Effect of laser‐assisted reconstructive surgical therapy of peri‐implantitis on protein biomarkers and bacterial load

Abstract

AbstractObjectivesThis randomized clinical trial assessed changes in protein biomarker levels and bacterial profiles after surgical reconstructive therapy of peri‐implantitis and investigated whether the adjunctive use of Er:YAG laser impacts protein biomarker and microbial outcomes.Materials and MethodsTwenty‐four patients received surgical reconstructive therapy for peri‐implantitis with guided bone regeneration following mechanical debridement with (test) or without (control) the adjunctive irradiation of Er:YAG laser. Bacterial and peri‐implant crevicular fluid (PICF) samples were collected over 6 months and analyzed with bacterial qPCR and luminex multiplex assays.ResultsSurgical reconstructive treatment significantly affected the concentration of PICF protein biomarkers, including a 50% reduction in IL‐1β between 2 and 4 weeks (p < .0001). Both MMP‐9 (p < .001) and VEGF (p < .05) levels steadily decreased after treatment. In the laser group, the peak increase in IL‐1β was attenuated at 2 weeks, followed by significant reduction in MMP‐9 (p < .01) and VEGF (p < .05) across all follow‐up appointments compared with the control nonlaser group. The total bacterial load was reduced 2 weeks after treatment, especially in the laser group, but recolonized to presurgical levels after 4 weeks in both groups (p < .01). The composition of selective pathogens varied significantly over the follow‐up, but recolonization patterns did not differ between groups.ConclusionsReconstructive therapy of peri‐implantitis significantly altered PICF protein biomarker and microbial levels during the healing process. The adjunctive use of Er:YAG laser significantly modulated the inflammatory response through reduced levels of MMP‐9 and VEGF during the postsurgical period. The bacterial load was reduced immediately after therapy, but recolonization was observed by 4 weeks in both groups.