Advancing Peri-Implantitis Treatment: A Scoping Review of Breakthroughs in Implantoplasty and Er:YAG Laser Therapies.

Background: Peri-implantitis represents a significant challenge in dental implantology, characterized by inflammatory reactions around osseointegrated dental implants that lead to progressive alveolar bone loss.

Objectives: To generate a scoping review that evaluates the efficacy of implantoplasty and Er:YAG laser therapies in managing peri-implantitis by synthesizing recent evidence on their impact on key clinical parameters-including probing depth reduction, bleeding on probing improvement, and marginal bone level stabilization-and to explore the potential synergistic benefits of combining these modalities for enhanced treatment outcomes.

Material And Methods: A comprehensive search was conducted in PubMed, EMBASE, the Cochrane Library, and Web of Science for studies published from January 2018 to the present. The search strategy combined Medical Subject Headings (MeSH) and free-text terms with Boolean operators (e.g., "peri-implantitis" AND "implantoplasty" OR "Er:YAG laser"). Eligible studies met the following PICOS criteria: Population-adults diagnosed with peri-implantitis; Intervention- implantoplasty procedures aimed at reducing biofilm retention via mechanical alteration of the implant surface; Comparison-Er:YAG laser treatment for implant decontamination; Outcomes-primary outcomes included changes in probing depth (PD), bleeding on probing (BOP), and marginal bone levels (MBL), while secondary outcomes comprised improvements in soft tissue health and patient-reported outcomes; Study design-randomized controlled trials, cohort studies, and case-control studies with a minimum follow-up of 6 months and at least 10 patients (or 10 implants) per group.

Results: Out of 649 identified articles, 24 studies met the inclusion criteria. In implantoplasty studies, follow-up ranged from 12 to 24 months with groups of 10-20 implants; in Er:YAG laser studies, follow-up ranged from 3 to 12 months with 12-24 patients per group. Both modalities produced significant improvements in PD reduction, BOP reduction, and MBL stabilization. Comparative analysis suggests that while each treatment offers distinct advantages, combining them may further optimize outcomes.

Conclusion: Implantoplasty and Er:YAG laser treatments are promising modalities for managing peri-implantitis. Implantoplasty reduces surface roughness and bacterial retention, whereas Er:YAG laser therapy provides precise decontamination with minimal thermal damage.