Comparison of Photodynamic Therapy and Air Abrasion for Implant Surface Decontamination with Laser Treatment in Terms of Efficacy and Implant Surface Alterations: A Systematic Review

Objectives: Considering the shortcomings of the currently applied mechanical and chemical methods for implant surface decontamination, this study compared the efficacy of three decontamination methods and their impact on implant surface. Materials and Methods: This systematic review was conducted based on the PRISMA guidelines, with searches performed in PubMed, Scopus, and Web of Science databases. The inclusion criteria were English-language animal, in vivo, and in vitro studies on the effects of photodynamic therapy (PDT), laser treatment, and air abrasion on implant surface changes or microbial load. Results: Of 1,076 initially retrieved articles, 30 studies were fully reviewed; out of which, 20 met the inclusion criteria. One study found that erbium-doped yttrium-aluminum-garnet (Er:YAG) laser and air abrasion were equally effective in reducing the microbial load, but seven studies favored laser treatment. Five studies noted minor surface changes with air abrasion, while three reported more changes with laser. Regarding biocompatibility, eight studies favored laser; while, three found both methods effective. In six studies, Er:YAG laser was more effective than PDT in reducing the microbial load, with five studies also showing better preservation of implant integrity. Both methods were biocompatible, but laser treatment was superior in preserving cell viability, with three studies favoring it over PDT. Additionally, PDT outperformed air abrasion in reducing the microbial load, preserving the implant surface, and enhancing biocompatibility. Conclusion: Both PDT and laser therapy are effective in reducing the microbial load. Additionally, laser causes the least surface alterations, with some studies reporting minor improvements in implant surface properties.