An Innovative, Non-surgical, and Minimally Invasive Treatment for Peri-Implantitis: A Case Report

Peri-implantitis (PI) is a progressive inflammatory condition characterized by the destruction of peri-implant tissues and alveolar bone loss around dental implants. Despite its rising prevalence, there are still no effective treatment protocols for the condition. This case report presents a relatively novel non-surgical approach for managing PI. The case involves a 57-year-old male smoker with PI around a mandibular first molar implant. Before treatment, a probing pocket depth (PPD) of 8 mm was recorded on the mesial side and 5.5 mm on the distal side using a periodontal probe (PCP UNC 15, HuFriedy, Chicago, IL). Bleeding on probing (BOP) was positive in 66.7% of all sites, and a plaque index of 2 was noted according to the Silness and Loe score. Marginal bone loss was also observed, with 2.5 threads (spiral grooves that anchor the implant in bone) exposed on the mesial and 1.5 threads on the distal. The patient underwent non-surgical treatment comprising ultrasonic mechanical debridement combined with adjunctive 1064 nm diode laser therapy. After 14 months, 4- and 3-mm PPDs on the mesial and distal aspects, respectively, were noted. Bone regeneration could not be confirmed or suspected, as no histological studies or CBCT were performed. This report demonstrates the potential efficacy of laser-assisted non-surgical protocol for managing PI. Further research with larger cohorts and longer follow-up is necessary to validate this approach as a standardized treatment option.