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Laser Management of Peri-Implantitis: A Comparison between Photodynamic Therapy Combined with Hydrogen Peroxide (OHLLT) and OHLLT + Er:YAG Laser. A Retrospective Controlled Study
Applied Sciences ( IF 2.5 ) Pub Date : 2021-07-23 , DOI: 10.3390/app11156771
Gianluigi Caccianiga , Gérard Rey , Paolo Caccianiga , Alessandro Leonida , Marco Baldoni , Alessandro Baldoni , Saverio Ceraulo

In peri-implantitis, treatment lasers are effectively used to enhance implant surfaces’ decontamination of bacteria. The type of lasers commonly used and tested in dentistry are Nd:YAG, Er:YAG and diodes. The Er:YAG laser is considered to be effective in removing biofilm from implant surfaces. Photodynamic therapy (PDT), realized with low-level laser therapy (LLLT) and a photosensitizer, seems to have limited efficacy in peri-implantitis management, while diode lasers used with high frequency and power (Wiser, Doctor Smile), performed with hydrogen peroxide 10 vol. 3% (OHLLT), seems to lead to a deep sanitization of implant surfaces, without any thermal effect. The aim of our retrospective controlled study is to compare an oxygen high-level laser therapy (OHLLT) protocol with OHLLT with an Er:YAG laser (Pluser, Doctor Smile) in order to maximize bacterial removal and to evaluate if an Er:YAG laser could improve hard tissue regeneration with respect to OHLLT alone. Two hundred and ten implants affected by peri-implantitis were divided into two groups: 88 implants were treated with OHLLT alone (control group) while 122 underwent OHLLT and Er:YAG treatment (test group). Mean bone loss before (T0) and after treatment (T1) (with a follow-up of 5 years) was registered for all implants. The collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 11.5. No statistically significant differences were found. In the OHLLT group, we noticed a mean bone loss after treatment of 2.1 mm in the upper arch and 2.4 mm in the mandible. In the OHLLT + Er:YAG group, the results indicate a mean bone loss of 2.0 mm in the upper arch and 2.5 mm in the mandible. Both groups showed a mean bone loss after treatment of 2.3 mm. According to the Kolmogorov–Smirnov test, overall, data followed a normal distribution (value of the K-S test statistic = 0.0912; p = 0.36112). OHLLT plays a central role in enhancing clinical results in peri-implantitis treatment, leading to an effective bacterial decontamination. Our results showed no statistically significant differences between OHLLT and OHLLT + Er:YAG laser; thus, the potential advantageous role of Er:YAG has been downgraded with the analysis of our study.

中文翻译:

种植体周围炎的激光治疗:光动力疗法联合过氧化氢 (OHLLT) 和 OHLLT + Er:YAG 激光的比较。一项回顾性对照研究

在种植体周围炎中,治疗激光有效地用于增强种植体表面的细菌净化。牙科中常用和测试的激光器类型有 Nd:YAG、Er:YAG 和二极管。Er:YAG 激光被认为可有效去除种植体表面的生物膜。使用低强度激光治疗 (LLLT) 和光敏剂实现的光动力治疗 (PDT) 在种植体周围炎管理中似乎效果有限,而使用高频和高功率的二极管激光 (Wiser, Doctor Smile),使用氢气进行治疗过氧化物 10 卷 3% (OHLLT),似乎可以对种植体表面进行深度消毒,而没有任何热效应。我们回顾性对照研究的目的是比较氧高强度激光治疗 (OHLLT) 方案与 OHLLT 和 Er:YAG 激光(Pluser,微笑医生)以最大限度地去除细菌并评估 Er:YAG 激光是否可以改善单独 OHLLT 的硬组织再生。受种植体周围炎影响的 210 个种植体分为两组:88 个种植体接受单独 OHLLT 治疗(对照组),122 个接受 OHLLT 和 Er:YAG 治疗(试验组)。之前的平均骨质流失 (T0 ) 和治疗后 (T 1 )(随访 5 年)对所有种植体进行登记。收集的数据使用社会科学统计包 (SPSS) 11.5 版进行分析。没有发现统计学上的显着差异。在 OHLLT 组中,我们注意到治疗后上牙弓平均骨质流失 2.1 毫米,下颌骨平均骨质流失 2.4 毫米。在 OHLLT + Er:YAG 组中,结果表明上牙弓平均骨质流失 2.0 毫米,下颌骨平均骨质流失 2.5 毫米。两组均在治疗 2.3 毫米后表现出平均骨质流失。根据 Kolmogorov–Smirnov 检验,总体而言,数据服从正态分布(KS 检验统计值 = 0.0912;p= 0.36112)。OHLLT 在增强种植体周围炎治疗的临床效果方面发挥着核心作用,从而实现有效的细菌净化。我们的结果显示 OHLLT 和 OHLLT + Er:YAG 激光之间没有统计学上的显着差异;因此,根据我们的研究分析,Er:YAG 的潜在优势作用已被降级。
更新日期:2021-07-23
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