A short-time non-randomized controlled clinical study on adjunctive photodynamic therapy in the treatment of peri-implantitis

Abstract

Objective To evaluate the short-term clinical efficacy of photodynamic therapy (PDT) assisted mechanical debridement (MD) in the treatment of peri-implantitis. Methods According to the new international classification of periodontal diseases and peri-implant diseases in 2018, single tooth implants diagnosed as peri-implantitis were included. Before treatment, the probing depth (PD), modified sulcus bleeding index (mSBI), and modified plaque index (mPLI) were recorded as the baseline, with mSBI ≥ 1 sites as the treatment sites. The MD group was a control group, and only mechanical subgingival debridement was performed. The PDT group was treated with photodynamic therapy twice, immediately after subgingival debridement and one week after. Follow-up was arranged at 6 and 12 weeks after the end of treatment to examine the changes in PD, mSBI, and mPLI at the included implant treatment sites. Results A total of 35 patients were included in this study, with 38 teeth affected by peri-implantitis and 154 treatment sites. The PDT group and MD group included 20 and 18 implants respectively, with a total of 78 treatment sites included in the PDT group, 51 sites with PD ≥ 6 mm, and 27 sites with PD<6 mm. A total of 76 treatment sites were included in the MD group, including 53 sites with PD ≥ 6 mm and 23 sites with PD<6 mm. At baseline, there was no statistically significant difference in PD, mSBI, and mPLI between the two groups. At 6 and 12 weeks after treatment, there were statistically significant differences in clinical indicators between the two groups compared to baseline (P<0.05). Among them, the mSBI in the PDT group was significantly lower than that in the MD group at 6 weeks after treatment (P<0.05). At sites with PD ≥ 6 mm, the mSBI of the PDT group was significantly lower than that of the MD group at 6 and 12 weeks after treatment (P<0.05). The number of implants in the PDT group and MD group that reached the treatment endpoint at 12 weeks follow-up was 70.00% and 55.56%, respectively, and there was no difference between the two groups (P>0.05). Conclusion Photodynamic therapy assisted with mechanical debridement can effectively treat peri-implantitis and is a safe and effective auxiliary method, and has significant therapeutic effects on inflammation control and improvement of mSBI in those sites with PD ≥ 6 mm.

Keywords

• |photodynamic therapy|peri-implantitis|mechanical debridement