Abstract :Objective: This clinical report describes a case of severe peri-implantitis in the anterior region of the maxilla successfully managed with the association of photodynamic therapy and conventional surgical treatment.
Background Data: In implant dentistry, several treatment modalities have been presented to treat peri-implantitis and regenerate the bone, however, no protocol has yet been established and defined as effective. Adjunct approaches, such as photodynamic therapy (PDT), may be able to improve the success of conventional treatments.
Methods: A 59-year-old man was diagnosed with severe peri-implantitis in implants 11, 13, 21 and 23. After open debridement and implantoplasty, PDT was performed by applying the photosensitizer methylene blue over the implant surface for 5 min. Laser irradiation was performed with a GaAlAs low-level diode laser, with a wavelength of 660 nm, energy density 100 J/cm2, and output power of 100 mW. The treatment was complemented with bone regeneration and free soft tissue graft.
Results: One year after the treatment, no bleeding-on-probing was observed and peri-implant pocket depths were reduced to 1 mm to 3 mm; this was maintained after 5 years of follow-up.
Conclusion: The treatment protocol, combined with support treatment, allowed the reduction of pathogenic bacteria and promoted the health of peri-implant tissues for a period of up to 5 years of follow-up.