Peri-implant diseases are a significant concern in dental implantology, with a high prevalence among patients with implants. Despite various treatments proposed over the past two decades, there remains a lack of universally accepted and predictable protocols for managing these conditions. Dr. Meizi Eliezer, a first-year graduate student in the Department of Periodontology at Bern University, presents an efficient non-surgical treatment for peri-implant diseases using mechanical therapy combined with adjunctive diode laser application.
Case Study: Miss Kay's Severe Peri-implantitis In July 2015, Miss Kay visited the clinic at Bern University, experiencing severe pain around her dental implants. Upon intraoral examination, significant overgrowth of peri-implant mucosa was observed, along with deep probing depths, severe bleeding on probing, and noticeable bone loss around several implants. These symptoms indicated advanced peri-implantitis, necessitating an effective treatment plan.
Treatment Protocol For the past three years, the periodontology clinic at Bern University has adopted a novel protocol for treating peri-implant diseases. This protocol involves the use of diode laser therapy during the hygienic phase of treatment. The combination of mechanical debridement and diode laser application aims to reduce probing depths, bleeding on probing, and prevent further bone loss.
Steps of the Treatment:
Initial Assessment and Diagnosis:
Comprehensive intraoral examination to assess the extent of peri-implant disease. Radiographic evaluation to determine bone loss around implants. Mechanical Therapy:
Thorough debridement of the peri-implant area to remove plaque and calculus. Diode Laser Application:
Use of diode laser to target and reduce the overgrown peri-implant mucosa. Application of laser therapy aimed at reducing inflammation, disinfecting the implant surface, and promoting tissue healing. Treatment Outcomes The effectiveness of this treatment protocol is evident in the case of Miss Kay. A series of photographs documented the shrinkage process of the overgrown peri-implant mucosa after each diode laser and curettage application. Over a 24-month period, significant improvements were observed:
Reduction in Probing Depths:
Consistent reduction in probing depths indicated successful management of the peri-implant pocket. Decrease in Bleeding on Probing:
Substantial reduction in bleeding on probing, signifying improved tissue health and reduced inflammation. Stability of Peri-implant Mucosa:
Long-term stability of healthy peri-implant mucosa with no signs of further bone loss. These results highlight the potential of diode laser therapy as an adjunctive treatment during the hygienic phase for peri-implant diseases. The stability of the peri-implant tissues after 24 months demonstrates the effectiveness of this non-surgical approach in managing peri-implantitis.
Conclusion The case study presented by Dr. Meizi Eliezer illustrates the promising outcomes of using diode laser therapy in conjunction with mechanical debridement for the non-surgical treatment of peri-implant diseases. The significant reduction in probing depths, bleeding on probing, and stabilization of peri-implant mucosa underscore the efficacy of this treatment protocol.
In conclusion, diode laser therapy should be considered a valuable tool in the hygienic phase for treating peri-implant diseases. Its ability to improve clinical parameters and maintain long-term tissue health offers a viable solution for managing peri-implantitis, thereby enhancing the prognosis for patients with dental implants.