Use of Er: YAG laser to decontaminate infected dental implant surface in preparation for reestablishment of bone-to-implant contact

The prevalence of peri-implantitis is of concern to all clinicians participating in implant dentistry. Peri-implant inflammation results in the loss of supporting bone for the implant that may or may not be accompanied by bleeding on probing and suppuration. Early diagnosis and intervention are mandated, but there is a paucity of evidence leading to the most effective therapy. There is agreement that one of the challenges in surgically treating peri-implant defects is the process of cleaning and decontaminating the implant surface, which may be contaminated by bacterial aggregates. This preclinical canine study investigates the erbium:yttrium-aluminum-garnet laser to decontaminate the complex rough surface of the implant by stripping the contaminated oxide layer for induction of hard and soft tissue adaptation to a compromised or failing implant. The results provide evidence of new bone-to-implant contact established at a level representative of the size of the defects. The soft tissues contain little or no evidence of inflammation, which can be interpreted as an arrest of the disease progression process. The results can be translated to a treatment goal of stabilizing the prognosis of an implant that has been compromised.