Treatment of ligature-induced peri-implantitis by lethal photosensitization and guided bone regeneration: a preliminary histologic study in dogs.
BACKGROUND
The purpose of this pilot study was to evaluate the healing potential and reosseointegration in ligature-induced peri-implantitis defects adjacent to various dental implant surfaces following lethal photosensitization.


METHODS
A total of 36 dental implants with 4 different surface coatings (9 commercially pure titanium surface [CPTi]; 9 titanium plasma-sprayed [TPS]; 9 hydroxyapatite [HA]; and 9 acid-etched [AE]) were inserted in 6 male mongrel dogs 3 months after extraction of mandibular premolars. After a 2-month period of ligature-induced peri-implantitis and 12 months of natural peri-implantitis progression, only 19 dental implants remained. The dogs underwent surgical debridement of the remaining dental implant sites and lethal photosensitization by combination of toluidine blue O (100 microg/ml) and irradiation with diode laser. All exposed dental implant surfaces and bone craters were meticulously cleaned by mechanical means, submitted to photodynamic therapy, and guided bone regeneration (GBR) using expanded polytetrafluoroethylene (ePTFE) membranes. Five months later, biopsies of the implant sites were dissected and prepared for ground sectioning and analysis.


RESULTS
The percentage of bone fill was HA: 48.28 +/- 15.00; TPS: 39.54 +/- 12.34; AE: 26.88 +/- 22.16; and CPTi: 26.70 +/- 16.50. The percentage of reosseointegration was TPS: 25.25 +/- 11.96; CPTi: 24.91 +/- 17.78; AE: 17.30 +/- 15.41; and HA: 15.83 +/- 9.64.


CONCLUSIONS
These data suggest that lethal photosensitization may have potential in the treatment of peri-implantitis.
Shibli
Jamil Awad
JA
Department of Periodontology, Dental School of Araraquara, State University of São Paulo, Araraquara, SP, Brazil.
Martins
Marilia Compagnoni
MC
Nociti
Francisco Humberto
FH
Garcia
Valdir Gouveia
VG
Marcantonio
Elcio
E
D000134:Acid Etching, Dental; D000818:Animals; D001861:Bone Regeneration; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D015921:Dental Implants; D019232:Dental Restoration Failure; D004195:Disease Models, Animal; D004285:Dogs; D017886:Durapatite / Q000737:chemistry; D016557:Guided Tissue Regeneration, Periodontal; D053685:Laser Therapy; D008297:Male; D008567:Membranes, Artificial; D016348:Osseointegration; D010518:Periodontitis / Q000628:therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry; D014048:Tolonium Chloride / Q000627:therapeutic use
D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D008567:Membranes, Artificial; D017319:Photosensitizing Agents; D014048:Tolonium Chloride; D011138:Polytetrafluoroethylene; D017886:Durapatite; D014025:Titanium