Laser applications in peri-implantitis therapy: A narrative review

Introduction/Objectives: The treatment of peri-implantitis remains one of the most challenging areas in implant dentistry, with no universally accepted gold standards for long-term disease resolution. As the prevalence of peri-implantitis continues to rise with increased implant placement, the need for predictable and effective therapies becomes increasingly critical. Laser-assisted treatment has emerged as a promising modality in surgical and non-surgical management of peri-implant diseases due to its ability to decontaminate the implant surface, reduce the bacterial load, and debride bone defects. Data/Sources: An electronic search utilizing terms related to “peri-implantitis” and “dental lasers” was conducted via PubMed and Google scholar with a focus on highly cited articles based on inclusion and exclusion criteria, and review articles as well as the authors personal experiences. This review does not follow PRISMA guidelines or include risk-of-bias analysis due to its narrative format. The aim of the present investigation was to analyze the current available literature on laser therapy in the treatment of peri-implantitis, with a focus on how clinical outcomes vary according to laser type, wavelength, power settings, and the use of adjunctive phototherapies such as photodynamic therapy (PDT) and photobiomodulation (PBM).

Conclusions: While there is significant limitation in the clinical evidence available, thus far the literature suggests potential use of Erbium and CO₂ wavelengths as an adjunct in peri-implantitis therapy, while the existing evidence against the use of the Nd:YAG-laser on implant surfaces. The evidence is inconclusive regarding the use of diode lasers including photodynamic therapy (PDT) and Photobiomodulation (PBM), and as the field of dental lasers continues to develop, specific power settings and standardized protocols will emerge and continuously improve. Clinical Significance: The paper demonstrates possibilities of phototherapy in the treatment of peri-implantitis and highlights opportunities of treatment based on the limitations of available evidence with mechanisms for each laser wavelength and their interactions with the peri-implant tissues.