Overview

The placement of endosseous dental implants is a well-accepted treatment option for edentulism as implants have demonstrated high survival rates over long periods of time.1 While dental implant survival rates remain high, reports indicate that a significant proportion of dental implants, a mean of 43% and 22%, will develop peri-implant mucositis and peri-implantitis, respectively.2-5 There are several risk factors that can lead to inflammation, peri-implant mucositis, and, later, peri-implantitis.3,6-8 Systemic and environmental factors may play a secondary role in disease progression and susceptibility, but peri-implant diseases are initiated by accumulation of bacterial biofilm.3,9,10 As bacterial plaque is the primary etiology for peri-implant disease, current therapies for peri-implantitis focus upon dental plaque removal and implant surface detoxification as a critical step to surgical and/or nonsurgical treatment of peri-implantitis.11,12 This surface detoxification has been accomplished with physical, chemical, and/or other means, including laser therapy. A variety of laser types have been used for implant surface detoxification including: Er:YAG, Nd;YAG, carbon dioxide, diode lasers, and photodynamic therapy.11,13,14 As of yet, there are no definitive data on superiority of laser type or treatment modality in conjunction with either surgical or nonsurgical therapy.15-17

Additionally, a recent consensus statement from the American Academy of Periodontology confirmed evidence for limited, short-term benefits to adjunctive laser use for peri-implant lesions, but no current definitive evidence regarding the long-term efficacy of this type of therapy.18 At present, there is insufficient evidence for the use of lasers of any type used as a monotherapy for the surgical or nonsurgical treatment of peri-implantitis.18,19 As the number of endosseous dental implants placed continues to increase, the cumulative incidence of peri-implantitis is also increasing. This course seeks to evaluate the use of laser therapy as an adjunctive means of implant surface detoxification in conjunction with surgical and non-surgical therapies.

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