Efficacy of Diode Lasers in Treatment of Peri-Implantitis: A Prospective Study

ABSTRACT

Background:

Peri-implantitis is a significant challenge in implant dentistry, characterized by inflammation and progressive bone loss around dental implants. Traditional nonsurgical treatments have shown limited efficacy. Diode lasers, due to their bactericidal properties and minimal invasiveness, offer a promising alternative.

Objective:

To evaluate the efficacy of diode lasers in managing peri-implantitis, focusing on clinical and radiographic outcomes.

Methods:

This prospective research involved 30 patients with diagnosed peri-implantitis. Patients were randomly assigned to diode laser therapy or conventional mechanical debridement. Clinical parameters, including “probing depth (PD),” “bleeding on probing (BOP),” and radiographic bone levels, were assessed at baseline, three months, and six months posttreatment.

Results:

Significant reductions in PD and BOP were observed in the diode laser group compared to the control group at 6 months (P < 0.05). Radiographic analysis demonstrated improved bone stability in the laser-treated group.

Conclusion:

Diode lasers show superior efficacy in managing peri-implantitis compared to mechanical debridement, with enhanced clinical outcomes and minimal adverse effects.

INTRODUCTION

Peri-implantitis, an inflammatory condition affecting tissues around dental implants, is a leading cause of implant failure. It is characterized by progressive bone loss and peri-mucosal inflammation, significantly impacting implant longevity.[1] The management of peri-implantitis remains challenging, as conventional mechanical debridement and chemical adjuncts often fail to achieve complete resolution.[2]

The diode laser, with wavelengths ranging from 800 to 980 nm, has emerged as a promising tool due to its antimicrobial and decontamination properties. Its ability to selectively target pigmented bacteria, reduce inflammation, and promote tissue regeneration has gained attention in recent years.[3] However, evidence supporting its long-term efficacy in peri-implantitis management remains sparse. This bleeding on probing aims to evaluate the clinical and radiographic efficacy of diode lasers in the treatment of peri-implantitis through a prospective design.

METHODOLOGY

A prospective research was conducted from January to December 2024 in a tertiary care dental center. Thirty patients diagnosed with peri-implantitis, aged 25–65 years, were recruited based on the following criteria:

1. Presence of at least one implant with peri-implant probing depth (PD) ≥5 mm and bleeding on probing (BOP).

2. Radiographic evidence of peri-implant bone loss >2 mm.

3. No systemic conditions contraindicating laser therapy.

Exclusion criteria included recent periodontal therapy (<6 months) and uncontrolled systemic diseases. Patient consent and ethical clearance were obtained for the research.

Intervention groups

Participants were randomly divided into two groups (n = 15 each):

1. Diode Laser Group: Patients underwent diode laser therapy (980 nm, 1 W, continuous mode) using a 300-μm fiber-optic tip for biofilm decontamination. Treatment was repeated weekly for four weeks.

2. Control Group: Patients received conventional mechanical debridement using titanium curettes and chlorhexidine irrigation.

Outcome measures

Clinical parameters, including PD, BOP, and CAL, were recorded at baseline, three months, and six months. Radiographic bone levels were assessed using standardized digital radiographs. Adverse events were monitored during follow-up.

Statistical analysis

Data were analyzed using Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY, USA). Paired t-tests assessed intragroup changes, and independent t-tests compared intergroup outcomes. A P value < 0.05 was considered statistically significant.

RESULTS

The baseline characteristics revealed no significant differences between the laser and control groups, ensuring comparability. Both groups demonstrated similar mean age PD, BOP, and radiographic bone loss at the start of the research (P > 0.05). The similarity in demographic and clinical parameters ensured that observed treatment effects were attributable to the intervention rather than baseline variability Table 1.

Table 1.

Baseline Characteristics

Variable	Laser (n=15)	Control (n=15)	P
Mean age (years)	45.3±8.2	46.1±7.9	0.78
PD (mm)	5.8±0.5	5.7±0.4	0.67
BOP (%)	85.0±10.5	83.5±9.8	0.81
Bone loss (mm)	3.2±0.7	3.3±0.8	0.89

Patients treated with diode lasers exhibited significantly greater improvements in PD, BOP, and bone gain compared to the control group (P < 0.05). The laser group showed a mean PD reduction of 2.1 mm and BOP reduction of 70.3%, with a notable 0.8 mm bone gain. These results underscore the superior efficacy of diode lasers in managing peri-implantitis Table 2.

Table 2.

Clinical and Radiographic Outcomes

Parameter	Laser	Control	P
PD reduction (mm)	2.1±0.3	1.2±0.4	<0.001
BOP reduction (%)	70.3±5.5	45.1±6.2	<0.001
Bone gain (mm)	0.8±0.2	0.4±0.3	<0.01

DISCUSSION

Peri-implantitis poses a significant challenge to the longevity of dental implants, necessitating effective and minimally invasive treatment modalities. This research demonstrated that diode laser therapy significantly improves clinical and radiographic outcomes in patients with peri-implantitis compared to conventional mechanical debridement.

Comparison with previous studies

Current findings align with Altindal et al.,[2] who highlighted the adjunctive benefits of diode laser therapy in reducing PD and BOP. Additionally, Huang et al.[4] and Srinivasan et al.[5] emphasized the superior antimicrobial efficacy and biostimulatory effects of diode lasers in systematic reviews and meta-analyses. The reduction in PD by 2.1 mm and significant BOP reduction observed in this research validate these findings.

Mechanisms of action

The efficacy of diode lasers lies in their ability to selectively target pigmented bacteria and decontaminate implant surfaces without causing thermal damage to surrounding tissues.[6,7] Romanos and Weitz[3] further support this mechanism, emphasizing lasers’ bactericidal effects and their ability to disrupt biofilms—a critical factor in managing peri-implantitis.

Radiographic outcomes and bone regeneration

The observed bone gain in the laser group (0.8 mm) highlights the regenerative potential of diode lasers. Alpaslan Yayli et al.[8] reported similar results, attributing improved bone stability to the laser-induced activation of growth factors and enhanced local vascularization.

Clinical relevance

Diode lasers are user-friendly, less technique-sensitive, and effective on micro-roughened implant surfaces, where traditional mechanical debridement may fail. Their noninvasive nature also reduces postoperative discomfort, improving patient compliance.[9,10]

Despite the promising results, this research has limitations. The small sample size and short follow-up period may limit the generalizability of findings. Future studies should involve larger cohorts and longer follow-up durations to validate these outcomes. Additionally, exploring combination therapies integrating lasers with systemic or local antimicrobial agents could further enhance treatment efficacy.

CONCLUSION

Diode laser therapy is an effective and minimally invasive option for managing peri-implantitis, offering superior reductions in PD and BOP and promoting bone stability. These findings underscore the potential of diode lasers as a primary or adjunctive treatment modality for peri-implantitis. Long-term, large-scale studies are needed to establish standardized protocols and evaluate long-term outcomes.

Ethical clearance

Ethical clearence was obtained for the study.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.