Is Laser Disinfection an Effective Adjunctive Treatment to Bone Augmentation for Peri-Implantitis? A Review of Current Evidence.

Focused Clinical Question: In patients with endosseous dental implants that demonstrate peri-implantitis, does surgical bone augmentation with adjunctive laser implant surface disinfection have an effect on implant survival rates, and do these rates differ based on laser treatment modality? Clinical Scenario: A 55-year-old female presents 10 years after implant placement at sites #18 and #20 (Fig. 1). She demonstrates a 9-mm probing depth mesially and distally at implant #20. Bleeding on probing is present at all six sites around implant #20. The patient has not noted any discomfort, and suppuration has not been noted on clinical examination. Her medical history is significant for osteoarthritis, gastroesophageal reflux disease, and anxiety. She reports taking ibuprofen as needed for pain, 150 mg ranitidine twice daily, and 20 mg citalopram daily. The patient is concerned about the possibility of implant loss and states that she wants to save and treat the implant, if possible. During flap reflection, a circumferential defect at implant #20 is noted intrasurgically (Fig. 2).