Use of Er:YAG Laser to Decontaminate Infected Dental Implant Surface in Preparation for Reestablishment of Bone-to-Implant Contact

The prevalence of peri-implantitis is of concern to all clinicians participating in implant dentistry. Peri-implant inflammation results in the loss of supporting bone for the implant that may or may not be accompanied by bleeding on probing and suppuration. Early diagnosis and intervention are mandated, but there is a paucity of evidence leading to the most effective therapy. There is agreement that one of the challenges in surgically treating peri-implant defects is the process of cleaning and decontaminating the implant surface, which may be contaminated by bacterial aggregates. This preclinical canine study investigates the erbium:yttrium-aluminum-garnet laser to decontaminate the complex rough surface of the implant by stripping the contaminated oxide layer for induction of hard and soft tissue adaptation to a compromised or failing implant. The results provide evidence of new bone-to-implant contact established at a level representative of the size of the defects. The soft tissues contain little or no evidence of inflammation, which can be interpreted as an arrest of the disease progression process. The results can be translated to a treatment goal of stabilizing the prognosis of an implant that has been compromised. (Int J Periodontics Restorative Dent 2014;34:461–466. doi: 10.11607/prd.2192)

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Treatment of Peri-implantitis Around TiUnite-Surface Implants Using Er:YAG Laser Microexplosions

Implant therapy can lead to peri-implantitis, and none of the methods used to treat this inflammatory response have been predictably effective. It is nearly impossible to treat infected surfaces such as TiUnite (a titanium oxide layer) that promote osteoinduction, but finding an effective way to do so is essential. Experiments were conducted to determine the optimum irradiation power for stripping away the contaminated titanium oxide layer with Er:YAG laser irradiation, the degree of implant heating as a result of Er:YAG laser irradiation, and whether osseointegration was possible after Er:YAG laser microexplosions were used to strip a layer from the surface of implants placed in beagle dogs. The Er:YAG laser was effective at removing an even layer of titanium oxide, and the use of water spray limited heating of the irradiated implant, thus protecting the surrounding bone tissue from heat damage. Peri-implantitis can be effectively treated using Er:YAG laser irradiation. (Int J Periodontics Restorative Dent 2013;33:21–29. doi: 10.11607/prd.1593)

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Innovative Regeneration Technology to Solve Peri-implantitis by Er:YAG Laser Based on the Microbiologic Diagnosis:
A Case Series

Peri-implantitis is an emerging problem, and corrective therapy requires a method for decontaminating the complex surface structure of the implant body and sterilizing the surrounding tissue. The erbium:yttrium-aluminum-garnet (Er:YAG) laser has proven to effectively allow tissue to regenerate when used for peri-implantitis. The power of the Er:YAG laser is absorbed by a water molecule; therefore, its target neither rises in temperature nor carbonizes. An antibacterial remedy based on the bacteriologic diagnosis, followed by debridement and sterilization of the implant surface and peri-implant tissues by Er:YAG laser is efficacious for periimplantitis treatment. The aim of this report was to present the effectiveness of the Er:YAG laser for peri-implant bone regeneration. This case series of two patients showed that antibiotic therapy reduced the bacterial amount from the periimplantitis sites significantly and that Er:YAG laser therapy, along with the bone augmentation, enhanced bone regeneration in the peri-implant bony defects. (Int J Periodontics Restorative Dent 2015;35:67–73. doi: 10.11607/prd.2116)

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