title: Nonsurgical antimicrobial photodynamic therapy in moderate vs severe peri-implant defects: a clinical pilot study.
abstract: OBJECTIVE
  Recent review articles have shown that open debridement is more effective in the treatment of peri-implantitis than closed therapy. However, surgery may result in marginal recession and compromise esthetics. The purpose of this study was to assess the efficacy of nonsurgical antimicrobial photodynamic therapy (aPDT) in moderate vs severe defects.
  
  
  METHODS
  The study encompassed 16 patients with a total of 18 ailing implants. Ten of these implants showed moderate bone loss (< 5 mm; Group 1) and eight implants severe defects (5 through 8 mm; Group 2). All implants received aPDT without surgical intervention. At baseline and 2 weeks, 3 months, and 6 months after therapy, peri-implant health was assessed including sulcus bleeding index (SBI), probing depth (PD), distance from implant shoulder to marginal mucosa (DIM), and clinical attachment level (CAL). Radiographic evaluation of distance from implant to bone (DIB) allowed comparison of peri-implant hard tissues after 6 months.
  
  
  RESULTS
  Baseline values for SBI were comparable in both groups. Three months after therapy, in both groups, SBI and CAL decreased significantly. In contrast, after 6 months, CAL and DIB increased significantly in Group 2, not in Group 1. However, DIM-values were not statistically different 6 months after therapy in both groups.
  
  
  CONCLUSIONS
  Within the limits of this 6-month study, nonsurgical aPDT could stop bone resorption in moderate peri-implant defects but not in severe defects. However, marginal tissue recession was not significantly different in both groups at the end of the study. Therefore, especially in esthetically important sites, surgical treatment of severe peri-implantitis defects seems to remain mandatory.
authors.affiliation: Oral Surgeon, Department of Oral and Maxillofacial Surgery, Technische Universität München, Mnich, Germany. herbert.deppe@mkg.med.tum.de
authors.forename: Herbert
authors.initials: H
authors.lastname: Deppe
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.forename: Marco
authors.initials: M
authors.lastname: Kesting
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000188:drug therapy; D000539:Alveolar Process / Q000000981:diagnostic imaging; D015921:Dental Implants; D018450:Disease Progression; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000188:drug therapy; D006801:Humans; D028022:Low-Level Light Therapy / Q000295:instrumentation; D008751:Methylene Blue / Q000627:therapeutic use; D057873:Peri-Implantitis / Q000188:drug therapy*; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D010640:Phenothiazines / Q000627:therapeutic use; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants; D010640:Phenothiazines; D017319:Photosensitizing Agents; C031637:phenothiazine; D008751:Methylene Blue