The application of antimicrobial photothermal therapy (EmunDo®) in the treatment of peri-implant diseases: Literature review and a case report
Emmanouil VLACHOS, Chrisoula VAKAKI, Ioannis FOURMOUSIS
Dental Clinic “Dental Excellence”, Athens, Greece (Head: Assist. Professor I. Fourmousis)
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 1, 11-24
SUMMARY: The main goals of therapy of biofilm-induced peri-implant diseases are the complete removal of mi- crobial biofilm and the control of inflammation, the clean- ing of implant surfaces, the regeneration (if feasible) of peri-implant tissues, and the maintenance of bone stability. The treatment alternatives comprise surgical or non- surgical procedures. Additionally, application of antimi- crobial agents, mechanical or chemical modification of implant surfaces, and laser application have been studied. Recently, a novel method used is “photodynamic therapy”. The main principle of this method is based on a photosensitizer that is absorbed by periodontopathogens and is activated by light energy in the presence of oxygen. As a result, cytotoxic molecules (and to a lesser extent developing heat) are produced, and eventually lead to cell death. A more recent modification of this technique is termed as “photothermal therapy”. One of the thera- peutic protocols applied in periodontal and peri-implant diseases is called EmunDo®. In the present study, a case of primary peri-implantitis treated with EmunDo® protocol is presented after a literature review.
KEY WORDS: peri-implant mucositis, peri-implantitis, infracyanine, photothermal therapy, Emundo
REFERENCES
Albrektsson T, Isidor F: Consensus report of session IV. In: Proceedings of the 1st European Workshop on Periodontology Lang NP, Kar- ring T, editors. London, UK, Quintessence Publishing Co: 365- 369, 1994
Berglundh T, Armitage G, et al: Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Work- shop on the Classification of Periodontal and Peri-Implant Dis- eases and Conditions. J Clin Periodontol 45 Suppl 20: S286- S291, 2018
Birang E, Talebi Ardekani MR, et al: Evaluation of Effectiveness of Pho- todynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis. J Lasers Med Sci 8(3): 136-142, 2017
Boehm TK and Ciancio SG: Diode laser activated indocyanine green selectively kills bacteria. J Int Acad Periodontol 13(2): 58-63, 2011 Fourmousis I and Vlachos M: Genetic Risk Factors for the Develop-
ment of Periimplantitis. Implant Dent 28(2): 103-114, 2019 Froum SJ and Rosen PS: A proposed classification for peri-implantitis.
Int J Periodontics Restorative Dent 32(5): 533-540, 2012
Jori G, Fabris C et al: Photodynamic therapy in the treatment of mi- crobial infections: basic principles and perspective applications. Lasers Surg Med 38(5): 468-481, 2006
Renvert S and Quirynen M: Risk indicators for peri-implantitis. A nar- rative review. Clin Oral Implants Res 26 Suppl 11: 15-44, 2015
Renvert S, Roos-Jansaker AM, et al: Non-surgical treatment of peri- implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 35(8 Suppl): 305-315, 2008
Romanos G, Ko HH, et al: The use of CO(2) laser in the treatment of peri-implantitis. Photomed Laser Surg 27(3): 381-386, 2009 Romanos GE, Everts H, et al: Effects of diode and Nd:YAG laser irra-
diation on titanium discs: a scanning electron microscope exami- nation. J Periodontol 71(5): 810-815, 2000
Romanos GE, Javed F, et al: Peri-implant diseases: a review of treat- ment interventions. Dent Clin North Am 59(1): 157-178, 2015
Romanos GE and Nentwig GH: Regenerative therapy of deep peri-implant infrabony defects after CO2 laser implant surface decon- tamination. Int J Periodontics Restorative Dent 28(3): 245-255, 2008
Roncati M, Lucchese A, et al: Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser. J Indian Soc Pe- riodontol 17(6): 812-815, 2013
Saffarpour A, Fekrazad R, et al: Bactericidal Effect of Erbium-Doped Yttrium Aluminum Garnet Laser and Photodynamic Therapy on Aggregatibacter Actinomycetemcomitans Biofilm on Implant Sur- face. Int J Oral Maxillofac Implants 31(3): e71-78, 2016
Saffarpour A, Nozari A, et al: Microstructural Evaluation of Contami- nated Implant Surface Treated by Laser, Photodynamic Therapy, and Chlorhexidine 2 percent. Int J Oral Maxillofac Implants 33(5): 1019-1026, 2018
Salvi GE, Cosgarea R, et al: Prevalence of Periimplant Diseases. Implant Dent 28(2): 100-102, 2019
Socransky SS and Haffajee AD: Dental biofilms: difficult therapeutic targets. Periodontol 2000 28: 12-55, 2002
Soukos NS and Goodson JM: Photodynamic therapy in the control of oral biofilms. Periodontol 2000 55(1): 143-166, 2011
Stubinger S, Etter C, et al: Surface alterations of polished and sand- blasted and acid-etched titanium implants after Er:YAG, carbon dioxide, and diode laser irradiation. Int J Oral Maxillofac Implants 25(1): 104-111, 2010
Takasaki AA, Aoki A, et al: Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 51: 109-140, 2009
Walker CB: The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000 10: 79-88, 1996
Wilson M: Photolysis of oral bacteria and its potential use in the treat- ment of caries and periodontal disease. J Appl Bacteriol 75(4): 299-306, 1993
Yan M, Liu M, et al: The effects of Er:YAG on the treatment of peri- implantitis: a meta-analysis of randomized controlled trials. Lasers Med Sci 30(7): 1843-1853, 2015
Καρούσης Ι: Περιεμφυτευματίτιδα: Από τη διάγνωση στην αντιμετώ- πιση. Αθήνα, Οδοντιατρικό Βήμα, 2020
Dental Clinic “Dental Excellence”, Athens, Greece (Head: Assist. Professor I. Fourmousis)
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 1, 11-24
SUMMARY: The main goals of therapy of biofilm-induced peri-implant diseases are the complete removal of mi- crobial biofilm and the control of inflammation, the clean- ing of implant surfaces, the regeneration (if feasible) of peri-implant tissues, and the maintenance of bone stability. The treatment alternatives comprise surgical or non- surgical procedures. Additionally, application of antimi- crobial agents, mechanical or chemical modification of implant surfaces, and laser application have been studied. Recently, a novel method used is “photodynamic therapy”. The main principle of this method is based on a photosensitizer that is absorbed by periodontopathogens and is activated by light energy in the presence of oxygen. As a result, cytotoxic molecules (and to a lesser extent developing heat) are produced, and eventually lead to cell death. A more recent modification of this technique is termed as “photothermal therapy”. One of the thera- peutic protocols applied in periodontal and peri-implant diseases is called EmunDo®. In the present study, a case of primary peri-implantitis treated with EmunDo® protocol is presented after a literature review.
