Clinical and biochemical evaluation of the efficacy of non-surgicaltreatment approaches in the treatment of peri-implantitis

Peri-implantitis is an inflammatory disease around implants characterized by progressive bone loss. There are many different approaches proposed for the treatment of peri-implantitis such as non-surgical mechanical treatment with the additional use of diode laser. There are conflicting results regarding the effectiveness of this approach in the literature. Evaluation of the clinical changes in peri-implant tissues as well as the biomarker levels associated with the pathogenesis of peri-implantitis before and after the treatment may solve this contradiction. The aim of the present study was to evaluate the clinical efficacy of the diode laser as an adjunct to non-surgical mechanical therapy in the treatment of peri-implantitis and also determine the biochemical profile by evaluating the peri-implant crevicular fluid (PICF) levels of interleukin (IL)-17, IL-10, IL-1β, tumor necrosis factor-related weak inducer of apoptosis (TWEAK), sclerostin, RANKL and OPG. A total of 27 people (21 females and 6 males) with the mean age of 55.08 ± 10.57 years agreed to participate in the present study. 40 implants diagnosed with peri-implantitis were randomly assigned to the laser group (laser application in addition to mechanical nonsurgical treatment, n=19) or the control group (mechanical nonsurgical treatment alone, n=18). Recording of peri-implant clinical parameters (pocket depth, gingival index, gingival bleeding time index, plaque index) and collecting PICF samples were performed at baseline, 3rd and 6th months. Biomarker levels in PICF were measured with ELISA. According to the results of the study, significant decreases were detected at 6th month both in clinical and biochemical parameters compared to the baseline in both groups. When treatment groups were compared, significant differences were detected in gingival index, gingival bleeding time index and plaque index, PICF IL-1β, IL-17 and sclerostin levels at 3rd month evaluation . However, no statistically significant difference was detected at 6th month. Within the limitations of the present study, diode laser seems to be an additional valuable tool for supporting the treatment in the early healing period of peri-implantitis. Moreover, IL-1β, IL-17 and sclerostin have found to be better biomarkers for the diagnosis of peri-implantitis and the evaluation of the treatment efficacy. Further studies are needed to confirm present findings.