PMID: 37366671 DOI: 10.3390/dj11060148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this in vitro study was to evaluate thermal effects on implant surfaces using a 445 nm diode laser (Eltech K-Laser Srl, Treviso, Italy) with different power settings and irradiation modalities. Fifteen new implants (Straumann, Basel, Switzerland) were irradiated to evaluate surface alteration. Each implant was divided into two zones: the anterior and posterior areas. The anterior coronal areas were irradiated with a distance of 1 mm between the optical fiber and the implant; the anterior apical ones were irradiated with the fiber in contact with the implant. Instead, the posterior surfaces of all of the implants were not irradiated and used as control surfaces. The protocol comprised two cycles of laser irradiation, lasting 30 s each, with a one-minute pause between them. Different power settings were tested: a 0.5 W pulsed beam (T-on 25 ms; T-off 25 ms), a 2 W continuous beam and a 3 W continuous beam. Lastly, through a scanning electron microscopy (SEM) analysis, dental implants' surfaces were evaluated to investigate surface alterations. No surface alterations were detected using a 0.5 W laser beam with a pulsed mode at a distance of 1 mm. Using powers of irradiation of 2 W and 3 W with a continuous mode at 1 mm from the implant caused damage on the titanium surfaces. After the irradiation protocol was changed to using the fiber in contact with the implant, the surface alterations increased highly compared to the non-contact irradiation modality. The SEM results suggest that a power of irradiation of 0.5 W with a pulsed laser light emission mode, using an inactivated optical fiber placed 1 mm away from the implant, could be used in the treatment of peri-implantitis, since no implant surface alterations were detected.
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Affiliation(s)
- Daniele Pergolini
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gaspare Palaia
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Riccardo De Angelis
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Federica Rocchetti
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gian Marco Podda
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Alessandro Del Vecchio
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Michela Relucenti
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Human Anatomy, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
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Khalil MI, Sakr H. Implant Surface Topography Following Different Laser Treatments: An In Vitro Study. Cureus 2023; 15:e38731. [PMID: 37292557 PMCID: PMC10246922 DOI: 10.7759/cureus.38731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/10/2023] Open
Abstract
Background Although dental implants have demonstrated very high success rates, they are susceptible to complications such as peri-implantitis that can lead to failure. Methods Twenty implants with surfaces grit-blasted using hydroxyapatite and acid-etched were randomly divided into four groups (five in each group). Three groups were assigned to laser treatments: Group I (erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser), Group II (650-nm diode laser), and Group III (808-nm diode), and one control group, Group IV. The surface roughness parameters (roughness average(Ra) and root mean square roughness(Rq)) were measured using a non-contact optical profilometer and scanning electron microscope to evaluate the surface topography after the laser treatments. Results Significant differences were observed between the laser groups regarding the surface roughness Ra (3.56±0.26, 3.45±0.19, 3.77±0.42, pc=0.0004, pe=0.0002, pf=0.001) and Rq values (4.49±0.34, 4.35±0.26, 4.72±0.56, pc=0.0007, pe=0.0006, pf=0.002) and the control group (2.81±0.10; 3.57±0.19). However, no significant difference was observed between the different laser treatment modalities. The scanning electron microscope images revealed some morphological changes on the implant surfaces following laser treatment, but no melted morphology was observed. Conclusions The application of Er,Cr:YSGG, 650-nm diode laser, and 808-nm diode did not show melting changes on implant topography. However, some increase in surface roughness was detected. Further studies are recommended to assess the effectiveness of these laser settings on bacterial reduction and osseointegration.
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Affiliation(s)
- Marwa I Khalil
- Department of Oral Medicine, Periodontology, Oral Diagnosis, and Oral Radiology, Faculty of Dentistry, Alexandria University, Alexandria, EGY
| | - Haitham Sakr
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, EGY
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Fragkioudakis I, Kallis A, Kesidou E, Damianidou O, Sakellari D, Vouros I. Surgical Treatment of Peri-Implantitis Using a Combined Nd: YAG and Er: YAG Laser Approach: Investigation of Clinical and Bone Loss Biomarkers. Dent J (Basel) 2023; 11:dj11030061. [PMID: 36975558 PMCID: PMC10046921 DOI: 10.3390/dj11030061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023] Open
Abstract
The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n = 10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n = 10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA). Baseline clinical values were similar for both groups, with no statistical differences between them. The study results indicated statistically significant improvements in the clinical parameters during the 6-month observation period in both groups. More specifically, PPD, PAL, and REC were improved in the test and control groups with no differences in the between-groups comparisons. However, a greater reduction in the BoP-positive sites was noted for the laser group (Mean change 22.05 ± 33.92 vs. 55.00 ± 30.48, p = 0.037). The baseline and six-month comparisons of sRANKL and OPG revealed no statistically significant differences between the two groups. The combined Nd: YAG—Er: YAG laser surgical therapy of peri-implantitis seemed to lead to more favorable improvements in regard to bleeding on probing six months after treatment compared to the conventional mechanical decontamination of the implant surface. None of the methods was found superior in the modification of bone loss biomarkers (RANKL, OPG) six months after treatment.
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Affiliation(s)
- Ioannis Fragkioudakis
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (I.F.); (I.V.)
| | - Antonios Kallis
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str., Goudi, 11527 Athens, Greece
| | - Evangelia Kesidou
- 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Olympia Damianidou
- 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (I.F.); (I.V.)
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11
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Atieh MA, Fadhul I, Shah M, Hannawi H, Alsabeeha NHM. Diode Laser as an Adjunctive Treatment for Peri-implant Mucositis: A Systematic Review and Meta-analysis. Int Dent J 2022; 72:735-745. [PMID: 35931559 PMCID: PMC9676556 DOI: 10.1016/j.identj.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
The early detection and management of peri-implant mucositis may help in reducing inflammatory parameters and arrest disease progression to peri-implantitis. The potential therapeutic benefits of different adjunctive therapies, such as the diode laser, are still not completely understood. The objective of this systematic review and meta-analyses was to assess the outcomes of using diode laser on the management of peri-implant mucositis in terms of changes in periodontal parameters. Electronic databases were searched to identify randomised controlled trials (RCTs) that compared the combined use of mechanical debridement and diode laser with mechanical debridement alone. A specific risk-of-bias tool was used to assess the risk of bias. Data were analysed using a statistical software programme. In total, 149 studies were found. A meta-analysis of 3 RCTs showed no statistically significant differences in probing pocket depths (mean difference [MD], -0.36; 95% confidence interval [CI], -0.88 to 0.16; P = .18) or bleeding on probing (MD, -0.71; 95% CI, 1.58-0.16; P = .11) between the 2 groups at 3 months. In the management of peri-implant mucositis, the combined use of diode laser and mechanical debridement did not provide any additional clinical advantage over mechanical debridement alone. Long-term, well-designed RCTs are still needed.
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Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates; Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - Israa Fadhul
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Haifa Hannawi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates; Dental Services Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Nabeel H M Alsabeeha
- Dental Services Department, Emirates Health Services, Dubai, United Arab Emirates
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12
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Chen JH, Lin YC, Kung JC, Yan DY, Chen IH, Jheng YS, Lai CH, Wu YM, Lee KT. Efficacy of Er:YAG laser for the peri-implantitis treatment and microbiological changes: a randomized controlled trial. Lasers Med Sci 2022; 37:3517-3525. [PMID: 35951124 DOI: 10.1007/s10103-022-03627-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 08/05/2022] [Indexed: 11/28/2022]
Abstract
The aims of this study were to identify the microbiological changes in the periodontal pockets following an Er:YAG laser (ERL) irradiation and mechanical debridement to compare the effectiveness of ERL irradiation to mechanical debridement for peri-implantitis treatment through randomized controlled trials. Twenty-three patients with peri-implantitis lesions were treated in either a test group, ERL set at energy level of 100 mJ/pulse, frequency of 10 Hz, pulse duration was 100 µs, and irradiated by three passages, or a control group, with mechanical debridement using an ultrasonic scaler. An examiner measured the following clinical parameters at different stages (a baseline and at 3- and 6-month post-treatment): probing depth (PD), bleeding on probing (BOP), marginal bone loss (MBL), and anaerobic bacteria counts. Linear regression, with generalized estimation equations, was used to compare the clinical parameters and anaerobic bacterial counts at different stages and between groups. The anaerobic bacterial counts significantly decreased within the control group during the follow-ups. At the 6-month follow-up, both groups showed a significant reduction in PD (test group: mean difference of 0.84 mm; control group: mean difference of 0.41 mm), and the test group showed a significantly higher PD reduction on the buccal site (1.31 mm) compared to that of the control group (0.25 mm). Both ERL and mechanical debridement treatments led to significant improvements in PD. When mechanical debridement therapy was used, significant anaerobic bacterial count reductions were observed. Future treatment of peri-implantitis should involve a combination of both of these therapies.
