Carbon dioxide laser and hydrogen peroxide conditioning in the treatment of periimplantitis: an experimental study in the dog.

Background: Various methods have been applied for the treatment of periimplantitis lesions. It has been reported that the procedures used have been effective in eliminating the inflammatory lesion but that re-osseointegration to the once-contaminated implant surface has been difficult or impossible to achieve.

Purpose: The aim of this study was to examine the use of carbon dioxide (CO2) laser in combination with hydrogen peroxide in the treatment of experimentally induced periimplantitis lesions.

Materials And Methods: Three dental implants (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland) were placed in each side of the edentulous mandible of four beagle dogs. Implants with a turned surface and implants with a sand-blasted large-grit acid-etched (SLA) surface (SLA, Straumann AG, Waldenburg, Switzerland) were used. Experimental periimplantitis was induced during 3 months. Five weeks later each animal received tablets of amoxicillin and metronidazole for a period of 17 days. Three days after the start of the antibiotic treatment, full-thickness flaps were elevated, and the granulation tissue in the bone craters was removed. In the two anterior implant sites in both sides of the mandible, a combination of CO2 laser therapy and application of a water solution of hydrogen peroxide was used. The implant in the posterior site of each quadrant was cleaned with cotton pellets soaked in saline. Biopsy specimens were obtained 6 months later.

Results: The amount of re-osseointegration was 21% and 82% at laser-treated turned-surface implants and SLA implants, respectively, and 22% and 84% at saline-treated turned-surface implants and SLA implants, respectively.

Conclusions: The present study demonstrated the following: (1) a combination of systemic antibiotics and local curettage and debridement resulted in the resolution of experimentally induced periimplantitis lesions; (2) at implants with a turned surface, a small amount of re-osseointegration was observed at the base of the bone defects whereas a considerable amount of re-osseointegration occurred at implants with an SLA surface; and (3) the use of CO2 laser and hydrogen peroxide during surgical therapy had no apparent effect on bone formation and re-osseointegration.