Laser therapy for treatment of periâ implant mucositis and periâ implantitis: An American Academy of Periodontology best evidence review

Abstract

BackgroundPeriâ implant diseases are prevalent, with numerous therapies studied in an attempt to combat this condition. The present review aims to systematically evaluate the effectiveness of laser therapy with nonâ surgical or surgical therapy in managing periâ implant mucositis and periâ implantitis.MethodsAn electronic search of three databases and a hand search of peerâ reviewed journals for relevant articles published (in English) from January 1980 to June 2016 were performed. Human clinical trials of ⠥ 10 patients with periâ implant diseases, treated with surgical or nonâ surgical approaches and laser therapy, and a followâ up period of ⠥ 6 months, were included. Randomâ effects metaâ analyses were performed to analyze weighted mean difference (WMD) and confidence interval for the recorded variables according to PRISMA guidelines. Risk of bias assessment was also performed for randomized controlled trials included.ResultsFrom 22 articles selected, 11 were included in the metaâ analyses. The outcomes of using lasers as a monotherapy could not be evaluated since no controlled studies were identified. Therefore, all reported results were the outcomes of applying lasers as an adjunct to surgical/nonâ surgical treatment. For the nonâ surgical approach, WMD of probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), marginal bone level (MBL) and recession (REC) was 0.15 mm (P = 0.50), â 0.10 mm (P = 0.32), 21.08% (P = 0.02), â 0.07 (P = 0.002), â 0.22 mm (P = 0.04) and â 0.11 mm (P = 0.34), respectively. For the surgical approach with a longâ term follow up, WMD of PD, CAL, BOP, and PI was 0.45 mm (P = 0.11), 0.22 mm (P = 0.56), 7.26% (P = 0.76) and â 0.09 (P = 0.84), respectively.ConclusionsCurrent evidence shows laser therapy in combination with surgical/nonâ surgical therapy provided minimal benefit in PD reduction, CAL gain, amount of REC improvement, and PI reduction in the treatment of periâ implant diseases. Lasers when used as an adjunct to nonâ surgical therapy might result in more BOP reduction in the short term. However, current evidence allowed for analysis of only Er:YAG, CO2, and diode lasers. Studies on others failed to have controlled evidence supporting their evaluation.