Treatment of Peri-implant Diseases using Lasers: A Systematic Review

Background: Adjuncts to mechanical debridement, including administration of systemically and locally delivered antimicrobials, are constantly evaluated to achieve additional benefits while treating peri-implantitis. However, the potential for the development of antimicrobial resistance limits their use. Evaluation of the use of lasers for the treatment of peri-implantitis has provided varying results. Objective: This study aimed to summarize the existing literature on the additional benefits of lasers as adjuncts to mechanical debridement while treating peri-implant diseases. Methods: Randomised clinical trials published in English till Sept 2022 in PubMed, Medline, and clinical trial registries using the MeSH terms "peri-implant diseases", "peri-implant mucositis", "peri-implantitis", and "lasers", were included in the study. Case reports, case series, longitudinal studies, and retrospective analysis were excluded. Results: A total of fifteen (n=15) randomised clinical trials pertaining to peri-implantitis and three (n=3) trials pertaining to peri-implant mucositis were assessed. The trials assessed the use of diode, Nd: YAG, Er:YAG, CO2 lasers, and photodynamic therapy as adjuncts in the treatment of peri-implant diseases. Conclusion: The existing evidence regarding the use of laser for peri-implant mucositis is inconclusive, whereas for peri-implantitis, the majority of the studies support the use of lasers. Future trials should utilize the 2018 classification of peri-implantitis, so that a comparison of trials based on the studied parameters would be more accurate.