Evaluation of clinical and immunological parameters after applying the adjunctive photodynamic therapy in the surgical treatment of peri-implantitis. A 6- and 12-month randomized controlled clinical trial

15675 ORAL COMMUNICATION CLINICAL RESEARCH - PERI-IMPLANT BIOLOGY

Background

Peri-implantitis is defined as an inflammatory process that affects the supporting marginal bone around the implant in function, resulting in bone resorption. Periodontopathogenic bacteria formed around an osseointegrated implant could lead to excessive stimulation of the immune response, resulting in a peri-implant lesion. Photodynamic therapy (PDT) is suggested as a non-invasive alternative adjunctive therapeutic method in the treatment of peri-implantitis.

Aim/Hypothesis

The aim of this study was to compare clinical and immunological outcomes before, 6 and 12 months after the surgical treatment of early and moderate peri-implantits when the two diverse methods for implant surface decontamination were performed.

Material and Methods

52 endoosseal bone-level implants in the function with clinical and radiological signs of peri-implantitis were randomly divided into two groups- experimental and control group. After a careful full thickness mucoperiosteal flaps evaluation, removal of granulation tissue and mechanical debridement of implant surface in the experimental group, decontamination of implant surfaces and peri-implant tissues was performed using the PDT. In the control group, 1% chlorhexidine gel (CHX) was applied for the decontamination of implant surfaces. Bleeding on probing (BOP), peri-implant probing depth (PPD), clinical attachment level (CAL), and plaque index (PI) were recorded at baseline, 6 and 12 months after the surgery. Concentrations of pro-inflammatory interleukins- IL-17, IL-1β, IL-6 in the peri-implant cervical fluid (PICF) were measured and analyzed by Enzyme-linked Immunosorbent Assays (ELISA) at baseline, 6 and 12 months after the surgery. SPSS softer was used for statistical analyses.

Results

52 implants with diagnosed peri-implantitis were treated and re-examined at 6 and 12 months period after the surgical procedure. Both groups showed a statistically significant reduction of clinical parameters- PPD and CAL in the period of 6 and 12 months, compared to baseline measurements (P < 0.05). There was a slight statistical reduction in the term of PPD in experimental groups compared with the control group, 12 months after the surgery (P = 0.045). PI and BOP were statistically significantly reduced in the experimental group in the period of 12 months after the surgery, compared to the control group (P < 0.01). Immunological parameters were statistically significantly decreased 6 and 12 months after the surgery in both examined groups. In the experimental group, treated with PDT, a statistically significant decrease of IL-17, IL-6 and IL-1β concentrations level was recorded compared to CHX application in the control group (P < 0.05).

Conclusion and clinical implications

With the limitations of the present study, photodynamic therapy could be suggested as one of the adjuvant methods for the decontamination of the implant surface and surrounding peri-implant tissues during the surgical treatment of peri-implantits.