Effect of photodynamic therapy as an adjunctive to mechanical debridement on the nonsurgical treatment of peri‑implant mucositis: A randomized controlled clinical trial

Abstract

Background: The use of photodynamic therapy (PDT) has been evaluated as an adjunctive technique
for bacterial decontamination of implants with peri‑implantitis. Given the controversies over the
efficacy of the application of PDT to treat peri‑implant diseases, the present clinical study aimed
to evaluate the posttherapeutic clinical parameters and cytokine levels in peri‑implant crevicular
fluid in patients with peri‑implant mucosal inflammation, receiving mechanical debridement (MD)
alone or in association with PDT.
Materials and Methods: In this double‑blinded randomized clinical trial, 52 patients with
peri‑implant mucosal inflammation were selected and they were randomly assigned to 2 treatment
groups: a MD group and an MD + PDT group using an 805 nm laser and indocyanine green (ICG).
Although the decrease in bleeding on probing was the primary outcome, pocket depth, PUS, pain
on probing, clinical attachment level, gingival recession, tumor necrosis factor‑α, interleukin (IL)‑1β,
IL‑6 and matrix metalloproteinase‑8 were also evaluated at baseline, 2‑week, and 3‑month
postintervention. Repeated measure analysis of variance was used to analyze inter‑group differences
and a P ≤ 0.05 was considered for significant differences between tested parameters.
Results: Statistically significant improvements (P < 0.001) were detected for all variables after
comparison of baseline data with those collected at each time interval of the study. Nevertheless,
the inter‑group comparisons of these variables between the baseline, 2‑week, and 3‑month intervals
did not reveal any significant decrease in sites treated with either MD alone or MD + PDT.
Conclusion: The application of PDT using 805‑nm laser and ICG as an adjunct therapy to MD
did not provide any additional improvements in the clinical or biologic parameters of peri‑implant
mucosal inflammation.
Key Words: Cytokines, peri‑implantitis, photochemotherapy