Although the long-term success of dental implants is relatively high and their function and utility have been widely documented, peri-implant diseases, including peri-implant mucositis and peri-implantitis, are common and can prove to be a clinical conundrum for practitioners. Laser, which is an acronym for “light amplification through stimulation of emission radiation”, therapy may be one of the therapeutic approaches to treat peri-implant disease as an adjunct to nonsurgical or surgical periodontal therapy.18 Commercially available lasers that have been used for implant surface disinfection include: carbon dioxide (CO2), diode, erbium yttrium aluminum garnet (Er:YAG), and neodymium yttrium aluminum garnet (Nd:YAG).18,102-104 Each laser generally has a fixed wavelength that determined the properties of the laser beam and its effects on tissues, materials, and microbes (Figure 4). For example, certain laser types are utilized and designed to target certain substances or tissues, known as chromophores.104 These may include: water, blood, pigmentation, cell types, collagen, bone, minerals, and/or bacteria (Table 1).
|Diode||450-1064 nm||Melanin, hemoglobin||Hot; soft tissue|
|Neodymium yttrium aluminum garnet (Nd:YAG)||1064 nm||Melanin, hemoglobin||Hot; soft tissue|
|Erbium yttrium aluminium garnet (Er:YAG)||2940 nm||Water, hydroxyapatite||Cold; hard or all tissue|
|Carbon dioxide (CO2)||9300 to 10,600 nm/td>||Water, hydroxyapatite||Hot or cold; soft or all tissue|
Positive treatment outcomes have been recorded in many investigations of laser therapy for peri-implant diseases, confounding risk factors, short follow up periods, and lack of homogeneity and/or transparency in the laser therapy protocols may not allow generalizability of the current data. Current evidence also demonstrates inconsistent data regarding laser reduction of bacterial loads on tooth surfaces beyond that achieved with nonsurgical periodontal therapy alone.105,106 While further controlled, long-term studies are necessary to determine the overall efficacy of laser therapy in the treatment of peri-implant diseases, there is data regarding the short-term benefit of laser therapy.15,16