Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain -
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Minerva Dent Oral Sci. 2024 Feb;73(1):53-60. doi: 10.23736/S2724-6329.23.04406-6. Epub 2023 May 31.
Placement of dental implants into fresh extraction sockets offers some advantages, such as reduced treatment times and enhanced patient comfort. The Er,Cr:YSGG (Erbium, Chromium-doped: Yttrium, Scandium, Gallium, and Garnet) laser can significantly reduce bacterial concentration after the extraction of a compromised tooth. The aim of this article is to provide a clinical protocol for the management of implants placed in infected extraction sites decontaminated with Er,Cr:YSGG laser.
A compromised tooth, which was an abutment for a fixed bridge, with clinical and radiological signs of infection was extracted. The infected site was treated and decontaminated with an Er,Cr:YSGG laser device (Biolase iPlus) and two implants (Straumann) were placed in the same surgery, in order to rehabilitate the edentulous area. The intervention was completed by tissue regeneration with biomaterials.
Prosthetic rehabilitation after the surgical phase allowed us to provide correct function and satisfactory esthetics. In the follow-up visit, clinicians found good tissue healing and did not observe any complications, such as implant loss or peri-implantitis. The technique used in our study is repeatable and predictable, but patient selection is very important for this type of protocol as the presence of contraindications can lead to failure. The photoacoustic effect exerted by this type of laser has been proven to be effective against many pathogens. Several authors have previously demonstrated the effectiveness of this technique.
Immediate implantation in infected sites decontaminated with Er,Cr:YSGG laser does not seem to contribute to an increased risk of failure; however, it is necessary to follow a certain set of protocols and procedures to prevent peri-implantitis and other complications.
将牙种植体植入新鲜拔牙窝中具有一些优势，例如缩短治疗时间和提高患者舒适度。Er,Cr:YSGG（掺铒、铬：钇、钪、镓、石榴石）激光可显著降低受损牙齿拔除后细菌浓度。本文旨在提供一种用 Er,Cr:YSGG 激光处理受感染拔牙窝以进行种植体植入的临床方案。
一颗有临床和放射学感染迹象的受损牙齿，作为固定桥的基牙，被拔除。受感染的部位用 Er,Cr:YSGG 激光设备（Biolase iPlus）进行处理和消毒，同时在同一手术中放置两颗种植体（Straumann），以修复缺牙区。通过生物材料进行组织再生完成干预。
手术阶段的修复体修复使我们能够提供正确的功能和满意的美观。在随访时，临床医生发现组织愈合良好，没有观察到任何并发症，如种植体丢失或种植体周围炎。我们研究中使用的技术是可重复和可预测的，但患者选择对于这种方案非常重要，因为存在禁忌症可能导致失败。这种激光产生的光声效应已被证明对许多病原体有效。以前有几位作者已经证明了这种技术的有效性。
用 Er,Cr:YSGG 激光消毒的受感染部位立即植入似乎不会增加失败的风险；然而，必须遵循一定的方案和程序，以防止种植体周围炎和其他并发症。
