Comparison of Different Lasers for the Treatment of Peri-Implantitis: A Systematic Review

Objectives: To evaluate the efficacy of various types of lasers (Nd:YAG, CO2, Diode, Er,Cr:YSGG ,and Er:YAG) in the treatment of peri-implantitis and their use in surgical and nonsurgical procedures.
Methods: Human studies for the treatment of peri-implantitis with laser therapy published between 2002 and January 2014, were collected utilizing the electronic database of PubMed, Ovid MEDLINE Cochrane and Google Scholar. Two reviewers conducted the study selection, data collection, and validity assessment.
Results: 812 studies were selected initially by a title search, 13 studies were then chosen for this review. No human studies evaluated the effect of Nd:YAG laser (Neodymium-doped Yttrium Aluminum Garnet; Nd:Y₃Al₅O₁₂) on peri-implantitis. The CO₂ (Carbon Dioxide) laser is reported to be safe and to possess an ability to enhance bone regeneration. The diode laser (980 nm) seems to be effective in its bactericidal effect without changing the implant surface pattern. The Er,Cr:YSGG (Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet) laser was able to obtain bone regeneration around a failing implant shown in one case report, while the Er:YAG laser exhibits a high bactericidal effect against periodontopathic bacteria at a low energy level.
Conclusions: Although lasers showed promising results in reducing clinical signs of peri-implantitis, due to the limited of small sample sizes and short follow-up periods, no firm conclusion can be drawn at this moment. Hence, there is a need for more well designed, longitudinal, randomized controlled clinical trials.