laser-assisted regenerative surgical therapy for peri-implantitis

Conditions: Peri-Implantitis

Summary: the purpose of the study is to evaluate if using erbium-doped yttrium aluminium garnet laser, erbium yag laser (er:yag) laser could have adjunctive benefits to the conventional standard mechanical debridement to ablate the infected tissue around the dental implant and detoxify the contaminated implant surface for resolving peri-implant infection and enhance bone regeneration of peri-implant defects.

the purpose of the study is to evaluate if using er:yag laser could have adjunctive benefits to the conventional standard mechanical debridement to ablate the infected tissue around the dental implant and detoxify the contaminated implant surface for resolving peri-implant infection and enhance bone regeneration of peri-implant defects. this study involves one center and a double-blinded randomized controlled clinical trial is planned. twenty-four adult patients in the need of surgical treatment due to peri-implantitis will be included. six visits are needed for each patient including a 24 week follow-up visit. specific aim 1: to compare the clinical benefit of er:yag laser-assisted peri-implant defect debridement and surface detoxification with conventional mechanical debridement for regenerative therapy specific aim 2: to evaluate whether er:yag laser-assisted regenerative surgical therapy can decrease bacterial load and alter microbial profile specific aim 3: to analyze whether er:yag laser-assisted regenerative surgical therapy can impact the molecular profile of the peri-implant crevicular fluid (picf) and the stability of the treatment

Eligibility criteria:
inclusion criteria: * subjects, aged 18 - 85 years * physical status according to the american society of anesthesiologists (asa) i or ii, which includes patients who are systemically healthy or suffer under mild to moderate, but well controlled systemic diseases. * subjects having a minimum of 1 dental implant with peri-implantitis. * dental implants with peri-implantitis ≥ 2 threads exposed (infrabony defect) identified on the radiograph and pocket probing depth (ppd) ≥ 5mm, with bleeding on probing (bop) and/or suppuration (pus) * the implants are in function for at least 6 months * only rough surface implant will be included in this study exclusion criteria: * long-term use of antibiotics \> 2 weeks in the past two months * obvious malpositioning of the dental implants * subjects taking medications known to modify bone metabolism (such as bisphosphonates, corticosteroids, hormone replacement therapy for menopausal women, parathyroid hormone, denosumab, strontium ranelate) * pregnant females or those planning to become pregnant * subjects with a history of major diseases, oral cancer, sepsis or those having adverse outcomes to oral procedures in the past, will be excluded * mobility of dental implants * history of alcoholism or drug abuse * current smokers * diseases of the immune system or any medical condition that may influence the outcome (uncontrolled diabetes (hba1c \>8) * uncontrolled systemic disease or condition known to alter bone metabolism, like osteoporosis, osteopenia, hyperparathyroidism, paget's disease premature exclusion criteria: * the researcher believes that it is not the best interest of the subject to stay in the study * if the subject becomes ineligible to participate based on the exclusion criteria * if the subject's medical condition requires interventions which preclude involvement in the study (radiation therapy, chemotherapy, etc) * if the subject does not follow study related instructions * the study is suspended or canceled.

Keywords: laser