Arısan Volkan, Sağlanmak Alper, Anıl Ata, Arıcı S Volkan, Sculean Anton
Oral Health Prev Dent. 2025 Jun 3;23:305-314. doi: 10.3290/j.ohpd.c_2078.
To evaluate the efficacy of photodynamic therapy (PDT) as an adjunct to resective and regenerative surgical peri-implantitis treatment (open flap debridement via scaling and smoothening of the implant surface [implantoplasty]) combined with guided bone regeneration (GBR) in a patient cohort of a university clinic.
Seventy-two patients were treated with either conventional therapy (CON) or conventional therapy plus PDT. CON included mechanical debridement, implantoplasty, and GBR. Clinical parameters, including marginal bone level (MBL), probing pocket depth (PPD) and bleeding on probing (BOP) were assessed at baseline, 6, 12, and 18 months. The primary outcome was the resolution of the infection using a composite success criterion.
After 18 months, infection resolution rates were 75% for CON and 80% for PDT groups (p = 0.75). Kaplan-Meier survival analysis showed no statistically significant difference for the infection resolution between groups (log-rank test, p = 0.6221). Both groups demonstrated statistically significant MBL gain after 6 months (mean 2.59 mm ± 1.25), with no statistically significant differences between groups throughout the follow-up. PPD was statistically significantly lower in the PDT group (two-way ANOVA, p = 0.018). BOP scores decreased initially but showed an increasing trend in both groups over time (chi-squared test, p = 0.045), with no statistically significant differences between groups.
PDT as an adjunct to conventional peri-implantitis treatment with GBR resulted in statistically significantly lower PPD values. However, no additional benefits were observed for infection resolution, maintenance of infection-free status, MBL or BOP. Initial improvements in both groups followed by gradual recurrences in clinical parameters over 18 months.
在一所大学诊所的患者队列中，评估光动力疗法（PDT）作为辅助手段用于种植体周围炎切除和再生性手术治疗（通过对种植体表面进行刮治和平整[种植体成形术]的开放瓣清创术）联合引导骨再生（GBR）的疗效。
72例患者接受了常规治疗（CON）或常规治疗加PDT。CON包括机械清创、种植体成形术和GBR。在基线、6个月、12个月和18个月时评估临床参数，包括边缘骨水平（MBL）、探诊袋深度（PPD）和探诊出血（BOP）。主要结局是使用综合成功标准来判定感染的消退情况。
18个月后，CON组的感染消退率为75%，PDT组为80%（p = 0.75）。Kaplan-Meier生存分析显示两组之间感染消退情况无统计学显著差异（对数秩检验，p = 0.6221）。两组在6个月后均显示出统计学显著的MBL增加（平均2.59 mm±1.25），在整个随访期间两组之间无统计学显著差异。PDT组的PPD在统计学上显著更低（双向方差分析，p = 0.018）。BOP评分最初下降，但两组随时间均呈上升趋势（卡方检验，p = 0.045），两组之间无统计学显著差异。
PDT作为GBR常规种植体周围炎治疗的辅助手段，导致PPD值在统计学上显著更低。然而，在感染消退、维持无感染状态、MBL或BOP方面未观察到额外益处。两组在最初均有改善，随后在18个月内临床参数逐渐复发。