KEY WORDS: peri-implant mucositis, peri-implantitis, infracyanine, photothermal therapy, Emundo
REFERENCES
Albrektsson T, Isidor F: Consensus report of session IV. In: Proceedings of the 1st European Workshop on Periodontology Lang NP, Kar- ring T, editors. London, UK, Quintessence Publishing Co: 365- 369, 1994
Berglundh T, Armitage G, et al: Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Work- shop on the Classification of Periodontal and Peri-Implant Dis- eases and Conditions. J Clin Periodontol 45 Suppl 20: S286- S291, 2018
Birang E, Talebi Ardekani MR, et al: Evaluation of Effectiveness of Pho- todynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis. J Lasers Med Sci 8(3): 136-142, 2017
Boehm TK and Ciancio SG: Diode laser activated indocyanine green selectively kills bacteria. J Int Acad Periodontol 13(2): 58-63, 2011 Fourmousis I and Vlachos M: Genetic Risk Factors for the Develop-
ment of Periimplantitis. Implant Dent 28(2): 103-114, 2019 Froum SJ and Rosen PS: A proposed classification for peri-implantitis.
Int J Periodontics Restorative Dent 32(5): 533-540, 2012
Jori G, Fabris C et al: Photodynamic therapy in the treatment of mi- crobial infections: basic principles and perspective applications. Lasers Surg Med 38(5): 468-481, 2006
Renvert S and Quirynen M: Risk indicators for peri-implantitis. A nar- rative review. Clin Oral Implants Res 26 Suppl 11: 15-44, 2015
Renvert S, Roos-Jansaker AM, et al: Non-surgical treatment of peri- implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 35(8 Suppl): 305-315, 2008
Romanos G, Ko HH, et al: The use of CO(2) laser in the treatment of peri-implantitis. Photomed Laser Surg 27(3): 381-386, 2009 Romanos GE, Everts H, et al: Effects of diode and Nd:YAG laser irra-
diation on titanium discs: a scanning electron microscope exami- nation. J Periodontol 71(5): 810-815, 2000
Romanos GE, Javed F, et al: Peri-implant diseases: a review of treat- ment interventions. Dent Clin North Am 59(1): 157-178, 2015
Romanos GE and Nentwig GH: Regenerative therapy of deep peri-implant infrabony defects after CO2 laser implant surface decon- tamination. Int J Periodontics Restorative Dent 28(3): 245-255, 2008
Roncati M, Lucchese A, et al: Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser. J Indian Soc Pe- riodontol 17(6): 812-815, 2013
Saffarpour A, Fekrazad R, et al: Bactericidal Effect of Erbium-Doped Yttrium Aluminum Garnet Laser and Photodynamic Therapy on Aggregatibacter Actinomycetemcomitans Biofilm on Implant Sur- face. Int J Oral Maxillofac Implants 31(3): e71-78, 2016
Saffarpour A, Nozari A, et al: Microstructural Evaluation of Contami- nated Implant Surface Treated by Laser, Photodynamic Therapy, and Chlorhexidine 2 percent. Int J Oral Maxillofac Implants 33(5): 1019-1026, 2018
Salvi GE, Cosgarea R, et al: Prevalence of Periimplant Diseases. Implant Dent 28(2): 100-102, 2019
Socransky SS and Haffajee AD: Dental biofilms: difficult therapeutic targets. Periodontol 2000 28: 12-55, 2002
Soukos NS and Goodson JM: Photodynamic therapy in the control of oral biofilms. Periodontol 2000 55(1): 143-166, 2011
Stubinger S, Etter C, et al: Surface alterations of polished and sand- blasted and acid-etched titanium implants after Er:YAG, carbon dioxide, and diode laser irradiation. Int J Oral Maxillofac Implants 25(1): 104-111, 2010
Takasaki AA, Aoki A, et al: Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 51: 109-140, 2009
Walker CB: The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000 10: 79-88, 1996
Wilson M: Photolysis of oral bacteria and its potential use in the treat- ment of caries and periodontal disease. J Appl Bacteriol 75(4): 299-306, 1993
Yan M, Liu M, et al: The effects of Er:YAG on the treatment of peri- implantitis: a meta-analysis of randomized controlled trials. Lasers Med Sci 30(7): 1843-1853, 2015
Καρούσης Ι: Περιεμφυτευματίτιδα: Από τη διάγνωση στην αντιμετώ- πιση. Αθήνα, Οδοντιατρικό Βήμα, 2020
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