Laser Therapy for Adjunctive Treatment of Peri-implant Disease
Peri-implant Mucositis

Peri-implant mucositis is an inflammatory lesion confined to the soft tissues surrounding an endosseous dental implant without loss of supporting bone loss (Figure 1). While this stage of disease may still be reversible, it has been noted that the inflammatory lesion seen in experimental peri-implant mucositis is larger than that seen in experimental gingivitis of the same chronicity and that resolution of the clinical signs of peri-implant mucositis requires a longer time period than the 21-day time period required for resolution of experimental gingivitis.⁷ This may indicate that more aggressive and/or invasive treatment may be indicated for such cases to allow for complete resolution of the defects; some authors have advocated earlier intervention, ideally as soon as disease is identified to prevent progression to bone loss and peri-implantitis.^7,8,48 Several factors have been identified as risk factors and/or potential risk factors for peri-implant mucositis, including plaque biofilm accumulation, smoking, head and neck radiation, diabetes mellitus/glycemic control, keratinized mucosa, and the presence of excess luting cement.^9,45,49-51 Successful treatment of peri-implant mucositis has been demonstrated through nonsurgical intervention consisting of supragingival and subgingival debridement with or without adjuncts such as laser and/or photodynamic therapy, locally delivered antibiotics, or chlorhexidine rinse.⁹ Regardless of treatment modality used, oral hygiene reinforcement, assurance of adequate plaque control, and regular maintenance is crucial to treat the inflammation and prevent future loss.