The safety implications of peri-implant defect morphology on temperature changes during CO2-Laser decontamination

Abstract

Background Laser irradiation of implants has been used in conjunction with mechanical debridement for treatment of peri-implantitis. The heat transferred to the peri-implant bone can cause iatrogenic damage to the patient. The aim of this study was to assess the influence of intra-bony defect morphology on temperature change (ΔT) of irradiated implants using a CO2−laser and to use this data to establish a safe protocol for laser decontamination. Materials and Methods Five separate defects (circumferential, one-walled, two-walled, three-walled or horizontal defect) were created around dental implants that were placed into a synthetic (bovine) bone analogue that mimics type II quality bone. Each implant surface and the surrounding bone were irradiated by a non-contact CO2−laser (2W power in continuous and pulsed mode, defocused beam) for 30 and 60 seconds. Results The most substantial pulse setting-induced temperature differences (30s) of the apical thermocouple were observed in the 2- and 3- wall defect. This was also seen at the 60s mark. Similar temperature changes were not observed at the apical thermocouple of circumferential, one-wall and horizontal defects using the pulse setting. ΔT at the coronal part of the implant during pulsed laser irradiation recorded less than 10°C. In contrast, the continuous mode was associated with ΔT over 10°C for circumferential, 3-walled and 2-walled defects during 30sec irradiation and over the critical threshold within 60sec of irradiation. In the apical area, the continuous mode created ΔT over 10°C in 3-wall or circumferential defects. Conclusions According to the results of this study, the morphology of the peri-implant defect appears to affect the resultant heat dissemination on an implant. The architecture of the peri-implant defect should influence the protocol with the CO2-laser treatment modality. Pulsed mode setting is ideal for all laser assisted peri-implant decontamination. It is important to consider that circumferential, two-and three-walled defects may have a greater risk for heat-induced implant failure and therefore irradiation should be kept within 30 second-bursts. Background Laser irradiation of implants has been used in conjunction with mechanical debridement for treatment of peri-implantitis. The heat transferred to the peri-implant bone can cause iatrogenic damage to the patient. The aim of this study was to assess the influence of intra-bony defect morphology on temperature change (ΔT) of irradiated implants using a CO2−laser and to use this data to establish a safe protocol for laser decontamination. Materials and Methods Five separate defects (circumferential, one-walled, two-walled, three-walled or horizontal defect) were created around dental implants that were placed into a synthetic (bovine) bone analogue that mimics type II quality bone. Each implant surface and the surrounding bone were irradiated by a non-contact CO2−laser (2W power in continuous and pulsed mode, defocused beam) for 30 and 60 seconds. Results The most substantial pulse setting-induced temperature differences (30s) of the apical thermocouple were observed in the 2- and 3- wall def...