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Affiliation(s)
- Jen-Hao Chen
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807378, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan
| | - Ying-Chun Lin
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807378, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan
| | - Jung-Chang Kung
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan.,Division of Clinical Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807378, Taiwan
| | - Dah-You Yan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807378, Taiwan
| | - I-Hui Chen
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807378, Taiwan
| | - You-Syun Jheng
- College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Chern-Hsiung Lai
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan
| | - Yi-Min Wu
- Division of Clinical Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807378, Taiwan
| | - Kun-Tsung Lee
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan. .,Division of Clinical Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807378, Taiwan.
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13
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Hafeez M, Calce L, Hong H, Hou W, Romanos GE. Thermal Effects of Diode Laser-Irradiation on Titanium Implants in Different Room Temperatures In Vitro. Photobiomodul Photomed Laser Surg 2022; 40:554-558. [DOI: 10.1089/photob.2021.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maryam Hafeez
- Laboratory for Periodontal-, Implant- and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Loredana Calce
- Laboratory for Periodontal-, Implant- and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Houlin Hong
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Georgios E. Romanos
- Laboratory for Periodontal-, Implant- and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
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14
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Rahman B, Acharya AB, Siddiqui R, Verron E, Badran Z. Photodynamic Therapy for Peri-Implant Diseases. Antibiotics (Basel) 2022; 11:antibiotics11070918. [PMID: 35884171 PMCID: PMC9311944 DOI: 10.3390/antibiotics11070918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed.
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Affiliation(s)
- Betul Rahman
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Anirudh Balakrishna Acharya
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, University City, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates;
| | - Elise Verron
- CNRS, UMR 6230, CEISAM, UFR Sciences et Techniques, Université de Nantes, 2, rue de la Houssinière, BP 92208, CEDEX 3, 44322 Nantes, France;
| | - Zahi Badran
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
- Correspondence:
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15
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Ting M, Alluri LSC, Sulewski JG, Suzuki JB, Paes Batista da Silva A. Laser Treatment of Peri-Implantitis: A Systematic Review of Radiographic Outcomes. Dent J (Basel) 2022; 10:dj10020020. [PMID: 35200245 PMCID: PMC8870827 DOI: 10.3390/dj10020020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: This systematic review aimed to evaluate the effects of laser therapy on radiographic bone level (RBL) changes in peri-implantitis defects. (2) Methods: A literature search with defined inclusion criteria was performed. PubMed, Web of Science, Cochrane Library, and Google Scholar were searched through September 2020. The evaluated primary outcomes were RBL changes. In studies that reported RBL data, corresponding secondary clinical outcomes were probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL). (3) Results: Thirteen articles were selected for data extraction and risk of bias assessment. Eight studies showed evidence of RBL gain in the laser groups compared to baseline, but did not report the statistical significance. Eight of these 13 studies reported comparisons to control. Five of the eight studies did not show RBL gain in the laser groups compared to control. In the laser groups compared to baseline, 11 of 13 reported reduced PD, and 6 of 13 reported significantly reduced BOP. Compared to the control, eight of the eight reported reduction of PD, and three of six reported significantly reduced BOP. Statistical significance was not consistently reported. (4) Conclusions: Within the limits of this systematic review, laser treatment may promote bone gain in peri-implantitis defects, may reduce BOP and PDs, and may be comparable to mechanical therapy. However, definitive conclusions can only be made with statistically significant data, which were found lacking in the currently available studies. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42020207972.
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Affiliation(s)
- Miriam Ting
- Think Dental Learning Institute, Paoli, PA 19301, USA
- Correspondence:
| | | | - John G. Sulewski
- The Institute for Advanced Dental Technologies, Huntington Woods, MI 48070, USA;
| | - Jon B. Suzuki
- University of Maryland, Baltimore, MD 21201, USA;
- University of Washington, Seattle, WA 98015, USA
- Nova Southeastern University, Ft. Lauderdale, FL 33314, USA
| | - Andre Paes Batista da Silva
- Department of Periodontics, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106, USA;
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16
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Shakerian K, Birang R, Birang E, Narimani T, Naghsh N, Fekrazad R. Comparison of antimicrobial effect of several decontaminating methods on contaminated Titanium discs. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.363570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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17
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Selvaganesh S, Gajendran PL, Nesappan T, Prabhu AR. Comparison of clinical efficacy of diode laser and erbium, chromium: Yttrium, scandium, gallium, and garnet for implant stage 2 recovery procedure - A randomized control clinical study. J Indian Soc Periodontol 2021; 25:335-340. [PMID: 34393405 PMCID: PMC8336765 DOI: 10.4103/jisp.jisp_448_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 12/31/2022] Open
Abstract
Aim: The aim is to compare the clinical efficacy of diode laser and erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er, Cr:YSGG) laser for implant stage 2 recovery procedure. Materials and Methods: A total of 30 patients who had undergone dental implant placement were included in this study. The subjects were randomly allocated into three groups. Group 1 patients (n = 10) had implant recovery using diode laser, Group 2 (n = 10) implant recovery with Er, Cr:YSGG and conventional scalpel method (n = 10) was the third group. The pain assessment was recorded using visual analog scale (VAS scale), time taken for the procedure, intra-operative bleeding, time taken for healing were recorded for the three groups. Results: Data were tabulated and the results were analyzed using SPSS software version 26. Mann–Whitney U-test was used to compare the postoperative analgesic used, postoperative VAS score, the time taken for recovery and time taken for healing between the three study groups. Results were considered to be statistically significant when P < 0.05. Operation duration under Er, Cr:YSGG were much faster than the diode laser, however the results were not statistically significant (P = 0.051). The operation time under Er, Ch: YSGG and laser were faster than the conventional scalpel group (P = 0.000). The time taken for healing was faster in the Er, Cr:YSGG laser group than the diode laser and the scalpel group (P = 0.000). VAS scale at day 0 was higher in the conventional group than the two laser groups (P = 0.000). Conclusion: Considering the advantages of both these laser systems such as less anesthesia, less surgical trauma and faster healing, and post-operative comfort, lasers are an effective tool for implant stage two recovery techniques. However, since diode lasers are more cost effective when compared to Er, Cr:YSGG, diode lasers may meet the clinical needs when compared to hard-tissue lasers.
