Er,Cr:YSGG Laser-Assisted Surgical Treatment of Peri-Implantitis With 1-Year Reentry and 18-Month Follow-Up

Background: Peri-implantitis may occur because of biologic or mechanical factors. It can be treated by a variety of methods. In the present case report, treatment was attempted by regenerative osseous surgery associated with an erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er, Cr. YSGG) laser. Methods: A 28-year-old, non-smoking male complained of gum recession around an implant in the area of upper left central incisor. After clinical examination and radiographs, it was found that there was 2 mm recession, a probing depth of 7 mm, mobility grade one, and bone mesially and distally. Regenerative osseous surgery was performed using an Er,Cr:YSGG laser (2,780 nm) at different settings to open the flap, remove the granulation tissues, perforate the bone, and clean the implant surface. A bone graft and a bioabsorbable membrane were used for bone regeneration. The patient was reevaluated at 3, 6, 12 (with reentry), and 18 months postoperatively. Results: At 3, 6, and 12 months postoperatively, there were no reported complications, with probing depths of 3 to 5 mm, <1mm recession, no bleeding or implant mobility, and good bone formation. Slight pus discharge was present at 12 months. At 18 months postoperatively, probing depth was 2 mm, recession was <1 mm, there was no bleeding, implant mobility, or discharge, and there was better bone formation. The results were satisfactory to the patient and the clinician. Conclusion: The Er,Cr.-YSGG laser enabled regenerative osseous surgery around an implant with no complications and with high patient and clinician satisaction and confidence. J Periodontol 2008;79:20002005.