Laser therapy in peri-implantitis management: A scoping review of efficacy and current evidence

Resumo

Peri-implantitis poses a persistent challenge in implant dentistry, driving interest in laser therapy as a potential treatment option. Despite encouraging outcomes, clinical applications of laser therapy differ significantly in terms of wavelength, power setting and session frequency, hindering the development of standardized protocols. This scoping review aimed to map and synthesize current clinical evidence on the efficacy of laser therapy in peri-implantitis management, identify knowledge gaps and provide a foundation for future clinical recommendations. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) guidelines, a comprehensive search was conducted across 5 databases (Scopus, PubMed, Cochrane Library, Embase, and Web of Science) between May and July 2024, covering studies published from 2000 to 2024, with no language restrictions. Two independent reviewers extracted data with high inter-rater agreement (κ = 0.97). A total of 98 clinical studies were included: 56 randomized controlled trials (RCTs), 38 cohort studies and 4 retrospective studies. Diode lasers were the most frequently studied (n = 50), followed by Er:YAG, aPDT, Nd:YAG, and Er,Cr:YSGG lasers. Exposure times ranged from 10 s to 700 s, most commonly around 60 s. Key clinical outcomes included probing depth (PD) reduction, bleeding on probing (BoP) and plaque index (PI), with additional outcomes related to bone loss, clinical attachment level (CAL), gingival recession (REC), cytokine levels, microbial analysis, suppuration, and gingival index (GI). Overall, laser therapy was associated with reduced inflammation, accelerated epithelialization, improved bone parameters, fewer complications, and better patient-reported outcomes. While laser therapy shows considerable promise in the treatment of peri-implantitis, further robust and standardized clinical research is essential to confirm its efficacy, optimize treatment parameters and inform evidence-based clinical guidelines.