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Affiliation(s)
- Sahana Selvaganesh
- Department of Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Priya Lochana Gajendran
- Department of Periodontology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Thiyaneswaran Nesappan
- Department of Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Abhinav Rajendra Prabhu
- Department of Oral and Maxillo Facial Surgery, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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18
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Romanos GE, Davis R, Gallagher B, Hou W, Delgado-Ruiz R. Thermal Transfer on Splinted Implants During Diode Laser Irradiation In Vitro. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:471-479. [PMID: 34009027 DOI: 10.1089/photob.2020.4944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: Laser irradiation is being used for treatment of peri-implantitis. Therefore, this study aimed to assess the heat transfer from laser irradiation on an implant-supported, metal-ceramic fixed prosthesis in vitro. Materials and methods: Two titanium implants were placed in artificial type I bone, and after abutment connection, a bridge was fabricated and cemented. A peri-implant 3-wall defect was created around one of the implants. Thermocouples were placed at coronal (T1/T2) and apical (T3/T4) positions of both implants, and the T5 thermocouple was placed in the pontic. An identical setup was created in the type IV artificial bone. Diode laser irradiation (2 W, noninitiated tips, 320-μm fiber, and noncontact) was performed for 60 sec on each experimental model. This experiment was performed separately with 810- and 980-nm lasers for pulsed and continuous modes. ΔT based on the baseline was recorded during irradiation. Statistical analysis was performed with repeated analysis of variance. Results: Across all experimental models, the recorded ΔT (°) values in T2, T4, and T5 at 10, 30, and 60 sec were significantly less than 10°C (p < 0.001) for both types of bones. For both types of bones, there was a statistically significant ΔT greater than 10°C (p < 0.001) for continuous and pulsed 980-nm irradiation and continuous 810-nm diode laser irradiation after 60 sec. For both 810- and 980-nm lasers, there was a statistically significant ΔT greater than 10°C (p < 0.001) for type I and IV bones under irradiation and only for the type I bone model under pulsed irradiation after 60 sec. Conclusions: Within the limitations of this study, 810- and 980-nm lasers on splinted implants placed in vitro may increase the temperature on adjacent splinted implants due to material conductivity and splinting. Clinicians are advised to keep the temperature lower than the critical threshold following recommended power settings to avoid excessive heat and control complications due to overheating.
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Affiliation(s)
- Georgios E Romanos
- Laboratory for Periodontal-, Implant-, and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.,Department of Oral Surgery and Implantology, School of Dentistry (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Ryan Davis
- Laboratory for Periodontal-, Implant-, and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Brendan Gallagher
- Laboratory for Periodontal-, Implant-, and Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
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Fenelon T, Bakr MM, Walsh LJ, George R. Effects of Lasers and Their Delivery Characteristics on Machined and Micro-Roughened Titanium Dental Implant Surfaces. Bioengineering (Basel) 2020; 7:bioengineering7030093. [PMID: 32796620 PMCID: PMC7552764 DOI: 10.3390/bioengineering7030093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/23/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Thomas Fenelon
- School of Dentistry and Oral Health, Queensland, Griffith University, Queensland 4215, Australia; (T.F.); (M.M.B.)
| | - Mahmoud M. Bakr
- School of Dentistry and Oral Health, Queensland, Griffith University, Queensland 4215, Australia; (T.F.); (M.M.B.)
| | - Laurence J. Walsh
- School of Dentistry, The University of Queensland, Queensland 4006, Australia;
| | - Roy George
- School of Dentistry and Oral Health, Queensland, Griffith University, Queensland 4215, Australia; (T.F.); (M.M.B.)
- Correspondence: ; Tel.: +61-0756780751
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20
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Chala M, Anagnostaki E, Mylona V, Chalas A, Parker S, Lynch E. Adjunctive Use of Lasers in Peri-Implant Mucositis and Peri-Implantitis Treatment: A Systematic Review. Dent J (Basel) 2020; 8:dj8030068. [PMID: 32635258 PMCID: PMC7560070 DOI: 10.3390/dj8030068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of this systematic review is to compare the effectiveness of lasers in the treatment of implant mucositis and peri-implantitis compared to conventional treatment (non-surgical or surgical: resective or regenerative). METHODS Sources of PubMed, Cochrane and Google Scholar search engines were used on articles published from 1997 to 2020 in English, with selected keyword criteria applied. Nine randomized controlled trials (RCTs) were selected. RESULTS All included studies were considered of "high quality" according to the quality assessment scale. The comparative assessment of the RCTs was done twice for each RCT based on the type of treatment and according to wavelength. There is strong scientific evidence that, regarding non-surgical treatment, adjunct laser application can provide better results only in the short term (three months). Regarding the surgical approach, the method of decontamination plays a subordinate role. All wavelengths/applications presented similar results. CONCLUSION Within the limitations of this study, the adjunctive use of lasers in the treatment of peri-implant inflammation is effective for up to three months; there is no strong evidence regarding the long term benefit compared to conventional treatment.
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Affiliation(s)
- Marianna Chala
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy
- Correspondence:
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | | | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89154, USA
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21
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Malmqvist S, Liljeborg A, Qadri T, Johannsen G, Johannsen A. Using 445 nm and 970 nm Lasers on Dental Implants-An In Vitro Study on Change in Temperature and Surface Alterations. MATERIALS 2019; 12:ma12233934. [PMID: 31783687 PMCID: PMC6926931 DOI: 10.3390/ma12233934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the safety of using a 445 nm laser on dental implants by comparing it with a laser with 970 nm wavelength. Two models, a pig mandible and glass ionomer cement, were used to evaluate the temperature increase in dental implants during laser irradiation with both wavelengths. Temperature was measured every second at four different places on the dental implants. Different power settings, effects of water cooling, distance of the laser fibre to the dental implant and continuous comparison to a pulsed laser beam were tested. Surface alterations on titanium discs after laser irradiation for 4 min at 2.0 W, were analysed in a scanning electron microscope (SEM). The maximum temperature and time to reach each of the thresholds were comparable between the 445 nm and 970 nm lasers. Neither the 445 nm nor the 970 nm wavelength showed any signs of surface alterations on the titanium discs. Using a 445 nm laser on dental implants is as safe as using a 970 nm laser, in terms of temperature increase and surface alterations. Applying a generous amount of cooling water and irradiating in short intervals is important when using lasers on dental implants.
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Affiliation(s)
- Sebastian Malmqvist
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 141 52 Huddinge, Sweden
- Correspondence:
| | - Anders Liljeborg
- Division of Nanostructure Physics, Department of Applied Physics, KTH Royal Institute of Technology, 106 91 Stockholm, Sweden
| | - Talat Qadri
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 141 52 Huddinge, Sweden
| | - Gunnar Johannsen
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 141 52 Huddinge, Sweden
- Danakliniken Specialisttandvård, Praktikertjänst AB, 182 31 Danderyd, Sweden
| | - Annsofi Johannsen
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 141 52 Huddinge, Sweden
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22
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Tunc SK, Yayli NZ, Talmac AC, Feslihan E, Akbal D. Clinical comparison of the use of ER,CR:YSGG and diode lasers in second stage implants surgery. Saudi Med J 2019; 40:490-498. [PMID: 31056627 PMCID: PMC6535160 DOI: 10.15537/smj.2019.5.24105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To compare the effects of diode and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers in second-stage implant surgery applications. METHODS This is a cross-sectional study that was carried out on patients who received implant treatment at the Departments of Oral and Maxillofacial Surgery and Periodontology, Van Yuzuncu Yil University, Van, Turkey between January 2017 and January 2018. Implants of the patients in the first group (n=20) were exposed with 940 nm Ga-Al-As diode laser while the implants of the second group (n=20) were uncovered with 2780 nm Er,Cr:YSGG laser in the second-stage surgery. Visual analogue scale (VAS) values during day 0 and following the operation on days 1, 2, 3 intraoperative bleeding grades, number of analgesics used in the postoperative period, operation time per implant, and postoperative complications were recorded. RESULTS When gender, smoking, the presence of systemic disease, toothbrushing frequency, analgesic use, bleeding and complications observed at the control session were analyzed, no statistically significant relationship was found between the 2 groups. It was observed that males had statistically significant higher VAS values than females (p less than 0.05). CONCLUSION Since diode lasers are more economical, smaller, and can meet the clinical needs of clinicians, it is likely that these lasers may be the preferred choice of the clinicians in surgical procedures.
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Affiliation(s)
- Serap K Tunc
- Department of Oral and Maxillofacial Surgery, Van Yuzuncu Yil University, Van, Turkey. E-mail.
