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A randomized clinical trial of an adjunct diode laser application for the nonsurgical treatment of peri-implantitis.

ABSTRACT: In this radiographic and microbiologic split-mouth clinical trial, efficacy of a diode laser as an adjunct to conventional scaling in the nonsurgical treatment of peri-implantitis was investigated.Eradication of pathogenic bacteria and infected sulcular epithelium presents a significant challenge in the nonsurgical treatment of peri-implantitis.Ten patients (mean age, 55.1 years; SD, 11.4) with 48 two piece, rough-surface implants and diagnosed with peri-implantitis were recruited (NCT02362854). In addition to conventional scaling and debridement (control group), crevicular sulci and the corresponding surfaces of 24 random implants were lased by a diode laser running at 1.0?W power at the pulsed mode (?, 810?nm; energy density, 3?J/cm(2); time, 1?min; power density, 400?mW/cm2; energy, 1.5 J; and spot diameter, 1?mm); (laser group). Healing was assessed via periodontal indexes (baseline and after 1 and 6 months after the intervention), microbiologic specimens (baseline and after 1 month), and radiographs (baseline and after 6 months).Baseline mean pocket depths (4.71, SD, 0.67; and 4.38, SD 0.42?mm) and marginal bone loss (2.71, SD 0.11; and 2.88, SD 0.18?mm) were similar (p?=?0.09 and p?=?0.12) between the control and laser groups, respectively. After 6 months, the laser group revealed higher marginal bone loss (2.79, SD 0.48) than the control groups (2.63, SD 0.53) (p?

SUBMITTER: Ar?san V

PROVIDER: S-EPMC4649765 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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A randomized clinical trial of an adjunct diode laser application for the nonsurgical treatment of peri-implantitis.

Arısan Volkan V Karabuda Zihni Cüneyt ZC Arıcı Selahattin Volkan SV Topçuoğlu Nursen N Külekçi Güven G

Photomedicine and laser surgery 20150918 11

<h4>Objective</h4>In this radiographic and microbiologic split-mouth clinical trial, efficacy of a diode laser as an adjunct to conventional scaling in the nonsurgical treatment of peri-implantitis was investigated.<h4>Background data</h4>Eradication of pathogenic bacteria and infected sulcular epithelium presents a significant challenge in the nonsurgical treatment of peri-implantitis.<h4>Materials and methods</h4>Ten patients (mean age, 55.1 years; SD, 11.4) with 48 two piece, rough-surface im ...[more]

PMID: 26382562

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Project description:BackgroundMicrobial biofilm accumulation is the main cause of peri-implantitis. The majority of surgical peri-implantitis treatment protocols suggests adjunctive use of systemic antibiotics to target specific putative bacteria. The aim of this systematic review was to critically evaluate the adjunctive use of systemically administered antibiotics in surgical treatment of peri-implantitis by reviewing previously published systematic reviews and primary studies.MethodsA systematic literature search was conducted in four electronic databases (MEDLINE, The Cochrane Library, EMBASE, and Web of Science) for randomised controlled trials, cohort studies, case-control studies, and systematic reviews reporting surgical treatment of peri-implantitis with and without adjunctive systemically administered antibiotic therapy. The included systematic reviews and primary studies were qualitatively assessed using AMSTAR and GRADE, respectively. No restrictions were set for date of publication, journal, or language.ResultsThe literature search identified 681 papers. Only seven systematic reviews and two primary studies met the inclusion criteria. Four out of seven included systematic reviews concluded that no evidence exists for use of systemic antibiotics to improve the clinical outcomes in surgical treatment of peri-implantitis. One review did not estimate the level of evidence, one did not clearly state any beneficial effect, whereas one reported a limited adjunctive effect. Further, the two included primary studies did not show a long-term significant benefit of adjunctive use of systemically administrated antibiotics. However, one study reported a short-term adjunctive effect in patients with modified surface implants. Due to heterogeneity in study design, low number of included primary studies, and grade of bias, no meta-analysis was performed.ConclusionThe use of systemically administered antibiotics as an adjunct to surgical interventions of peri-implantitis cannot be justified as a part of a standard treatment protocol. A pervasive problem is the lack of uniform diagnosis criteria for peri-implantitis, deficient information about patient characteristics, absence of high quality long-term randomised controlled trials, and authors' declaration on conflict of interest.

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A randomized clinical trial of an adjunct diode laser application for the nonsurgical treatment of peri-implantitis.

Publications

A randomized clinical trial of an adjunct diode laser application for the nonsurgical treatment of peri-implantitis.

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