Abstract
•The aPDT is useful in the treatment of peri-implant diseases.•The outcome of MD with or without aPDT is compromised in tobacco-smokers.•In never-smokers, MD + aPDT is more effective than MD alone.•Smoking retards healing and masks BOP.
The aim was to assess the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri-implantitis among cigarette-smokers and waterpipe-users.
Patients diagnosed with peri-implantitis were included. Demographic data was collected using a questionnaire. Individuals in the test- and control-groups underwent MD with adjunct aPDT and MD alone, respectively. Peri-implant clinical (plaque-index [PI], bleeding on probing [BOP] and probing depth [PD]) and radiographic (crestal bone loss [CBL]) inflammatory parameters were measured at baseline and at 6- and 12-months follow-up. Sample-size estimation was performed, and statistical analysis was done. P-values <0.05 were considered statistically significant.
Ninety-eight male patients with peri-implantitis (34 cigarette-smokers, 32 waterpipe-users and 32 never-smokers) were included. At baseline, there was no difference in the peri-implant PI, PD and CBL in all groups; and BOP levels were significantly high among never-smokers (n = 16) (P < 0.01) than cigarette-smokers (n = 17) and waterpipe-users (n = 16). There was no difference in PI, BOP, PD and CBL among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD alone at 3- and 6-months’ follow-up compared with baseline. Compared with baseline, PI (P < 0.05) and PD (P < 0.05) were significantly lower among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD + aPDT at 3-months’ follow-up. At 6-months’ follow-up, PI, BOP and PD were significantly lower in never-smokers (n = 16) than their respective baseline and 3-months’ follow up outcomes.
MD with adjunct aPDT is effective for the treatment of peri-implantitis. Routine oral hygiene maintenance plays a role in the overall success of MD with or without aPDT in patients with peri-implantitis.