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Froum SH, Cantor-Balan R, Kerbage C, Froum SJ. Thermal Testing of Titanium Implants and the Surrounding Ex-Vivo Tissue Irradiated With 9.3um CO2 Laser. IMPLANT DENT 2019; 28:463-471. [PMID: 31348019 DOI: 10.1097/id.0000000000000923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To measure the temperature rise and surface damage of titanium dental implants and the surrounding tissue in a pig jaw during 9.3-μm carbon dioxide (CO2) laser irradiation at various durations of time. MATERIALS AND METHODS Thermal analysis tests were performed on 12 implants with the same surface. Twelve implants mounted alone or in pig jaws were laser-irradiated with a 9.3-μm CO2 laser using 3 different power settings. The temperature of the implant body and the proximal tissues was measured with a J-Type Thermocouple after being laser-irradiated with 3 different power setting for 30, 60 seconds, and 2 minutes. Scanning electron microscope (SEM) and digital microscope images were also taken of the all the implants before and after laser irradiation to detect the presence or absence of surface damage. RESULTS Temperature analysis showed that in all cases the implant and the proximal tissue temperatures remained around the start temperatures of the implant and tissues with fluctuations of ±3°C but never reached the upper threshold of 44°C, the temperature at which thermal injury to bone has been reported. Digital and SEM images that were taken of the implants showed an absence of surface damage at the cutting speed of 20% (0.7 W); however, cutting speeds of 30% to 100% (1.0-4.2 W) did yield surface damage. CONCLUSIONS Laser irradiation of titanium implant surfaces using a 9.3-μm carbon dioxide laser with an average power of 0.7 W showed no increase in thermal temperature of the implant body and tissue temperatures as well as no evidence of implant surface damage.
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Affiliation(s)
- Scott H Froum
- Assistant Professor, Department of Periodontics, Stony Brook Dental School, Stony Brook, NY
| | | | - Charles Kerbage
- Vice President of Research and Development, Convergent Dental, Needham, MA
| | - Stuart J Froum
- Clinical Adjunct Professor and Director of Clinical Research, Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY
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Aimetti M, Mariani GM, Ferrarotti F, Ercoli E, Liu CC, Romano F. Adjunctive efficacy of diode laser in the treatment of peri‐implant mucositis with mechanical therapy: A randomized clinical trial. Clin Oral Implants Res 2019; 30:429-438. [DOI: 10.1111/clr.13428] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/18/2019] [Accepted: 03/11/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Francesco Ferrarotti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Elena Ercoli
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Chun Ching Liu
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
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Delgado-Ruiz R, Romanos G. Potential Causes of Titanium Particle and Ion Release in Implant Dentistry: A Systematic Review. Int J Mol Sci 2018; 19:E3585. [PMID: 30428596 PMCID: PMC6274707 DOI: 10.3390/ijms19113585] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/09/2018] [Accepted: 11/11/2018] [Indexed: 01/03/2023] Open
Abstract
Implant surface characteristics, as well as physical and mechanical properties, are responsible for the positive interaction between the dental implant, the bone and the surrounding soft tissues. Unfortunately, the dental implant surface does not remain unaltered and changes over time during the life of the implant. If changes occur at the implant surface, mucositis and peri-implantitis processes could be initiated; implant osseointegration might be disrupted and bone resorption phenomena (osteolysis) may lead to implant loss. This systematic review compiled the information related to the potential sources of titanium particle and ions in implant dentistry. Research questions were structured in the Population, Intervention, Comparison, Outcome (PICO) framework. PICO questionnaires were developed and an exhaustive search was performed for all the relevant studies published between 1980 and 2018 involving titanium particles and ions related to implant dentistry procedures. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for the selection and inclusion of the manuscripts in this review. Titanium particle and ions are released during the implant bed preparation, during the implant insertion and during the implant decontamination. In addition, the implant surfaces and restorations are exposed to the saliva, bacteria and chemicals that can potentially dissolve the titanium oxide layer and, therefore, corrosion cycles can be initiated. Mechanical factors, the micro-gap and fluorides can also influence the proportion of metal particles and ions released from implants and restorations.
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Affiliation(s)
- Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
| | - Georgios Romanos
- Department of Periodontics, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
- Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, 60323 Frankfurt, Germany.
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Management of Retrograde Peri-Implantitis Using an Air-Abrasive Device, Er,Cr:YSGG Laser, and Guided Bone Regeneration. Case Rep Dent 2018; 2018:7283240. [PMID: 29850281 PMCID: PMC5925184 DOI: 10.1155/2018/7283240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.
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Guzzardella G, Torricelli P, Aldini NN, Giardino R. Laser Technology in Orthopedics: Preliminary Study on Low Power Laser Therapy to Improve the Bone-Biomaterial Interface. Int J Artif Organs 2018. [DOI: 10.1177/039139880102401207] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Low Power Laser (LPL) seems to enhance the healing of bone defects and fractures. The effect of LPL In other orthopedic areas such as osteointegration of implanted prosthetic bone devices is still unclear. In the present study, 12 rabbits were used to evaluate whether Ga-AI-As (780 nm) LPL stimulation has positive effects on osteointegration. Hydroxyapatite (HA) cylindrical nails were drilled into both distal femurs of rabbits. From postoperative day 1 and for 5 consecutive days, the left femura of all rabbits were given LPL treatment (Laser Group-LG) with the following parameters: 300 Joule/cm2 1 Watt, 300 Hertz, pulsating emission, 10 minutes. The right femura were sham-treated (Control Group-CG). At 4 and 8 weeks after implantation, histologic and histomorphometric investigations evaluated bone-biomaterial-contact. Histomorphometry showed a higher degree of osteointegration at the HA-bone interface in the LG Group at 4 (p<0.0005) and 8 weeks (p<0.001). These preliminary positive results seem to support the hypothesis that LPL treatment can be considered a good tool to enhance the bone-implant interface in orthopedic surgery.
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Affiliation(s)
- G.A. Guzzardella
- Experimental Surgery Department, Research Institute Codivilla Putti, Rizzoli Orthopedic Institute, Bologna - Italy
| | - P. Torricelli
- Experimental Surgery Department, Research Institute Codivilla Putti, Rizzoli Orthopedic Institute, Bologna - Italy
| | - N Nicoli Aldini
- Experimental Surgery Department, Research Institute Codivilla Putti, Rizzoli Orthopedic Institute, Bologna - Italy
| | - R. Giardino
- Experimental Surgery Department, Research Institute Codivilla Putti, Rizzoli Orthopedic Institute, Bologna - Italy
- Chair of Surgical Pathophysiology, School of Medicine, University of Bologna, Bologna - Italy
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Matys J, Botzenhart U, Gedrange T, Dominiak M. Thermodynamic effects after Diode and Er:YAG laser irradiation of grade IV and V titanium implants placed in bone - an ex vivo study. Preliminary report. ACTA ACUST UNITED AC 2017; 61:499-507. [PMID: 26985682 DOI: 10.1515/bmt-2015-0135] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 02/17/2016] [Indexed: 11/15/2022]
Abstract
Many inserted implants are affected by peri-implantitis. The aim of our study was to evaluate increases in implant temperature, depending on the diameter and chemical composition of implants. In particular we measured the time it takes for the temperature of an implant to rise by 10°C and evaluated laser power settings required to prevent thermal injury when an implant surface is decontaminated during the treatment of peri-implantitis. The study analysed six implants placed in porcine ribs and divided into two groups according to their diameter and chemical composition (grade IV and grade V titanium). The implants were irradiated with Diode and Er:YAG lasers using different laser parameters. The temperature was measured with a K-type thermocouple. The temperature on the implant surface rose as the laser power increased and the implant diameter decreased. The time required to increase the temperature of an implant by 10°C was less than it was for titanium grade IV. The temperature gradient was below 10°C for all implants treated using a laser power up to 1 W. It is important to choose the correct laser parameters, depending on the chemical composition and diameter of the implant, so that decontamination of the implant surface is thorough, effective and safe.
