Peri-implant Care of Ailing Implants with the Carbon Dioxide Laser

One of the many applications for which lasers have been proposed in implant dentistry is for the decontamination process. The purposes of this study were to assess possible alterations in titanium implants in vitro and in vivo by use of the carbon dioxide (CO₂) laser and to determine whether new bone formation can occur on previously contaminated implants. In vitro, temperature changes at the bone-titanium implant interface were recorded during use of a CO₂ laser-scanning system (Swiftlase). Additionally, the effects of laser irradiation on titanium implants at various power settings were examined. In 6 beagle dogs, a total of 60 implants and bony defects resulting from plaque accumulation were treated by air-powder abrasive (the conventional treatment), laser irradiation, or both. Depending on the parameters chosen, melting and other surface alterations were seen in vitro, especially in the superpulse mode. Otherwise, no alterations were found, even at high power settings in the continuous mode. In vivo, corresponding histologic examination of 4-month sections showed evidence of new direct bone-to-implant contact after laser-assisted therapy, especially when the implants had been treated concomitantly with submerged membranes. These results support the hypothesis that peri-implant defects can be treated successfully by laser decontamination without damaging the surrounding tissues in the dog model. Nevertheless, further investigations will be required to determine the clinical efficacy of the treatment.