Peri-implantitis, Comparing Treatments 970 nm Laser and Mucosal Flap Surgery

NCT ID: NCT04249024

Last Updated: 2022-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-25

Study Completion Date

2022-06-21

Brief Summary

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A clinical trial comparing laser treatment and conventional mucosal flap surgery for treatment of peri-implantitis. The main aim of the study is to evaluate if treatment of peri-implantitis with 970 nm laser combined with scaling and root planning (SRP) is clinically comparable to conventional mucosal flap surgery in terms of pocket probing depth reduction.

Detailed Description

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The present project aims to evaluate a novel method in treating peri-implantitis, with focus on decreasing the patient's suffering as well as disease progression. Peri-implantitis has a direct influence on both physical and psychological wellbeing and have been related to difficulty in chewing due to loss of implants, bad esthetic appearance as well as high costs. Therefore, it is of importance for the individual as well as for the society to thoroughly investigate any new treatment approaches.

The study is a prospective randomized clinical trial comparing laser treatment (test group) and conventional mucosal flap surgery (active control group). Assessment of clinical variables at baseline and after 6 months. Patient reported outcomes at baseline, directly after treatment and after 10 days.

Primary Objective:

To evaluate if treatment of peri-implantitis with 970 nm laser combined with scaling and root planning (SRP) is clinically comparable to conventional mucosal flap surgery in terms of pocket probing depth reduction.

Secondary Objectives:

* To evaluate other clinical and radiological variables connected to peri-implantitis and the inflammation surrounding the dental implant.
* To evaluate the patient experience of treatment of peri-implantitis.
* To evaluate the inflammatory and microbial response after laser treatment

Conditions

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Peri-Implantitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Masking for the assessors of microbial, immunological and radiographic analyses.

Study Groups

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Laser treatment

Laser treatment with diode laser 970nm and settings 1.2W in intervals of max 20s, until satisfactory removal of diseased epithelium and granulation tissue.

Group Type EXPERIMENTAL

Laser treatment

Intervention Type DEVICE

The participants in the laser group are treated with a 970 nm diode laser and if calculus is present scaling and root planning (SRP). The peri-implant pocket will be radiated with the 970 nm laser, removing bacteria, diseased epithelium and granulation tissue. The laser will be used at a maximum of 20s intervals before water irrigation. Laser settings continuous wave mode and power between 1.0-1.3W. Total treatment time will vary with the depth of the pocket and size of the surrounding bone crater.

Oral hygiene instructions

Intervention Type BEHAVIORAL

Oral hygiene instructions of how to clean around dental implants as per individual needs in terms of access to clean and fine motor skills.

Mucosal flap surgery

Conventional mucosal flap surgery of affected dental implant.

Group Type ACTIVE_COMPARATOR

Mucosal flap surgery

Intervention Type PROCEDURE

The participants will receive a conventional peri-implant mucosal flap surgery of affected implants, and return after 7-10 days for suture removal. The surgery is a well-established treatment of peri-implantitis.

Oral hygiene instructions

Intervention Type BEHAVIORAL

Oral hygiene instructions of how to clean around dental implants as per individual needs in terms of access to clean and fine motor skills.

Interventions

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Laser treatment

The participants in the laser group are treated with a 970 nm diode laser and if calculus is present scaling and root planning (SRP). The peri-implant pocket will be radiated with the 970 nm laser, removing bacteria, diseased epithelium and granulation tissue. The laser will be used at a maximum of 20s intervals before water irrigation. Laser settings continuous wave mode and power between 1.0-1.3W. Total treatment time will vary with the depth of the pocket and size of the surrounding bone crater.

Intervention Type DEVICE

Mucosal flap surgery

The participants will receive a conventional peri-implant mucosal flap surgery of affected implants, and return after 7-10 days for suture removal. The surgery is a well-established treatment of peri-implantitis.

Intervention Type PROCEDURE

Oral hygiene instructions

Oral hygiene instructions of how to clean around dental implants as per individual needs in terms of access to clean and fine motor skills.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Signs of peri-implantitis around one or more dental implants. All criteria below need to be fulfilled for inclusion.

* Presence of pocket probing depth (PPD) \> 5 mm
* Bleeding on probing/suppuration (BOP/Pus)
* At least 2 mm loss of bone, visible on radiographs, after initial osseointegration.
* ≥ 18 years old.
* Patient able to understand Swedish.

Exclusion Criteria

* Antibiotic treatment 6 months prior to baseline.
* Peri-implant treatment 6 months prior to baseline.
* Myocardial infarction 6 months prior to baseline.
* Previous radiation treatment in the affected jaw area.
* Previous i.v. bisphosphonate treatment.
* Moderate or severe impairment of cognitive function (e.g. dementia).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Annsofi Johannsen

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Annsofi Johannsen

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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Danakliniken Specialist Dentistry

Danderyd, Stockholm County, Sweden

Site Status

Specialist Dentistry Clinic, Karolinska Institutet, Dept. of Dental Medicine

Huddinge, Stockholm County, Sweden

Site Status

Countries

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Sweden

Other Identifiers

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Peri-implantitis 970 nm laser

Identifier Type: -

Identifier Source: org_study_id

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