MARISA RONCATI, BS, RDH, DDS. Teacher in Dental School, Albanian University. Assistant Professor: Master of Prosthesis and Implantology, Bologna University (2008-2020); European Master Degree on Oral Laser Applications (EMDOLA), Parma and Rome University, and Master Degree in Oral Surgery and Pathology, Parma University, Italy. Invited Lecturer for Harvard School of Dental Medicine, Continuing Education programs.

Periodontal and Peri-implant Diseases: Differentiated Laser-assisted Surgical & Nonsurgical Protocols

The surgical treatment of periodontal and peri-implant diseases should always follow nonsurgical therapy and performed only when initial treatment results are unsatisfactory. Periodontal patient management and modus operandi will be discussed.

Guidance will be provided on differentiated protocols. The use of modified subgingival debridement techniques, state-of-the-art technologies, cause-related laser-assisted nonsurgical periodontal therapy, and novel materials to obtain effective decontamination of the implant surface will be fully illustrated.  Innovative materials for a multi-antimicrobial approach will be also reviewed. Specific protocols for mucositis and/or peri-implantitis will be outlined and discussed. The nonsurgical approach has proven effective for mucositis, when adequate home care is combined with mechanical instrumentation, and can sometimes even

prolong the survival of severely ailing implants. In addition, for patients who may not be able to accept surgical management for any reasons, the dentist must evaluate the potential for a nonsurgical approach to achieve reasonable long-term results.

Clinical cases will be used to demonstrate how patient home care performance can influence the clinical management and outcomes, as well as to document satisfactory clinical stability following periodontal nonsurgical treatment. Although it is often possible to treat periodontal and peri-implant disease, prevention remains the best cure.

On-line: Periodontal and Peri-implant Diseases: Differentiated Laser-assisted Surgical & Nonsurgical Protocols

A 10-year follow-up clinical case is presented, limited to the right lateral incisor, which at the time of the initial visit had localized and severe periodontal disease.

The case was managed with a non-surgical laser-assisted approach, and after 1 year of follow-up the clinical results are more than satisfactory, whereas the healing process had not yet fully matured in the preceding months. In the presentation, emphasis is placed on waiting a congruous period of at least 1 year, in case of initial ≥6 mm pockets, based on the clinical evidence and iconographic documentation of the case.

The site remains stable for about 5 years. Then at 6-year follow-up the site shows signs of clinical instability, again managed and solved by a nonsurgical laser-assisted approach. The success of such treatment then is maintained for the subsequent years for a total of 10 years follow-up.

Clinical outcomes in the other areas of the same clinical case will be presented during the congress.