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implants - international magazine of oral implantology

Studies have demonstrated that the treatment with an Er:YAG laser has a bactericidal effect.8 Er:YAG laser treatment can debride the implant surface effectively and safely withoutdamaging.31,35 MuchbetterclinicalresultshavebeenreportedforEr:YAGlaser treatment compared with non-surgical mechanical debridement.15,27,31,35 _Aim Theaimofthe(presentstudy)intercontinentalresearchledbySyneronwastoas- sess the clinical outcomes of an open-flap procedure performed with conventional mechanical therapy (CMT) or laser-assisted surgical treatment (LAS) with the novel LiteTouch Er:YAG laser (Syneron Dental Lasers) in patients with implants and a diag- nosis of peri-implantitis. _Materials and methods The design was a single-masked, randomized six-month clinical intervention trial with two groups of patients diagnosed with peri-implantitis. The ethics committees of Cheng Hsin General Hospital, Taipei, Taiwan, and the Faculty of Dental Medicine, Plovdiv Medical University, Bulgaria, approved the study. Written consent was ob- tainedfromallenlistedpatients.Patientswereenrollediftheypresentedwithatleast one dental implant with bone loss of > 3mm around the implant identified on intra- oralradiographs(Fig.1),andwithaPPDof>5mmwithbleedingand/orpusdischarge (Fig. 2) on probing. The study was conducted between September 2010 and August 2011 at the Cheng Hsin General Hospital and Plovdiv Medical University‘s Faculty of DentalMedicine.Thefollowinggeneralcriteriawereusedtoexcludesubjectsfromthe study: _subjects having taken medications likely to cause gingival hyperplasia within one month prior to baseline examination; _subjectsreceivingregularperiodontalmaintenancetreatmentorhavingundergone any sub-gingival cleaning less than twelve months prior to baseline examination; _subjectsreceivedperi-implantitissurgeryofanytypepriortobaselineexamination; _subjects with clinically significant chronic illness (diabetes mellitus, compromised heart condition, rheumatism, joint replacement) requiring antibiotic prophylaxis; _subjectshavingundergonesystemiccancertherapyand/orradiationtherapyatany time; _subjects taking or having taken bisphosphonates; _subjects having taken antimicrobials, steroids or non-steroidal anti-inflammatory drugs within one month prior to baseline examination; _pregnant or lactating women; _subjects engaged in excessive tobacco or alcohol intake or drug abuse. Sixty-eight patients with a total number of 128 implants were included consecu- tively over a period of one year. _Clinical measurements Themeasurementscaleusedinthisstudywasconstructedinordertoobtainquan- titative measurement data: _PPD at four sites per implant (mm); _presence/absence of BOP at the implant (four sites/implant), graded as follows: _no bleeding, (1) point of bleeding, (2) line of blood and (3) drop of blood; _bone loss (in mm on segment radiographs). ThePPDandBoPmeasurementsweretakenusingacolor-codedplasticperiodon- tal probe (Kerr). All clinical measurements were obtained after removing the supra- structures. Intraoral standardized radiographs of sites of interest were obtained at baseline and at six months. Holders were used for standardization purposes. Radi- AD