Objectives: To evaluate possible benefits of the adjunctive use of light-activated disinfection (LAD) in the treatment of peri-implantitis. Materials and methods: Eighty patients with at least one implant affected by peri-implantitis defined as at least 3 mm of bone loss from the baseline radiographs in the presence of signs of infection (pus exudation and/or soft tissue swelling and/or soft tissue redness) were nonsurgically or surgically treated. A total of 50% were randomly allocated to receive an additional treatment of LAD (FotoSan) according to a parallel group design at four different centres. Only one implant per patient was considered. Outcome measures recorded up to 4 months after treatment were implant failures, complications, probing pocket depth (PPD) changes and number of re-treatment sessions recorded by blinded assessors. Patients were followed for 4 months after treatment. Results: Five treated patients did not fit the original inclusion criteria, 4 because they were not affected by peri-implantitis (as defined in the present study) and one because the patient was treated with antibiotics, however they were included according to an intention-to-treat analysis concept. Nine patients of the LAD group were treated surgically versus 10 control patients. After 4 months, 1 patient dropped out from the LAD group and no implant failed. Fifteen implants had to be re-treated in the LAD group versus 16 implants in the control group, the difference was not significant. Three minor complications occurred: 2 in the LAD group and 1 in the control group. PPD significantly decreased in both groups, and at 4 months there was no significant differences between groups (difference -0.12 mm, 95% CI of difference -0.94 to 0.69, P = 0.77). There were significant differences between centres for number of re-treatments needed, PPD changes, plaque and marginal bleeding 4 months after treatment. The results did not change when removing the 5 patients who did not match the present inclusion criteria. Conclusions: The use of adjunctive LAD therapy with mechanical cleaning of implants affected by peri-implantitis did not improve any clinical outcomes up to 4 months after treatment, however longer follow-ups are needed to evaluate the possible effect of repeated LAD therapy over time. Conflict-of-interest statement: CMS Dental A/S, the manufacturer of FotoSan, the LAD device tested in this investigation, partially supported this trial. However, the data belonged to the authors and by no means did FotoSan interfere with the conduct of the trial or the publication of the results.
The effectiveness of adjunctive light-activated disinfection (LAD) in the treatment of periimplantitis: 4-month results from a multicentre pragmatic randomised controlled trial
De Angelis N.;
2012-01-01
Abstract
Objectives: To evaluate possible benefits of the adjunctive use of light-activated disinfection (LAD) in the treatment of peri-implantitis. Materials and methods: Eighty patients with at least one implant affected by peri-implantitis defined as at least 3 mm of bone loss from the baseline radiographs in the presence of signs of infection (pus exudation and/or soft tissue swelling and/or soft tissue redness) were nonsurgically or surgically treated. A total of 50% were randomly allocated to receive an additional treatment of LAD (FotoSan) according to a parallel group design at four different centres. Only one implant per patient was considered. Outcome measures recorded up to 4 months after treatment were implant failures, complications, probing pocket depth (PPD) changes and number of re-treatment sessions recorded by blinded assessors. Patients were followed for 4 months after treatment. Results: Five treated patients did not fit the original inclusion criteria, 4 because they were not affected by peri-implantitis (as defined in the present study) and one because the patient was treated with antibiotics, however they were included according to an intention-to-treat analysis concept. Nine patients of the LAD group were treated surgically versus 10 control patients. After 4 months, 1 patient dropped out from the LAD group and no implant failed. Fifteen implants had to be re-treated in the LAD group versus 16 implants in the control group, the difference was not significant. Three minor complications occurred: 2 in the LAD group and 1 in the control group. PPD significantly decreased in both groups, and at 4 months there was no significant differences between groups (difference -0.12 mm, 95% CI of difference -0.94 to 0.69, P = 0.77). There were significant differences between centres for number of re-treatments needed, PPD changes, plaque and marginal bleeding 4 months after treatment. The results did not change when removing the 5 patients who did not match the present inclusion criteria. Conclusions: The use of adjunctive LAD therapy with mechanical cleaning of implants affected by peri-implantitis did not improve any clinical outcomes up to 4 months after treatment, however longer follow-ups are needed to evaluate the possible effect of repeated LAD therapy over time. Conflict-of-interest statement: CMS Dental A/S, the manufacturer of FotoSan, the LAD device tested in this investigation, partially supported this trial. However, the data belonged to the authors and by no means did FotoSan interfere with the conduct of the trial or the publication of the results.
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