Photodynamic therapy to treat periimplantitis.
OBJECTIVE
: Periimplantitis is a bacterial complication after dental implants implantation. Photodynamic therapy (PDT) implies the use of low-power laser in combination with appropriate photosensitizer to increase the detoxification of the implant surfaces. Little information exists about PDT in the treatment of periimplantitis. A randomized comparative case-control study has been conducted with 20 patients and 20 controls to compare the efficacy of antimicrobial PDT versus surgical therapy in patients with periimplantitis, who have received dental implants with rough surfaces.


METHODS
In the surgery group, mucoperiosteal flap surgery was used with scaling on implant surfaces and debridement of granulation tissue. Microbiologic testing was evaluated before and after intervention treatment, at 12 and 24 weeks in the study subjects.


CONCLUSIONS
Total anaerobic counts of bacteria did not differ significantly between patients assigned to receive PDT and those assigned to receive surgical therapy (mean, 95.2% and 80.85%, respectively). PDT was associated with a significant decrease in bleeding scores (P = 0.02) as well as inflammatory exudation (P = 0.001).


CONCLUSIONS
Treatment with PDT in patients with periimplantitis was not associated with major reduction of total anaerobic bacteria on the rough surfaces of dental implants as compared with surgical therapy. A significantly lower proinflammatory index of periimplantitis was observed in the PDT group at 24 weeks of follow-up.
*Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Pathology and Medicine, University of Milan, Milan, Italy. †Italian Association for Metals and Biocompatibility Research-AIRMEB, Milan, Italy. ‡Private Practice, Bergamo, Italy.
Gian Paolo
GP
Bombeccari
Gianpaolo
G
Guzzi
Federico
F
Gualini
Sara
S
Gualini
Franco
F
Santoro
Francesco
F
Spadari
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000187:drug effects; D058491:Bacterial Load; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000188:drug therapy* / Q000382:microbiology; D010778:Photochemotherapy / Q000379:methods*; D014048:Tolonium Chloride / Q000627:therapeutic use; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D014048:Tolonium Chloride