Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 05 May 2020

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial

BDS, MDS,
BDS, MSc, PhD,
BDS, MDS,
MDS, PhD,
PhD, and
BDS, DScD
Page Range: 526 – 531
DOI: 10.1563/aaid-joi-D-19-00367
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We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

Figure 1.
Figure 1.

Patient allocation according to the CONSORT guidelines. MD indicates mechanical debridement; LLLT, low-level laser therapy.


Figure 2.
Figure 2.

Comparison of peri-implant plaque index (dark grey bars) and bleeding upon probing (light grey bars) among patients with peri-implantitis who underwent mechanical debridement with and without adjunct low-level laser therapy. *Compared with plaque index at the 3-month follow-up (P < .05); †Compared with bleeding upon probing at the 3-month follow-up (P < .05). ‡Compared with plaque index at the 3-month (P < .05) and 6-month (P < .05) follow-ups. §Compared with bleeding upon probing at the 3-month (P < .05) and 6-month (P < .05) follow-ups. ‖Compared with patients who underwent mechanical debridement with adjunct low-level laser therapy at the 3-month follow-up (P < .05). ¶Compared with patients who underwent mechanical debridement with adjunct low-level laser therapy at the 6-month follow-up (P < .05). MD indicates mechanical debridement; LLLT, low-level laser therapy.


Figure 3.
Figure 3.

Comparison of peri-implant probing depth (dark grey bars) and crestal bone resorption (light grey bars) among patients with peri-implantitis who underwent mechanical debridement with and without adjunct low-level laser therapy. *Compared with probing depth at the 3-months follow-up (P < .05). †Compared with probing depth at the 3-month (P < .05) and 6-month (P < .05) follow-ups. ‡Compared with patients who underwent mechanical debridement with adjunct low-level laser therapy at the 3-month follow-up (P < .05). MD indicates mechanical debridement; LLLT, low-level laser therapy.


Contributor Notes

Corresponding author, e-mail: implantologist@yahoo.com
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