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Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ = 808 nm GaAlAs diode laser or chlorhexidine: in vitro study. Lasers Med Sci 2017; 32:1309-1320. [PMID: 28551763 DOI: 10.1007/s10103-017-2243-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/19/2017] [Indexed: 12/15/2022]
Abstract
Preservation of implant biocompatibility following peri-implantitis treatments is a crucial issue in odontostomatological practice, being closely linked to implant re-osseointegration. Our aim was to assess the responses of osteoblast-like Saos2 cells and adult human bone marrow-mesenchymal stromal cells (MSCs) to oxidized titanium surfaces (TiUnite®, TiU) pre-treated with a 808 ± 10 nm GaAlAs diode laser operating in non-contact mode, in continuous (2 W, 400 J/cm2; CW) or pulsed (20 kHz, 7 μs, 0.44 W, 88 J/cm2; PW) wave, previously demonstrated to have a strong bactericidal effect and proposed as optional treatment for peri-implantitis. The biocompatibility of TiU surfaces pre-treated with chlorhexidine digluconate (CHX) was also evaluated. In particular, in order to mimic the in vivo approach, TiU surfaces were pre-treated with CHX (0.2%, 5 min); CHX and rinse; and CHX, rinse and air drying. In some experiments, the cells were cultured on untreated TiU before being exposed to CHX. Cell viability (MTS assay), proliferation (EdU incorporation assay; Ki67 confocal immunofluorescence analysis), adhesion (morphological analysis of actin cytoskeleton organization), and osteogenic differentiation (osteopontin confocal immunofluorescence analysis; mineralized bone-like nodule formation) analyses were performed. CHX resulted cytotoxic in all experimental conditions. Diode laser irradiation preserved TiU surface biocompatibility. Notably, laser treatment appeared even to improve the known osteoconductive properties of TiU surfaces. Within the limitations of an in vitro experimentation, this study contributes to provide additional experimental basis to support the potential use of 808 ± 10 nm GaAlAs diode laser at the indicated irradiation setting, in the treatment of peri-implantitis and to discourage the use of CHX.
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Karam PSBH, Ferreira R, Oliveira RC, Greghi SLA, de Rezende MLR, Sant'Ana ACP, Zangrando MSR, Damante CA. Stimulation of human gingival fibroblasts viability and growth by roots treated with high intensity lasers, photodynamic therapy and citric acid. Arch Oral Biol 2017; 81:1-6. [PMID: 28456059 DOI: 10.1016/j.archoralbio.2017.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 03/20/2017] [Accepted: 04/17/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effect of root biomodification by lasers, citric acid and antimicrobial photodynamic therapy (aPDT) on viability and proliferation of human gingival fibroblasts (FGH). DESIGN Groups were divided in control (CC - only cells), and root fragments treated by: scaling and root planing (positice control - SC), Er:YAG (ER-60mJ,10pps,10Hz,10s,2940nm), Nd:YAG (ND-0.5W,15Hz,10s,1640nm), antimicrobial photodynamic therapy (PDT-InGaAIP,30mW,45J/cm2,30s,660nm,toluidine blue O), citric acid plus tetracycline (CA). Fibroblasts (6th passage, 2×103) were cultivated in a 24-h conditioned medium by the treated root fragments. Cell viability was measured by MTT test at 24, 48, 72 and 96h. In a second experiment, FGH cells (104) were cultivated on root fragments which received the same treatments. After 24, 48, 72h the number of cells was counted in SEM pictures. In addition, chemical elements were analyzed by energy dispersive spectroscopy (EDS). Data was analyzed by two-way ANOVA (first experiment), repeated measures ANOVA (second experiment) and ANOVA (EDS experiment) tests complemented by Tukey's test (p<0.05). RESULTS ND, PDT and CA promoted higher cell viability (p<0.05). ND and ER groups presented higher number of cells on root surfaces (p<0.05). ER group presented higher calcium and CA group a higher carbon percentages (p<0.05). CONCLUSIONS All treatments but scaling and root planing stimulated fibroblast viability while Er:YAG and Nd:YAG treated root surfaces presented higher number of cells.
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Affiliation(s)
| | - Rafael Ferreira
- Discipline of Periodontics, Bauru School of Dentistry, University of São Paulo, Brazil.
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Batsukh N, Feng SW, Lee WF, Leu SJ, Tsai PY, Ho KN, Lin CT, Su CH, Chang WJ. Effects of Porphyromonas gingivalis on Titanium Surface by Different Clinical Treatment. J Med Biol Eng 2017. [DOI: 10.1007/s40846-016-0194-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abduljabbar T, Javed F, Kellesarian SV, Vohra F, Romanos GE. Effect of Nd:YAG laser-assisted non-surgical mechanical debridement on clinical and radiographic peri-implant inflammatory parameters in patients with peri-implant disease. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 168:16-19. [PMID: 28135574 DOI: 10.1016/j.jphotobiol.2017.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIM The efficacy of neodymium-doped yttrium aluminium garnet (Nd:YAG) laser-assisted non-surgical mechanical debridement (MD) in the treatment of periimplant diseases remains uninvestigated. The aim was to assess the efficacy of Nd:YAG laser-assisted non-surgical MD on clinical and radiographic periimplant inflammatory parameters in patients with periimplant disease. METHODS Treatment wise, 63 male patients with periimplant diseases were divided into 2 groups: Group-1 (32 patients): treatment of periimplant disease using MD alone (control group); and Group-2 (n=31 patients): treatment of periimplant disease using MD with a single application of Nd:YAG laser. Peri-implant inflammatory parameters (plaque index [PI], bleeding on probing [BOP] and probing depth [PD]) were measured at baseline and at 3 and 6months' follow-up. Periimplant crestal bone loss (CBL) was measured at baseline and at 6months' follow-up. Statistical analysis was performed using the Kruskall-Wallis and Bonferroni Post hoc tests. P-values<0.05 were considered statistically significant. RESULTS In both groups, mean age of patients and baseline scores of periimplant PI, BOP and PD were comparable. At 3-month follow-up, scores of periimplant PI, BOP and PD were higher among patients in Group-1 compared with Group-2. At 6-month follow-up, scores of periimplant PI, BOP and PD were comparable among patients in groups 1 and 2. There was no statistically significant difference in periimplant CBL in both groups at all time intervals. CONCLUSION Nd:YAG laser-assisted non-surgical MD is more effective in reducing periimplant soft tissue inflammatory parameters than MD alone in short-term but not in long-term.
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Affiliation(s)
- Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, Frankfurt, Germany
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Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y. Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 2017; 68:217-69. [PMID: 25867988 DOI: 10.1111/prd.12080] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 12/18/2022]
Abstract
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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Giannelli M, Landini G, Materassi F, Chellini F, Antonelli A, Tani A, Zecchi-Orlandini S, Rossolini GM, Bani D. The effects of diode laser on Staphylococcus aureus biofilm and Escherichia coli lipopolysaccharide adherent to titanium oxide surface of dental implants. An in vitro study. Lasers Med Sci 2016; 31:1613-1619. [PMID: 27475996 DOI: 10.1007/s10103-016-2025-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
Effective decontamination of biofilm and bacterial toxins from the surface of dental implants is a yet unresolved issue. This in vitro study aims at providing the experimental basis for possible use of diode laser (λ 808 nm) in the treatment of peri-implantitis. Staphylococcus aureus biofilm was grown for 48 h on titanium discs with porous surface corresponding to the bone-implant interface and then irradiated with a diode laser (λ 808 nm) in noncontact mode with airflow cooling for 1 min using a Ø 600-μm fiber. Setting parameters were 2 W (400 J/cm2) for continuous wave mode; 22 μJ, 20 kHz, 7 μs (88 J/cm2) for pulsed wave mode. Bactericidal effect was evaluated using fluorescence microscopy and counting the residual colony-forming units. Biofilm and titanium surface morphology were analyzed by scanning electron microscopy (SEM). In parallel experiments, the titanium discs were coated with Escherichia coli lipopolysaccharide (LPS), laser-irradiated and seeded with RAW 264.7 macrophages to quantify LPS-driven inflammatory cell activation by measuring the enhanced generation of nitric oxide (NO). Diode laser irradiation in both continuous and pulsed modes induced a statistically significant reduction of viable bacteria and nitrite levels. These results indicate that in addition to its bactericidal effect laser irradiation can also inhibit LPS-induced macrophage activation and thus blunt the inflammatory response. The λ 808-nm diode laser emerges as a valuable tool for decontamination/detoxification of the titanium implant surface and may be used in the treatment of peri-implantitis.
