Evaluation of the Adjunctive Use of Er:
YAG
Laser or Erythritol Air‐Polishing in the Non‐Surgical Treatment of Peri‐Implantitis: A Pilot
RCT
Marco Clementini, Margherita Minoli, Simone Fabrizi, Isabella De Rubertis, Nicola Discepoli, Massimo de Sanctis ABSTRACT
Aim
Evaluate the efficacy of adjunctive mechanical/physical decontamination to non‐surgical submarginal instrumentation in patients with peri‐implantitis.
Material and Methods
Patients with at least one implant diagnosed with peri‐implantitis were included in this 6‐month single‐masked randomized clinical trial with three parallel groups: non‐surgical submarginal instrumentation with titanium curettes (control); control plus erythritol air‐polishing (test 1) and control plus Er:YAG laser (test 2). Clinical variables were collected at baseline, 1, 3 and 6 months. The primary outcome was probing pocket depth (PPD) reduction. Secondary outcomes included bleeding on probing (BoP) reduction and endpoint of therapy (implants with PPD ≤ 5 mm, BoP ≤ 1 site, no suppuration). A multilevel logistic model was computed to evaluate the predictive value of implant‐ and patient‐level variables.
Results
Forty‐seven patients (84 implants) were enrolled. PPD reductions were observed in all groups (mean: 1–1.4 mm at 1 month), remaining stable at 3 months, with slight relapse at 6 months. All treatments led to significant BoP reduction (24%–36%) at 1 month, with no further significant changes at later follow‐ups and no intergroup differences. Therapeutic endpoint rates were 12%–18%. Multilevel analysis suggested an association between the presence of ≥ 2 mm vestibular keratinized mucosa and the use of Er:YAG with higher odds of achieving treatment success. Healing was uneventful in all groups, except for one case of surgical emphysema associated with erythritol air‐polishing.
Conclusion
Irrespective of the adjunctive treatment modality, achievement of peri‐implantitis therapeutic endpoint was limited across groups. Possible associations with treatment outcomes were observed; these findings require confirmation in larger studies.
Trial Registration