Terapia fotodinamica nelle perimplantiti: studio clinico comparativo.

OBJECTIVES. The aim of this study was to compare the effects of photodynamic therapy (PDT) associated to conventional therapy (CT) and CT alone on clinical and microbiological parameters in active peri-implantitis patients. MATERIALS AND METHODS. Twenty patients were enrolled in the study and they were divided into four groups, two test groups (treated by PDT + CT) and two control groups (treated by CT only), according to their bone defect depth. CT consisted in scaling associated to chlorexidine irrigation. In defects deeper than 2 mm a mucoperiosteal flap was carried out. PDT consisted in applying toluidine blue into peri-implantitis site and irradiating it with a diode laser for 1.5 minutes in continuous wave mode. Microbiological samples were obtained before, immediately after treatment and six months later. RESULTS. Mean global anaerobia bacterial count was reduced by 93.6% in test groups, vs 83.5% of control groups. Qualitative assay of pathogens showed a mean 3 log steps re-duction for P gingivalis e Prevotella intermedia and 2 log steps for A. actinomycetemcomitans in test groups, vs 2 log steps and 1 log step of reduction for the same species in the control groups. Microbiological assay six months later displayed a partial bacteria re-colonization. CONCLUSIONS. Progressive peri-implant bone loss accompanied by inflammatory lesions of soft tissues are referred to as peri-implantitis. The findings of this study suggest that photodynamic therapy can be considered a useful method associated to conventional therapy in order to reduce micro-organism in peri-implantitis affected sites.