title: Is mechanical curettage with adjunct photodynamic therapy more effective in the treatment of peri-implantitis than mechanical curettage alone?
abstract: BACKGROUND
  The aim of the present study was to review the pertinent literature on the effects of mechanical curettage (MC) with and without adjunct photodynamic therapy (PDT) for the management of peri-implantitis.
  
  
  METHODS
  The addressed focused question was "Is PDT effective in the treatment of peri-implantitis?" A search without language or time restrictions up to March 2016 was conducted using various key words. The exclusion criteria included; review papers, in vitro Studies, case reports, commentaries, interviews, and letters to the editors.
  
  
  RESULTS
  In total 9 studies were included. Among them 5 studies were clinical and 4 were experimental. All the studies used PDT as an adjunctive to MC in their test groups. The laser wavelengths used ranged from 660nm to 830nm. One study showed significant reduction of the bleeding scores, inflammatory exudates and Aggregatibacter actinomycetemcomitans count in group with PDT as an adjunctive when compared to MC and 0.2% chlorhexidine. However, in four clinical studies comparable periodontal parameters were reported when PDT is used as an adjunct to MC was compared to MC in treatment of peri-implantitis. In three experimental studies, outcomes were significantly better in group with PDT as an adjunct to MC when compared to MC alone at follow-up.
  
  
  CONCLUSIONS
  The role of PDT as an adjunct to MC in the treatment of peri-implantitis is debatable. Further longterm randomised control trails are needed to justify the role PDT as an adjunct to MC in treatment of peri-implantitis.
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA. Electronic address: alexis_ghanem@urmc.rochester.edu.
authors.forename: Alexis
authors.initials: A
authors.lastname: Ghanem
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Pasumarthy
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
authors.forename: Vinisha
authors.initials: V
authors.lastname: Ranna
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
authors.forename: Sergio Varela
authors.initials: SV
authors.lastname: Kellesarian
authors.affiliation: Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riaydh, Saudi Arabia.
authors.forename: Tariq
authors.initials: T
authors.lastname: Abduljabbar
authors.affiliation: Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riaydh, Saudi Arabia.
authors.forename: Fahim
authors.initials: F
authors.lastname: Vohra
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
authors.forename: Hans
authors.initials: H
authors.lastname: Malmstrom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000706:statistics & numerical data; D004285:Dogs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D015995:Prevalence; D011817:Rabbits; D012307:Risk Factors; D013357:Subgingival Curettage / Q000706:statistics & numerical data*; D016896:Treatment Outcome