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Affiliation(s)
- Marco Giannelli
- Odontostomatologic Laser Therapy Center, Via dell' Olivuzzo 162, 50143, Florence, Italy.
| | - Giulia Landini
- Department of Medical Biotechnologies, University of Siena, Santa Maria alle Scotte University Hospital, Viale Bracci, Siena, Italy
| | - Fabrizio Materassi
- Odontostomatologic Laser Therapy Center, Via dell' Olivuzzo 162, 50143, Florence, Italy
| | - Flaminia Chellini
- Department of Experimental and Clinical Medicine - Section of Anatomy and Histology, Largo Brambilla 3, University of Florence, 50134, Florence, Italy
| | - Alberto Antonelli
- Department of Medical Biotechnologies, University of Siena, Santa Maria alle Scotte University Hospital, Viale Bracci, Siena, Italy.,Department of Experimental and Clinical Medicine, Section of Critical Care and Specialistic Medicine, University of Florence, and 5Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Via San Damiano, 50134, Florence, Italy
| | - Alessia Tani
- Department of Experimental and Clinical Medicine - Section of Anatomy and Histology, Largo Brambilla 3, University of Florence, 50134, Florence, Italy
| | - Sandra Zecchi-Orlandini
- Department of Experimental and Clinical Medicine - Section of Anatomy and Histology, Largo Brambilla 3, University of Florence, 50134, Florence, Italy
| | - Gian Maria Rossolini
- Department of Medical Biotechnologies, University of Siena, Santa Maria alle Scotte University Hospital, Viale Bracci, Siena, Italy.,Department of Experimental and Clinical Medicine, Section of Critical Care and Specialistic Medicine, University of Florence, and 5Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Via San Damiano, 50134, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Via San Damiano, 50134, Florence, Italy
| | - Daniele Bani
- Department of Experimental and Clinical Medicine - Section of Anatomy and Histology, Largo Brambilla 3, University of Florence, 50134, Florence, Italy
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Alshehri FA. The role of lasers in the treatment of peri-implant diseases: A review. Saudi Dent J 2016; 28:103-8. [PMID: 27656076 PMCID: PMC5021821 DOI: 10.1016/j.sdentj.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 11/28/2015] [Accepted: 12/07/2015] [Indexed: 11/15/2022] Open
Abstract
We reviewed the indexed literature regarding the efficacy of laser therapy in the treatment of peri-implantitis (PI). Databases were searched using combinations of the following keywords: peri-implantitis, bone loss, photodynamic therapy, laser, and light-activated disinfection. Titles and abstracts of publications from these search results were screened to determine which studies fulfilled the eligibility criteria. Full texts of relevant studies were read and independently assessed against the eligibility criteria. The resulting 28 studies described the role of lasers in the treatment of PI. The erbium:yttrium–aluminum-garnet laser can be used to sterilize implant surfaces without damaging them. Likewise, the carbon dioxide laser can disinfect implant surfaces and enhance the bone-to-implant contact around previously infected sites. Photodynamic therapy exhibits high target specificity and can destroy pathogens associated with the etiology of PI. Laser therapy can significantly reduce levels of clinical markers of peri-implant tissue inflammation (i.e., bleeding upon probing and clinical attachment loss) without jeopardizing the integrity of the implant or alveolar bone. In conclusion, laser therapy as an adjunct to conventional mechanical debridement therapy can be used effectively for the treatment of PI.
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Rios FG, Viana ER, Ribeiro GM, González JC, Abelenda A, Peruzzo DC. Temperature evaluation of dental implant surface irradiated with high-power diode laser. Lasers Med Sci 2016; 31:1309-16. [PMID: 27365109 DOI: 10.1007/s10103-016-1974-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/24/2016] [Indexed: 11/27/2022]
Abstract
The prevalence of peri-implantitis and the absence of a standard approach for decontamination of the dental implant surface have led to searches for effective therapies. Since the source of diode lasers is portable, has reduced cost, and does not cause damage to the titanium surface of the implant, high-power diode lasers have been used for this purpose. The effect of laser irradiation on the implants is the elevation of the temperature surface. If this elevation exceeds 47 °C, the bone tissue is irreversibly damaged, so for a safety therapy, the laser parameters should be controlled. In this study, a diode laser of GaAsAl was used to irradiate titanium dental implants, for powers 1.32 to 2.64 W (real) or 2.00 to 4.00 W (nominal), in continuous/pulsed mode DC/AC, with exposure time of 5/10 s, with/without air flow for cooling. The elevation of the temperature was monitored in real time in two positions: cervical and apical. The best results for decontamination using a 968-nm diode laser were obtained for a power of 1.65 and 1.98 W (real) for 10 s, in DC or AC mode, with an air flow of 2.5 l/min. In our perspective in this article, we determine a suggested approach for decontamination of the dental implant surface using a 968-nm diode laser.
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Affiliation(s)
- F G Rios
- Centro de Pesquisas Odontológicas São Leopoldo Mandic (SLMANDIC), Dental Research Center, Rua Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, SP, Brazil.
| | - E R Viana
- Physics Department (DAFIS), Universidade Tecnológica Federal do Paraná (UTFPR), Av. Sete de Setembro 3165, Rebouças, Curitiba, PR, Brazil.
| | - G M Ribeiro
- Physics Department, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - J C González
- Physics Department, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - A Abelenda
- Physics Department, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - D C Peruzzo
- Centro de Pesquisas Odontológicas São Leopoldo Mandic (SLMANDIC), Dental Research Center, Rua Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, SP, Brazil
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Kushima SS, Nagasawa M, Shibli JA, Brugnera A, Rodrigues JA, Cassoni A. Evaluation of Temperature and Roughness Alteration of Diode Laser Irradiation of Zirconia and Titanium for Peri-Implantitis Treatment. Photomed Laser Surg 2016; 34:194-9. [PMID: 27058359 DOI: 10.1089/pho.2015.4026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study investigated the effects of diode laser (gallium, aluminium, arsenide [GaAlAs]) irradiation with decontamination parameters on the temperature and roughness of yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP), titanium (TI), and sandblasted large grit acid-etched titanium (SLA). MATERIALS AND METHODS Three groups (n = 10) of standardized disks with 5 mm diameter and 2 mm thickness were produced with Y-TZP obtained from computer-aided design and computer-aided manufacturing (CAD-CAM), machined TI and SLA. The diode laser single application (808 nm, 20 sec, 1 W, 50 Hz, t on = 100 ms, t off = 100 ms, energy density = 28.29 J/cm(2)) was performed in contact mode, on each disk. The temperature was measured by a thermosensor attached to a digital thermometer fixed to the opposite irradiated surface. The temperature gradient (ΔT) was calculated (ΔT = final temperature - initial temperature) for each group. The parameters Ra (in μm) and Sa (in μm(2)) were measured by white light confocal laser microscopy to express the surface roughness. Data of ΔT was statistically analyzed by one way ANOVA at the 95% confidence level and compared by Tukey post-hoc test (α = 0.05). Roughness data was analyzed by t test. RESULTS The diode laser irradiation presented the following results (ΔT value): Y-TZP = 10.3°C(B); TI = 38.6°C(A), and SLA = 26.7°C(A). The ΔT values ((°)C) of the titanium groups were higher than for the Y-TZP group. For both roughness parameters (Ra and Sa), data did not show statistical significant differences to "irradiation" factor (p > 0.05) to Y-TZP and SLA. The Ra results (in μm) were: Y-TZP (control) = 0.73 (0.55); Y-TZP (irradiated) = 0.45 (0.27); SLA (control) = 0.74 (0.23); and SLA (irradiated) = 0.99 (0.33). The Sa results (in μm(2)) were: Y-TZP (control) = 1.39 (1.05); Y-TZP (irradiated) = 0.73 (0.41); SLA (control) = 0.85 (0.08); and SLA (irradiated) = 1.27 (0.44). CONCLUSIONS Diode laser irradiation for peri-implantitis treatment increased both zirconia and TI temperature without surface roughness alterations.
