Peri-implantitis: Traditional Versus Laser Treatment

Samuel Low, DDS, MS, MEd
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The dental implant market is experiencing steady growth, with millions of implants being placed each year by dentists in the United States. Unfortunately, peri-implantitis can occur in about one out of 10 implant procedures.

Clearly, it is incumbent upon practitioners to find the safest and most effective methods for managing infected subgingival implant surfaces. Dental lasers offer a minimally invasive therapy that results in less pain and provides an easier recovery.

Lasers eliminate hemorrhaging by sealing or welding blood vessels, increasing visibility and substantially improving the speed and accuracy of the procedure. Laser therapy also encourages wound healing by stimulating mitochondria in cells to produce energy (ATP), allowing the wound to heal more efficiently.

This is a particularly effective alternative to traditional treatments for peri-implantitis. Traditional mechanical debridement for mild to moderate cases is an invasive procedure, and it can be ineffective at removing biofilm inside the threads of the implants due to access. It may also cause significant damage to implant surfaces, leaving them more susceptible to biofilm accumulation and decreasing opportunities for osteo-integration. Despite the oral hygiene prescribed to reduce the chance of infection, the scratched implant surface can become a haven for bacterial growth.

With more advanced cases of peri-implantitis, bone loss and implant failure traditionally require an invasive removal procedure and bone grafting before replacement of the implant. As with any invasive therapy, the patient is subjected to significant pain and a healing period that can take several months, which undermines patient confidence in both the procedure and the provider.

The advantages of laser treatment are clear. Lasers: 

  • Decontaminate the threads of an implant
  • Detoxify bacterial growth on the implant’s surface
  • Avoid opening flap tissue in mild to moderate cases
  • Do not damage implant surfaces
  • Non-invasively remove the diseased granulation tissue surrounding a failing implant. 

As the number of patients requiring implants continues to increase, providers should consider the adoption of the innovative technologies that offer the safest, most effective, and least invasive treatment options to peri-implantitis. 

Dr. Low is the chief dental officer of Biolase Inc. He also serves as Professor Emeritus at the University of Florida College of Dentistry and as an associate faculty member of the Pankey Institute, with 30 years of private practice experience in periodontics, lasers, and implant placement. He is a Diplomate of the American Board of Periodontology and past president of the American Academy of Periodontology as well. He received his DDS and MS degrees from the University of Texas at Houston. He also completed his residency in periodontics at the University of Texas at Houston and received a master of education degree from the University of Florida. He can be reached at slow@dental.ufl.edu.

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