Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Department of Clinical Pathology-Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
BMC Oral Health. 2024 Aug 22;24(1):980. doi: 10.1186/s12903-024-04698-5.
The major struggle in peri-implantitis therapy is the availability of successful decontamination of the infected implant surface. The main hypothesis of this study was the Er,Cr: YSGG laser decontamination efficacy investigation on the infected implant surfaces with various peri-implantitis defects. The primary objective of this study was to decide the efficacy of Er,Cr:YSGG laser as a decontamination tool at various peri-implantitis simulating defects. The secondary objective was to compare the efficacy of the Er,Cr: YSGG laser on oral biofilm removal between two protocols the first protocol (4 cycles at 2.5 min) and the second protocol (5 cycles at 5 min) at various peri-implantitis simulating defects.
A total of 3 subjects whose plaque biofilms formed in-vivo on twenty-four tested implants were divided into four tested groups. Two native implants were tested as controls.The in vitro defect model was computer-aided designed and printed into a 3D-printed model with various anulations in peri-implant infrabony defects, which were 15,30,60,and 90 degrees.
Both Er, Cr: YSGG decontamination protocols at 50 mJ (1.5 W/30 Hz), 50% air, and 40% water were effective at reducing the total implant surface area/ biofilm ratio (%), but the second protocol had a markedly greater reduction in the duration of application (5 cycles at 5 min) than did the first protocol (4 cycles at 2.5 min).
The Er, Cr: YSGG laser is an effective decontamination device in various peri-implantitis defects. The second protocol(5 cycles at 5 min) with greater application time and circles is more effective than the first one. The defect angulation influence the decontamination capability in peri-implantitis therapy.
CLINICAL RELEVANCE (SCIENTIFIC RATIONALE FOR STUDY): Clinicians anticipate that the exploration of suitable therapeutic modalities for peri-implantitis therapy is limited by the obvious heterogeneity of the available evidence in the literature and need for a pre-clinical theoretical basis setup. The major challenges associated with peri-implantitis therapy include the successful decontamination of the infected implant surface, the absence of any damage to the treated implant surface with adequate surface roughness, and the biocompatibility of the implant surface, which allows osteoblastic cells to grow on the treated surface and is the key for successful re-osseointegration. Therefore, these are the expected empirical triads that need to be respected for successful peri-implantitis therapy. Failure of one of the triads represents a peri-implantitis therapeutic failure. The Er, Cr: YSGG laser is regarded as one of the expected devices for achieving the required triad.
"Efficacy of Er,Cr YSGG Laser in Treatment of Peri-implantitis".
gov ID NCT05137821. First Posted date: 30 -11-2021.
在种植体周围炎治疗中，主要的困难在于如何成功清除受感染的种植体表面。本研究的主要假设是研究 Er,Cr:YSGG 激光对不同种植体周围炎缺陷感染种植体表面的去污效果。本研究的主要目的是确定 Er,Cr:YSGG 激光作为一种去污工具在各种种植体周围炎模拟缺陷中的效果。次要目的是比较两种 Er,Cr:YSGG 激光协议（第 1 协议：4 个周期，每个周期 2.5 分钟；第 2 协议：5 个周期，每个周期 5 分钟）在各种种植体周围炎模拟缺陷中对口腔生物膜去除的效果。
共有 3 名受试者，他们的菌斑生物膜在 24 个测试种植体上体内形成，将他们分为四个测试组。两个天然种植体作为对照。体外缺陷模型采用计算机辅助设计，并使用 3D 打印模型打印出各种种植体周围骨缺损的印模，缺损角度为 15、30、60 和 90 度。
两种 Er,Cr:YSGG 去污方案（50mJ，1.5W/30Hz，50%空气，40%水）均能有效降低总种植体表面积/生物膜比值（%），但第 2 方案（5 个周期，每个周期 5 分钟）的应用时间和循环明显长于第 1 方案（4 个周期，每个周期 2.5 分钟）。
Er,Cr:YSGG 激光是一种有效的各种种植体周围炎缺陷去污设备。具有更大应用时间和循环的第二方案（5 个周期，每个周期 5 分钟）比第一方案更有效。缺陷角度会影响种植体周围炎治疗中的去污能力。
临床意义（研究的科学依据）：临床医生预计，由于文献中可用证据的明显异质性和对临床前理论基础设置的需求，对种植体周围炎治疗的合适治疗方法的探索受到限制。与种植体周围炎治疗相关的主要挑战包括成功清除受感染的种植体表面、对处理后的种植体表面不造成任何损伤并具有足够的表面粗糙度、以及种植体表面的生物相容性，使成骨细胞能够在处理后的表面上生长，这是成功重新骨整合的关键。因此，这些是成功进行种植体周围炎治疗所需要的预期经验性三联体。三联体中的任何一个失败都代表种植体周围炎治疗的失败。Er,Cr:YSGG 激光被认为是实现所需三联体的预期设备之一。
“Er,Cr YSGG 激光治疗种植体周围炎的疗效”。
gov ID NCT05137821。首次报告日期：2021 年 11 月 30 日。