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Affiliation(s)
- Sonia Setsuko Kushima
- 1 Department of Oral Implantology, School of Dentistry, Guarulhos University Centro CEP , Guarulhos, São Paulo, Brazil
| | - Magda Nagasawa
- 1 Department of Oral Implantology, School of Dentistry, Guarulhos University Centro CEP , Guarulhos, São Paulo, Brazil
| | - Jamil Awad Shibli
- 1 Department of Oral Implantology, School of Dentistry, Guarulhos University Centro CEP , Guarulhos, São Paulo, Brazil
| | - Aldo Brugnera
- 2 Dental Clinic, Department of Biomedicine Engineering, Camilo Castelo Branco University and Instituto Brugnera e Zanin , Eugênio de Melo CEP São José dos Campos, São Paulo, Brazil
| | - José Augusto Rodrigues
- 3 Department of Restorative Dentistry, School of Dentistry, Guarulhos University Centro CEP, Guarulhos, São Paulo, Brazil
| | - Alessandra Cassoni
- 3 Department of Restorative Dentistry, School of Dentistry, Guarulhos University Centro CEP, Guarulhos, São Paulo, Brazil
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Mizutani K, Aoki A, Coluzzi D, Yukna R, Wang CY, Pavlic V, Izumi Y. Lasers in minimally invasive periodontal and peri-implant therapy. Periodontol 2000 2016; 71:185-212. [DOI: 10.1111/prd.12123] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/28/2022]
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Abstract
Direct pulp capping helps extend the life of a diseased tooth by maintaining tooth vitality. Nowadays, lasers are more frequently used during direct pulp capping in the clinic, but their use has not been previously reviewed. This review presents the basic properties of currently available lasers, scientific evidence on the effects of laser application on direct pulp capping, and future directions for this technology. An extensive literature search was conducted in various databases for articles published up to January 2015. Original in vitro, in vivo, and clinical studies, reviews, and book chapters published in English were included. Various laser systems have been increasingly and successfully applied in direct pulp capping. Lasers offer excellent characteristics in terms of hemostasis and decontamination for field preparation during direct pulp capping treatment; however, the sealing of exposed pulp with one of the dental materials, such as calcium hydroxide, mineral trioxide aggregates, and bonded composite resins, is still required after laser treatment. Clinicians should consider the characteristics of each wavelength, the emission mode, irradiation exposure time, power, type of laser tip, and the distance between the laser tip and the surface being irradiated.
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Romanos G. Current concepts in the use of lasers in periodontal and implant dentistry. J Indian Soc Periodontol 2015; 19:490-4. [PMID: 26644712 PMCID: PMC4645532 DOI: 10.4103/0972-124x.153471] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Lasers have various periodontal applications including calculus removal (Er: YAG, Er, Cr: YSGG lasers); soft tissue excision, incision and ablation; decontamination of root and implant surfaces; biostimulation; bacteria reduction; and osseous surgery. This paper reviews some of the major opportunities for using lasers in periodontal and implant specialty practices. The literature relating to the use of lasers for removal of the pocket epithelium, root conditioning, bacterial reduction and decontamination of infected implant surfaces is discussed, and a summary of the advantages and disadvantages of using lasers for periodontal treatment is provided.
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Affiliation(s)
- Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA ; Department of Oral Surgery and Implant Dentistry, Dental School (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany
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Efficacy of non-surgical periodontal therapy with adjunct Nd:YAG laser therapy in the treatment of periodontal inflammation among patients with and without type 2 diabetes mellitus: A short-term pilot study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 149:230-4. [DOI: 10.1016/j.jphotobiol.2015.06.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/12/2015] [Accepted: 06/15/2015] [Indexed: 01/15/2023]
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Cho K, Lee SY, Chang BS, Um HS, Lee JK. The effect of photodynamic therapy on Aggregatibacter actinomycetemcomitans attached to surface-modified titanium. J Periodontal Implant Sci 2015; 45:38-45. [PMID: 25932337 PMCID: PMC4415000 DOI: 10.5051/jpis.2015.45.2.38] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 03/20/2015] [Indexed: 12/02/2022] Open
Affiliation(s)
- Kyungwon Cho
- Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Si Young Lee
- Department of Oral Microbiology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Beom-Seok Chang
- Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Heung-Sik Um
- Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Jae-Kwan Lee
- Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Kang HK, Chu TM, Dechow P, Stewart K, Kyung HM, Liu SSY. Laser-treated stainless steel mini-screw implants: 3D surface roughness, bone-implant contact, and fracture resistance analysis. Eur J Orthod 2015; 38:154-62. [PMID: 25908868 DOI: 10.1093/ejo/cjv017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES This study investigated the biomechanical properties and bone-implant intersurface response of machined and laser surface-treated stainless steel (SS) mini-screw implants (MSIs). MATERIAL AND METHODS Forty-eight 1.3mm in diameter and 6mm long SS MSIs were divided into two groups. The control (machined surface) group received no surface treatment; the laser-treated group received Nd-YAG laser surface treatment. Half in each group was used for examining surface roughness (Sa and Sq), surface texture, and facture resistance. The remaining MSIs were placed in the maxilla of six skeletally mature male beagle dogs in a randomized split-mouth design. A pair with the same surface treatment was placed on the same side and immediately loaded with 200 g nickel-titanium coil springs for 8 weeks. After killing, the bone-implant contact (BIC) for each MSI was calculated using micro computed tomography. Analysis of variance model and two-sample t test were used for statistical analysis with a significance level of P <0.05. RESULTS The mean values of Sa and Sq were significantly higher in the laser-treated group compared with the machined group (P <0.05). There were no significant differences in fracture resistance and BIC between the two groups. LIMITATION animal study CONCLUSIONS/IMPLICATIONS Laser treatment increased surface roughness without compromising fracture resistance. Despite increasing surface roughness, laser treatment did not improve BIC. Overall, it appears that medical grade SS has the potential to be substituted for titanium alloy MSIs.
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Affiliation(s)
- He-Kyong Kang
- Department of Orthodontics, University of Detroit Mercy School of Dentistry, MI, Department of Orthodontics and Oral Facial Genetics
| | - Tien-Min Chu
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN
| | - Paul Dechow
- Department of Biomedical Sciences, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, TX
| | - Kelton Stewart
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN, USA, and
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyung-Pook National University, Daegu, Korea
| | - Sean Shih-Yao Liu
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN, USA, and
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Wang Y, Zhang Y, Miron RJ. Health, Maintenance, and Recovery of Soft Tissues around Implants. Clin Implant Dent Relat Res 2015; 18:618-34. [PMID: 25873299 DOI: 10.1111/cid.12343] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. PURPOSE To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. MATERIALS AND METHODS Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. RESULTS The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. CONCLUSION Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants.
