Efficiency of photodynamic therapy in the treatment of peri-implantitis - A three-month randomized controlled clinical trial.

INTRODUCTION: Peri-implantitis is an inflammatory lesion of peri-implant tissues. Eradication of the causative bacteria and decontamination of the implant surface is essential in achieving predictable and stabile clinical results. Photodynamic therapy (PDT) is non-invasive adjuvant therapeutic method to surgery in the treatment of bacterial infection. OBJECTIVE: The aim of this study was to evaluate early clinical and microbiological outcomes of periimplantitis after surgical therapy with adjuvant PDT. METHODS: Fifty-two diagnosed peri-implantitis sites were divided into two groups. PDT was used for decontamination of implant surface in the study group; in the control group, chlorhexidine gel (CHX) followed by saline irrigation was applied. Several clinical parameters were recorded before the treatment (baseline values) and three months after surgical treatment. Samples for microbiological identification were collected before therapy, during the surgical therapy (before and after decontamination of implant surface), and three months thereafter, and analyzed with identification systems using biochemical analysis. RESULTS: The use of PDT resulted in significant decrease of bleeding on probing in comparison to CHX (p < 0.001). It showed significant decontamination of implant surfaces with complete elimination of anaerobic bacteria immediately after surgical procedure and three months later. CONCLUSION: The results indicate that PDT can be used as an adjuvant therapy to surgery for decontamination of implant surface and surrounding peri-implant tissues within the treatment of peri-implantitis.