Peri-implant care of ailing implants with the carbon dioxide laser

One of the many applications for which lasers have been proposed in implant dentistry is for the decontamination process. The purposes of this study w ere to assess possible alterations in titanium implants in vitro and in viv o by use of the carbon dioxide (CO2) laser and to determine whether new bon e formation can occur on previously contaminated implants. In vitro, temper ature changes at the bone-titanium implant interface were recorded during u se of a CO2 laser-scanning system (Swiftlase). Additionally, the effects of laser irradiation on titanium implants at various power settings were exam ined. In 6 beagle dogs, a total of 60 implants and bony defects resulting f rom plaque accumulation were treated by air-powder abrasive (the convention al treatment), laser irradiation, or both. Depending on the parameters chos en, melting and other surface alterations were seen in vitro, especially in the superpulse mode. Otherwise, no alterations were found, even at high po wer settings in the continuous mode. In vivo, corresponding histologic exam ination of 4-month sections showed evidence of new direct bone-to-implant c ontact after laser-assisted therapy, especially when the implants had been treated concomitantly with submerged membranes. These results support the h ypothesis that periimplant defects can be treated successfully by laser dec ontamination without damaging the surrounding tissues in the dog model. Nev ertheless, further investigations will be required to determine the clinica l efficacy of the treatment.