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Affiliation(s)
- Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Richard J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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The utilization of a diode laser in the surgical treatment of peri-implantitis. A randomized clinical trial. Clin Oral Investig 2015; 19:1851-60. [PMID: 25623382 DOI: 10.1007/s00784-014-1397-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES A comparison of different treatment modalities of peri-implantitis can lead to the development and application of more effective and efficient methods of therapy in clinical practice. This study compares the effectiveness of open flap debridement used alone, with an approach employing the additional use of a diode laser for the treatment of peri-implantitis. MATERIALS AND METHODS Nineteen patients were divided into two groups and treated for peri-implantitis. In the control group (C group), the therapy utilized access flaps, plastic curettes, and sterilized gauzes soaked in saline. The test group (L group) was treated similarly but with additional irradiation using a diode laser. The parameters studied were pocket depth (PD) as the primary outcome variable, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI) as secondary variables. Measurements were performed at three different time points, baseline (BSL), 3 months, and 6 months after treatment. Three months after treatment, a mean PD reduction of 1.19 mm for the control group and 1.38 mm for the laser group was recorded. The corresponding BOP changes were 72.9 and 66.7%, respectively. These changes were significant and remained at the same levels at the 6-month examination (p < 0.05). CAL was reduced significantly only in group L from 5.25 mm at baseline to 4.54 mm at 3 months, remaining at this level at 6 months (p < 0.05). PI was reduced significantly in group C at 3 months from 37.5 to 6.3%. The 6-month data showed no statistically significant difference (p < 0.05) from the 3-month measurements. RESULTS The two methods of therapy for peri-implantitis examined seemed to be equally efficient in the reduction of the PD and BOP 3 months after surgery, with the results sustained at the same levels after 6 months. CAL significantly improved only in the test group after 3 months. PI was reduced and maintained at low levels in both groups. CONCLUSIONS Surgical treatment of peri-implantitis by access flaps leads to improvement of all clinical parameters studied while the additional use of diode laser does not seem to have an extra beneficiary effect. CLINICAL RELEVANCE The additional use of a diode laser in the surgical treatment of peri-implantitis offers a limited clinical benefit.
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Romanos GE, Javed F, Delgado-Ruiz RA, Calvo-Guirado JL. Peri-implant diseases: a review of treatment interventions. Dent Clin North Am 2014; 59:157-78. [PMID: 25434564 DOI: 10.1016/j.cden.2014.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The ideal management of peri-implant diseases focuses on infection control, detoxification of implant surfaces, regeneration of lost tissues, and plaque-control regimens via mechanical debridement (with or without raising a surgical flap). However, a variety of other therapeutic modalities also have been proposed for the management of peri-implantitis. These treatment strategies encompass use of antiseptics and/or antibiotics, laser therapy, guided bone regeneration, and photodynamic therapy. The aim of this article was to review indexed literature with reference to the various therapeutic interventions proposed for the management of peri-implant diseases.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA.
| | - Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Derriyah, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, 1103 Westchester Hall, Stony Brook, NY 11794-8712, USA
| | - José Luis Calvo-Guirado
- Faculty of Medicine and Dentistry, Hospital Morales Meseguer, University of Murcia, 2° Planta Clínica Odontológica Calle Marques de los Velez S/n, Murcia 30007, Spain
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Different laser wavelengths comparison in the second-stage implant surgery: an ex vivo study. Lasers Med Sci 2014; 30:1631-9. [PMID: 24989333 DOI: 10.1007/s10103-014-1623-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022]
Abstract
The implant surgery consists of two distinct techniques, the transmucosal, also known as "one-stage" and the "two-stage" technique. Lasers represent a possible aid in implant dentistry, especially in the two-stage technique and its main characteristics are represented by a decreased trauma to bone and soft tissues, a reduction of pain as well as a reduction of the risk of postoperative infections. The aim of this study was to analyze in an animal model the thermal elevation induced by four different laser wavelengths (diode, Nd:YAG, Er:YAG, KTP) during the implant uncovering. Four pig jaws were used to carry out this study. Five implants were placed in each anatomical specimen for a total of 20 fixtures. Four wavelengths (532, 810, 1,064 and 2,940 nm) were used to uncover the implants. Two thermocouples were used to measure temperature changes during laser irradiation at bone level, peri-implant tissues and on the fixture surface The thermocouples were connected with two probes of 1.5 mm in diameter, in order to simultaneously recording two temperature variations. Surface temperature was also checked during all procedures with a thermal camera (Thermovision A 800, Flyr Systems, Stockolm, Sweden) connected to a PC. The mean temperatures of each specimen (five fixtures) were calculated (TM1, mean temperature at the beginning; TM2, mean peak temperature). Furthermore, a record of the temperature at 1 min after the end of the surgical procedure was taken (mean: TM3). All the recorded values were statistically evaluated by one-way analysis of variance (ANOVA). The thermocouples recorded a lower increase in temperature for Er:YAG and KTP laser; Nd:YAG and diode laser produced similar increases characterized by higher values. The thermo-camera pointed out the lower increase for Er:YAG and higher for diode laser. KTP laser resulted faster in uncovering implants and diode laser was the one that needed more time. This ex vivo study showed that laser utilization with the recommended parameters gives no risks of dangerous thermal elevation to the tissues and implants.
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El-Kholey K. Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study. Int J Oral Maxillofac Surg 2014; 43:633-8. [DOI: 10.1016/j.ijom.2013.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 09/17/2013] [Accepted: 10/02/2013] [Indexed: 11/26/2022]
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Roncati M, Lucchese A, Carinci F. Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser. J Indian Soc Periodontol 2014; 17:812-5. [PMID: 24554897 PMCID: PMC3917217 DOI: 10.4103/0972-124x.124531] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 07/18/2013] [Indexed: 11/21/2022] Open
Abstract
An 810-nm diode laser was used to non-surgically treat a 7-mm pocket around an implant that had five threads of bone loss, BoP+, and exudate, and the patient was followed up for 5 years. Non-surgical treatment, home care reinforcement, clinical indices records, and radiographic examination were completed in two consecutive 1-h appointments within 24 h. The patient was monitored frequently for the first 3 months. Subsequently, maintenance debridement visits were scheduled at 3-month intervals. The patient had a decreased probing pocket depth and a negative BoP index compared to initial clinical data, and the results were stable after 1 year. After 5 years of follow-up visits, there appeared to be rebound of the bone level radiographically. Within the limits of this case report, conventional non-surgical periodontal therapy with the adjunctive use of an 810-nm diode laser may be a feasible alternative approach for the management of peri-implantitis. The 5-year clinical and radiographic outcomes indicated maintenance of the clinical improvement.
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Affiliation(s)
- Marisa Roncati
- Department of Specialistic and Odontostomatologic Clinical Sciences, School for Dental Hygienists, Polytechnic University of Marche, Ancona, Italy
| | - Alessandra Lucchese
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Mailoa J, Lin GH, Chan HL, MacEachern M, Wang HL. Clinical outcomes of using lasers for peri-implantitis surface detoxification: a systematic review and meta-analysis. J Periodontol 2014; 85:1194-202. [PMID: 24476547 DOI: 10.1902/jop.2014.130620] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
UNLABELLED The aim of this systematic review is to compare the clinical outcomes of lasers with other commonly applied detoxification methods for treating peri-implantitis. An electronic search of four databases and a hand search of peer-reviewed journals for relevant articles were conducted. Comparative human clinical trials and case series with ≥ 6 months of follow-up in ≥ 10 patients with peri-implantitis treated with lasers were included. Additionally, animal studies applying lasers for treating peri-implantitis were also included. The included studies had to report probing depth (PD) reduction after the therapy. RESULTS Seven human prospective clinical trials and two animal studies were included. In four and three human studies, lasers were accompanied with surgical and non-surgical treatments, respectively. The meta-analyses showed an overall weighted mean difference of 0.00 mm (95% confidence interval = -0.18 to 0.19 mm) PD reduction between the laser and conventional treatment groups (P = 0.98) for non-surgical intervention. In animal studies, laser-treated rough-surface implants had a higher percentage of bone-to-implant contact than smooth-surface implants. In a short-term follow-up, lasers resulted in similar PD reduction when compared with conventional implant surface decontamination methods.
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Affiliation(s)
- James Mailoa
- Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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