Decontamination of Anodized Implant Surface With Different Modalities for Peri‐Implantitis Treatment: Lasers and Mechanical Debridement With Citric Acid

Background: Although oral rehabilitation with dental implants is a very promising and effective procedure, peri‐implantitis is an emerging concern. Surgical and non‐surgical methods have been applied to treat peri‐implantitis together with various implant surface decontamination methods. However, there is no consensus concerning the most effective treatment for peri‐implantitis. The aim of the present study is to evaluate the effects of erbium‐doped:yttrium, aluminum, and garnet (Er:YAG) laser, photodynamic therapy (PDT), and titanium bur with and without citric acid on ligature‐induced peri‐implantitis around an anodized implant surface. Methods: Thirty dental implants with anodized surface (3.3 × 10 mm) were installed in the mandibles of five beagle dogs. After 3 months, peri‐implantitis was induced by applying cotton ligatures subgingivally. After ligature removal (baseline), the implants were divided into the following treatment groups: 1) Er:YAG laser, 2) PDT, 3) titanium bur alone, and 4) titanium bur with citric acid. Animals were sacrificed after 3 months, and clinical, radiologic, histologic, and histomorphometric evaluations were conducted for all treatment modalities. The data were analyzed using one‐way analysis of variance and Tukey test. A value of P <0.05 was considered statistically significant. Results: The titanium bur with citric acid group exhibited statistically significantly greater improvement in vertical bone height than the Er:YAG laser group and significantly better bone‐to‐implant contact than the PDT group and the bur‐alone group. Conclusion: Within the limits of the study, the combination of mechanical and chemical treatment proved to be the most effective treatment for disinfection of the anodized implant surface.