Effectiveness of Laser Therapy as an Adjunctive Treatment of Peri-Implantitis: A Systematic Review

Dental implants are widely used for the restoration of edentulous or partially edentulous areas of the mouth. Despite their high success rate, complications such as peri-implantitis can occur, jeopardizing implant stability. While mechanical debridement remains the standard treatment, recent evidence has suggested that adjunctive laser therapy, including photodynamic and low-level laser therapy, may offer improved outcomes. This systematic review aimed to evaluate the efficacy of laser therapy combined with mechanical debridement compared to mechanical debridement alone in the treatment of peri-implantitis.

A systematic review search was conducted in accordance with the 2020 PRISMA protocol. The search included articles published between 2019 and 2024 in English, retrieved from PubMed, Scopus, and ScienceDirect databases. After exporting the results into Microsoft Excel, articles were screened based on their titles, abstracts, and full texts to determine relevance. Only studies comparing laser-assisted therapy with conventional mechanical debridement in the context of peri-implantitis were included.

A total of 90 articles were initially identified. After screening and applying the inclusion criteria, 5 studies were selected for the final analysis. These studies consistently demonstrated that adjunctive laser therapy resulted in greater improvements in clinical outcomes, including reductions in probing depth, plaque index, bleeding on probing, and bone loss, when compared to mechanical debridement alone.

The findings of this review suggested that laser therapy, when used in conjunction with mechanical debridement, offers enhanced clinical benefits in managing peri-implantitis. The anti-inflammatory and bactericidal properties of photodynamic and low-level laser therapies appear to contribute to improved tissue healing and infection control. However, the included studies varied in terms of laser protocols, treatment durations, and follow-up periods, limiting the generalizability of the results. Standardized methodologies and longer-term follow-up are needed to validate these outcomes further and define best practices.

Combining laser therapy with mechanical debridement appears to be a more effective treatment strategy for peri-implantitis than mechanical debridement alone. This approach shows promise in reducing inflammation and promoting healing. Nonetheless, further high-quality research is necessary to confirm long-term benefits and establish clear clinical guidelines for its use.