Efficacy of non-surgical mechanical debridement with and without adjunct antimicrobial photodynamic therapy in the treatment of peri-implantitis among patients undergoing chemotherapy

Abstract

Objective

Studies have shown that a single session of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) is effective for treating peri‑implant diseases. The objective was to assess the efficacy of MD with and without adjunct aPDT in treating peri‑implantitis among patients undergoing chemotherapy.

Methods

Patients with peri‑implantitis were included. These individuals were divided into two groups (a) patients with peri‑implantitis undergoing chemotherapy; (b) systemically healthy patients with peri‑implantitis. These individuals were further subclassified into two subgroups: (a) individuals that received NSMD alone and (b) individuals that underwent NSMD with adjunct aPDT. Non-surgical MD was performed using plastic curettes. The aPDT was performed using a 680 nm diode laser at a power and power density of 150 mW and 1.1 mW/cm², respectively. The photosensitizer was placed in the peri‑implant pocket and left in place for 60 s following which the laser was applied using a using an optical fiber with a diameter of 600 μm. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD) and crestal bone loss (CBL) were measured at baseline and after three months. Group comparisons were performed using one way analysis of variance and Bonferroni post-hoc adjustment tests. P-values <0.05 were considered statistically significant.

Results

At baseline, there was no statistically significant difference in peri‑implant mPI, mGI, PD and CBL among patients undergoing chemotherapy and systemically healthy individuals with peri‑implantitis. At three months’ follow up, there was no statistically significant difference in peri‑implant mPI, mGI, PD and CBL among patients undergoing chemotherapy and systemically healthy individuals with peri‑implantitis compared to their respective baseline scores.

Conclusion

Among patients undergoing chemotherapy and systemically healthy individuals, a single session of aPDT and NSMD is ineffective in the treatment of peri‑implantitis. Nevertheless, poor oral hygiene of the participants and the short-term follow-up may have influenced the results. Hence further long-term follow-up clinical trials involving multiple sessions of aPDT after MD are needed.