Decontamination of Anodized Implant Surface With Different Modalities for Peri-Implantitis Treatment: Lasers and Mechanical Debridement With Citric Acid.

Background: Although oral rehabilitation with dental implants is a very promising and effective procedure, peri-implantitis is an emerging concern. Surgical and non-surgical methods have been applied to treat peri-implantitis together with various implant surface decontamination methods. However, there is no consensus concerning the most effective treatment for peri-implantitis. The aim of the present study is to evaluate the effects of erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser, photodynamic therapy (PDT), and titanium bur with and without citric acid on ligature-induced peri-implantitis around an anodized implant surface.

Methods: Thirty dental implants with anodized surface (3.3 × 10 mm) were installed in the mandibles of five beagle dogs. After 3 months, peri-implantitis was induced by applying cotton ligatures subgingivally. After ligature removal (baseline), the implants were divided into the following treatment groups: 1) Er:YAG laser, 2) PDT, 3) titanium bur alone, and 4) titanium bur with citric acid. Animals were sacrificed after 3 months, and clinical, radiologic, histologic, and histomorphometric evaluations were conducted for all treatment modalities. The data were analyzed using one-way analysis of variance and Tukey test. A value of P <0.05 was considered statistically significant.

Results: The titanium bur with citric acid group exhibited statistically significantly greater improvement in vertical bone height than the Er:YAG laser group and significantly better bone-to-implant contact than the PDT group and the bur-alone group.

Conclusion: Within the limits of the study, the combination of mechanical and chemical treatment proved to be the most effective treatment for disinfection of the anodized implant surface.