Methods: In four dogs, the mandibular premolars were extracted. After healing, two implant fixture holes with dehiscence-type defects (3mm x 5mm) on the buccal aspect were prepared on each side of mandible and totally four SLA ITI® implants were placed in all dogs. The buccal defects were then filled with silicone impression material. Twelve weeks after fixture placement, the silicone was surgically removed and stainless steel mesh with ligature was placed on the defect to induce infection. After four weeks, the metal mesh was nonsurgically removed and then, after one week, the peri-implant infection was surgically treated. On the implants placed on the right side, an Er:YAG laser was employed at 10.0J/cm2/pulse (62mJ at chisel tip) and 20Hz in contact mode with saline water spray for degranulation and implant surface debridement. On the left side, a plastic curet was used and saline water irrigation was performed. The time required for each treatment was recorded. After 24 weeks, the dogs were sacrificed and undecalcified bucco-lingual histological sections were prepared and analyzed.
Results: With the Er:YAG laser, the treatment time was significantly shorter than curet instrumentation. Clinically, degranulation and implant surface debridement were safely and effectively performed with no visible major thermal damage. Immediately after treatment, more bleeding tended to occur from the bone defect in the laser group than in the control group. Histologically, the lased implant surface did not inhibit the formation of new bone to the implant surface and rather the laser group showed a tendency to produce greater bone to implant contact than control group.
Conclusion: These results indicate that the Er:YAG laser therapy would be promising in the surgical treatment of peri-implantitis, resulting in favorable bone healing.