Head of Oral Surgery Department of Wroclaw Medical University, Poland, ViceRector of Strategic Initiatives Wroclaw Medical University, FDI Edu Committee President of Polish Dental Association, Professor, oral surgeon
Vitamin D, Laser and Periimplantitis Management
Peri-implantitis is an immune-mediated biological complication that is estimated to affect 12%-24% of dental implants. For more than ten years, peri-implantitis was treated with antibiotics and mechanical periodontitis agents until it was realized that these treatments were ineffective. This was because they had similar symptoms when cross-sectionally assessed. Both are characterized by clinical signs such as inflammation, bleeding, swelling of the oral mucosa, progressive alveolar bone loss, and histologically, the tissues are saturated with leukocytes with proinflammatory cytokines.
Importantly, inflammation of the periodontium and around implants is associated with the presence of biofilms of appropriately different quality for the periodontium and the implant. This situation is additionally aggravated by the observed phenomenon of corrosion of titanium implants, and titanium dissolution products are active factors shaping the structure and diversity of the microbiome. Therefore, the antibiotic therapy used in periodontitis was not fully effective in peri-implantitis. It is required to establish a new algorithm of procedure and to select new chemo-mechanical means, including laser therapy, which will be more effective than those used so far and will enable the development of a new model of treatment of periimplanatitsis. In addition, attention should be paid to general factors, such as the level of vitamin D or the presence of oxidative stress affecting the formation of systemic metainflammation, which worsens the prognosis in the course of peri-implantitis.