Peri-İmplantitis Tedavisinde Cerrahi Olmayan Tedavi Yaklaşımlarının Etkinliğinin Klinik ve Biyokimyasal Olarak Değerlendirilmesi
Erduran, Nazan Ece
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Peri-implantitis is an inflammatory disease around implants characterized by progressive bone loss. There are many different approaches proposed for the treatment of peri-implantitis such as non-surgical mechanical treatment with the additional use of diode laser. There are conflicting results regarding the effectiveness of this approach in the literature. Evaluation of the clinical changes in peri-implant tissues as well as the biomarker levels associated with the pathogenesis of peri-implantitis before and after the treatment may illuminate this contradiction. The aim of this study is to evaluate the efficacy of diode laser application in addition to non-surgical mechanical theraphy in the treatment of peri-implantitis, both clinically and biochemically. A total of 27 people (21 females and 6 males) with the mean age of 55.08 ± 10.57 years agreed to participate in our study. 40 implants diagnosed with peri-implantitis were randomly assigned to the laser group (laser application in addition to conventional treatment, n=19) or the control group (conventional treatment alone, n=18). Clinical parameters of the implants such as pocket depth, gingival index, gingival bleeding time index, plaque index were recorded and peri-implant crevicular fluid (PICF) samples were collected and also IL-1β, IL-10, IL-17, TWEAK, sclerostin, RANKL and OPG levels in PICF samples were measured with ELISA tests in both treatment groups at baseline, third month and sixth month. According to the results of the study, significant decreases were detected at 6th month both in clinical and biochemical parameters compared to the initial values in each treatment group. When comparing both treatment groups, clinical parameters such as gingival index, gingival bleeding time index and plaque index; and biochemical parameters such as IL-1β, IL-17 and sclerostin were significantly different in favor of the laser group at the third month controls. However, the difference at the third month between groups equalized at 6th month. Within the limitations of this study, diode laser seems to be an additional valuable tool in the early healing period of peri-implantitis treatment. In addition, IL-1β, IL-17 and sclerostin have found to be better biomarkers for the diagnosis of peri-implantitis and the evaluation of the treatment efficacy. Further studies are needed to confirm these findings.