Efficacy of mechanical debridement with and without adjunct antimicrobial photodynamic therapy in the treatment of peri-implantitis among moderate cigarette-smokers and waterpipe-users

Fawaz Alqahtani; Nasser Alqhtani; Fahad Alkhtani; Darshan Devang Divakar; Abdulaziz A Al-Kheraif; Fawad Javed

doi:10.1016/j.pdpdt.2019.09.003

Efficacy of mechanical debridement with and without adjunct antimicrobial photodynamic therapy in the treatment of peri-implantitis among moderate cigarette-smokers and waterpipe-users

Photodiagnosis Photodyn Ther. 2019 Dec:28:153-158. doi: 10.1016/j.pdpdt.2019.09.003. Epub 2019 Sep 13.

Authors

Fawaz Alqahtani¹, Nasser Alqhtani², Fahad Alkhtani³, Darshan Devang Divakar⁴, Abdulaziz A Al-Kheraif⁴, Fawad Javed⁵

Affiliations

¹ Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia. Electronic address: implantologist@yahoo.com.
² Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
³ Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
⁴ Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
⁵ Department of Periodontology, Stony Brook University, Stony Brook, NY, USA; Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, NY, USA.

PMID: 31525451
DOI: 10.1016/j.pdpdt.2019.09.003

Abstract

Objective: The aim was to assess the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri-implantitis among cigarette-smokers and waterpipe-users.

Materials and methods: Patients diagnosed with peri-implantitis were included. Demographic data was collected using a questionnaire. Individuals in the test- and control-groups underwent MD with adjunct aPDT and MD alone, respectively. Peri-implant clinical (plaque-index [PI], bleeding on probing [BOP] and probing depth [PD]) and radiographic (crestal bone loss [CBL]) inflammatory parameters were measured at baseline and at 6- and 12-months follow-up. Sample-size estimation was performed, and statistical analysis was done. P-values <0.05 were considered statistically significant.

Results: Ninety-eight male patients with peri-implantitis (34 cigarette-smokers, 32 waterpipe-users and 32 never-smokers) were included. At baseline, there was no difference in the peri-implant PI, PD and CBL in all groups; and BOP levels were significantly high among never-smokers (n = 16) (P < 0.01) than cigarette-smokers (n = 17) and waterpipe-users (n = 16). There was no difference in PI, BOP, PD and CBL among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD alone at 3- and 6-months' follow-up compared with baseline. Compared with baseline, PI (P < 0.05) and PD (P < 0.05) were significantly lower among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD + aPDT at 3-months' follow-up. At 6-months' follow-up, PI, BOP and PD were significantly lower in never-smokers (n = 16) than their respective baseline and 3-months' follow up outcomes.

Conclusion: MD with adjunct aPDT is effective for the treatment of peri-implantitis. Routine oral hygiene maintenance plays a role in the overall success of MD with or without aPDT in patients with peri-implantitis.

Keywords: Alveolar bone loss; Antimicrobial photodynamic therapy; Dental implant; Inflammation; Peri-implantitis.

MeSH terms

Combined Modality Therapy
Debridement / methods*
Humans
Male
Middle Aged
Peri-Implantitis / diagnostic imaging
Peri-Implantitis / therapy*
Photochemotherapy / methods*
Smokers*
Water Pipe Smoking