Dual-light antibacterial photodynamic therapy in periimplant mucositis treatment

Background. The link between biofilm accumulation around dental implants and the development of an inflammatory disease around them has been demonstrated in classical pre-clinical and clinical studies. In patients with peri-implant mucositis, the EFP S3 level clinical practice guideline suggest not to use locally administered agents (antiseptics, postbiotics, desiccant gel) or photodynamic therapy, as adjunct methods to professional mechanical plaque removal (PMPR). Instead, the use of a time limited self-administration of oral rinse antiseptics (chlorhexidine and herbal-based) or the professionally guided self-administration of probiotics may be considered. In previous studies, some antiseptics have been associated with undesirable side effects, such as transient anaesthetic sensation in the oral mucosa or higher levels of staining of the teeth or tongue. Previously, antibacterial photodynamic therapy (aPDT) has been used mainly in dental offices practice and rare aplications (1-4 times per year ) usually did not improve the results. Recently, LED based aPDT has been developed allowing repeated and practical use at home. Objective of the study. This study aimed to determine the clinical outcomes obtained with regular antibacterial photodynamic therapy in peri-implant mucositis treatment. Materials and methods. After applying inclusion and exclusion criteria, 29 patients were enrolled in the study. Each of them had at least 1 implant diagnosed with mucositis. Patients were randomized into 2 groups: Study Group (GS) – 14 patients, and Control Group (GC) – 15 patients. Patients from GS, besides submarginal instrumentation, received repeated aPDT treatment. The study used a medical device containing a light-activated Lumorinse® mouthwash and a Lumoral® light activator. The primary outcome variable was peri-implant probing depth reduction (PiPD), while the secondary outcome variables were changes in bleeding on probing (mBOP) and plaque index (mPI). Clinical parameters were assessed at the beginning and after 2 months. Results. All 29 patients included in the study finalized the study. In GS and GC respectively, the results were: PiPD of 5.3±0.6 mm and 5.4±0.5 mm initially, and after 2 months 4.1±0.5 mm and 4.2±0.7 mm respectively (p >0.05), mPI was more reduced in GS group than GC (p < 0.05), and mBoP was lower in GS comparing to GC (p < 0.05). Conclusion. Patients from the control group showed better results on mPI and mBoP indices. Repeated aPDT treatment at home can improve oral hygiene and the results of peri-implant mucositis treatment. Additional studies are required to validate the current results.