Aslan Y. Gökbuget: Treatment of Peri-implantitis with Er:YAG and Nd:YAG Combinations
Peri-implantitis is defined as an inflammatory reaction with loss of supporting bone around the implant (Albrektsson & Isidor 1994). The frequency of peri-implantitis has been reported in the range of 5–8% for selected implant systems (Berglundh et al. 2002). Similar figures are reported in a recent long-term follow-up study (Roos-Jansaaker et al. 2006a). More recently (Marrone et al. 2012): 37% of the subjects and 23% of implants.
Different regenerative therapies have been tried to resolve peri-implantitis (for a review, see Roos-Jansaker et al. 2003, Schou et al. 2004 and Schwarz et al. 2012). The concept of submerged healing was earlier reported as a treatment option for periodontally involved teeth. Laser-supported peri-implantitis therapy became an adjunct therapy for controlling the disease activity (Er:YAG and Nd:YAG Lasers). One of the important things to consider is that in order to use a laser beam effectively, we need to understand the interaction between the laser beam and the periodontal tissues. Variable parameters affecting absorption include the wavelength/form, power, pulse duration, energy density, angulation, pigmentation, water and mineral content, heat capacity and tissue density.
The best treatment option for managing peri-implantitis is an Er:YAG and Nd:YAG combination therapy. It is possible to eradicate granulation tissues and perform implant surface decontamination with Er:YAG, and do bacterial decontamination with the Nd:YAG laser. This combination enables regenerative osseous surgery around implants with no complications and with high patient and clinician satisfaction and confidence.
There is a need for evidence-based studies. Randomized, blinded, controlled and longitudinal, clinical trials are essential to achieve reliable evidence.
