Peri-implantitis surface decontamination: which method?
One of the often cited complications of dental implants, which may lead to loss of the implant in the long term, is peri-implantitis. Peri-implantitis has been defined as an inflammatory lesion of the tissues surrounding the implant subjected to functional loading, with a loss of supporting bone. Two popular physical decontamination methods used to treat/prevent peri-implantitis, are the mechanical removal of biofilm from the implant surface using curettes or decontamination using a Laser. Laser decontamination is based on its thermal effect, which denatures proteins and causes cellular necrosis.
But which method produces better results? A recent study assessed the long-term outcomes (>4 years) following combined surgical resective/regenerative therapy of advanced peri-implantitis lesions using either (i) an Er:YAG laser (ERL) or (ii) plastic curettes + cotton pellets + sterile saline (CPS).
The conclusion:
1\. J Clin Periodontol. 2017 Mar;44(3):337-342. [Combined surgical therapy of advanced peri-implantitis evaluating two methods of surface decontamination: a 7-year follow-up observation](https://www.ncbi.nlm.nih.gov/pubmed/28101947) Schwarz F et al.At 7 years, both ERL and CPS were associated with similar mean bleeding on probing reductions (CPS: 89.99 ± 11.65% versus ERL: 86.66 ± 18.26%) and clinical attachment level gains (CPS: 2.76 ± 1.92 mm versus ERL: 2.06 ± 2.52 mm). Combined surgical resective/regenerative therapy of advanced peri-implantitis was effective on the long-term, but not influenced by the initial method of surface decontamination.1