Er,Cr:YSGG and Diode Lasers in the Treatment of Peri-implantitis
Peri-Implantitis
About this trial
This is an interventional treatment trial for Peri-Implantitis focused on measuring Peri-implant disease, laser therapy, Er,Cr:YSGG, Diode, MMP-9, TIMP-1
Eligibility Criteria
Inclusion Criteria:
Inflammation in the peri-implant area,
- Probing depth ≥ 3 mm in one or more areas,
- Bleeding with probing with or without suppuration under light forces (0.25 N)
- Patients with bone loss [Patients with bone loss ≥ 2mm identified as peri-implantitis],
- There is no evidence of occlusal overload,
- Implant-supported fixed prosthesis that has been in use for at least 6 months in the mouth and does not interfere with the evaluation of clinical parameters.
Exclusion Criteria:
- Smoking
- Having a systemic disease that may affect the treatment results such as uncontrolled diabetes, metabolic bone diseases, hematological disorders, radiotherapy in the head and neck region, kidney disease,
- Being in pregnancy or breastfeeding period,
- Using antibiotics and / or non-steroidal anti-inflammatory drugs in the last 3 months,
- Steroid and bisphosphonate use,
- To have any dental treatment in the last 3 months,
- Requiring surgical techniques in the treatment of peri-implant disease.
Sites / Locations
- Nazli Zeynep Alpaslan Yayli
Arms of the Study
Arm 1
Arm 2
Arm 3
Placebo Comparator
Active Comparator
Active Comparator
Traditional non-surgical mechanical therapy
Diode laser-assisted non-surgical mechanical therapy
Er, Cr: YSGG laser-assisted non-surgical mechanical therapy
Mechanical instrumentation in all groups continued with titanium Gracey curettes (8mm in diameter, Langer ½, item code: 7103, Kohler Medizintechnik, GmbH & Co, Ltd, Stockach, Germany) until the clinician gently felt that the surface was sufficiently debrided.There is no laser application. The laser tip is placed in the peri-implant sulcus but not activated.
1 week after mechanical debridment, 940 nm diode laser (Ezlase®, Biolase Technology, Inc., San Clemente, CA) has been applied with the aid of a 300 µm diameter optical fiber tip (E3-9 mm) placed approximately 1 mm above the most apical part of the peri implant pocket, parallel to the implant surface. Pocket irrigation was performed with 3% hydrogen peroxide solution for 10 seconds before and after diode laser application.The fiber was moved in apico-coronal and mesial-distal directions for a total of 30 seconds during laser light emission.The laser tip was checked every 7-8 seconds and wiped with sterile saline in order to prevent a possible coagulation or temperature increase.The laser was used in continuous pulse mode, at a power of 0.8 Watt (W), an energy density of 3J / cm2 and a spot diameter of 1 mm. Pulse width and pulse interval were applied as 20 milliseconds.
1 week after mechanical debridment, 2780 nm Er, Cr: YSGG laser (Waterlase®, Biolase Technology, Inc., San Clemente, CA), with 500 µm diameter fiberoptic periodontal tip (RFPT5-14 mm) was applied in short pulse '' H '' mode, water cooled with a non-contact sweeping motion for 30 seconds parallel to the implant surface.The settings used are: 1.5 W power, 30 Hz frequency, 50% water, 40% air, 140 s pulse duration and 1 cm spot size.