Peri-implant diseases: a review of treatment interventions

Evaluation of Temperature and Roughness Alteration of Diode Laser Irradiation of Zirconia and Titanium for Peri-Implantitis Treatment

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.

Current concepts in the use of lasers in periodontal and implant dentistry

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.

Can Periimplantitis Be Treated?

Over the past few decades, dental implants have been found to have high predictability and survival rates because of improvements in knowledge, clinical expertise, and implant designs. As such, dental implants are frequently integrated in the clinical management of fully or partially edentulous patients. It is prudent to realize that despite the high early survival rates, dental implants do have their fair share of long-term esthetic, biological, and mechanical complications. Therefore, this paper aims to review the current evidence on the management of peri-implant diseases in an attempt to answer the following question: Can periimplantitis be treated?

Role of antimicrobial photodynamic therapy in the treatment of aggressive periodontitis: A systematic review

BACKGROUND

The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the treatment of aggressive periodontitis (AgP).

METHODS

The addressed focused question was "Is aPDT effective in the treatment of AgP?" MEDLINE/PubMed, EMBASE, Scopus, ISI Web of knowledge and Google-Scholar databases were searched from 1977 till May 2015 using combinations of the following keywords: antimicrobial; photochemotherapy; photodynamic therapy; photosensitizing agents; AgP; scaling and root-planing (SRP). Reviews, case reports, commentaries, and articles published in languages other than English were excluded.

RESULTS

Seven studies were included. In 5 studies, aPDT was performed as an adjunct to SRP. Laserwavelengths and duration of irradiation ranged between 660-690 nm and 60-120 s, respectively. Laser power output as reported in 2 studies was 75 mW. One study showed significant improvement in periodontal parameters for subjects receiving aPDT as an adjunct to SRP as compared to treatment with SRP alone at follow up. However, comparable periodontal parameters were reported when aPDT as an adjunct to SRP was compared to SRP alone in the treatment of AgP in one study. One study showed comparable outcomes when aPDT was compared to SRP in the treatment of AgP. In two studies, adjunctive antibiotic administration to SRP showed significantly better outcomes when compared to application of adjunctive use of aPDT to SRP.

CONCLUSION

aPDT is effective as an adjunct to SRP for the management of AgP, however, further randomized clinical trials with well defined control groups are needed in this regard.

Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report

The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.