Non-Cochrane · intervention · PM41590175
Microbiological Effects of Laser-Assisted Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Neophytou Chariklia, Vlachodimou Elpiniki, Kaklamanos Eleftherios G, et al. · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14010049
Findings
Population Adults with peri-implantitis
22 findings
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts Baseline · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD 0.11 [-0.372, 0.592] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts 3 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -0.044 [-0.525, 0.436] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts 6 months · Non-surgical treatment of peri-implantitis | SMD 0.132 [-0.348, 0.613] Very low Downgraded: imprecision, inconsistency, indirectness 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts Baseline · Non-surgical treatment of peri-implantitis | SMD 0.127 [-0.427, 0.681] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts 6 months · Non-surgical treatment of peri-implantitis | SMD -1.559 [-4.994, 1.876] Very low Downgraded: imprecision, inconsistency, indirectness 2 studies · 89 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts 3 months · Non-surgical treatment of peri-implantitis | SMD -1.034 [-2.863, 0.796] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts Baseline · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD 0.005 [-0.364, 0.375] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts 6 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -1.384 [-1.968, -0.8] GRADE not reported 2 studies · 89 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts 3 months · Non-surgical treatment of peri-implantitis | SMD -3.196 [-9.237, 2.846] GRADE not reported 2 studies · 89 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts Baseline · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD 0.103 [-0.358, 0.564] GRADE not reported 2 studies · 89 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts All timepoints combined (baseline, 3 and 6 months) · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -0.416 [-0.64, -0.192] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts All timepoints combined (baseline, 3 and 6 months) · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD 0.066 [-0.212, 0.343] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts 6 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD 0.132 [-0.348, 0.613] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts All timepoints combined (baseline, 3 and 6 months) · Non-surgical treatment of peri-implantitis · Mixed-effects model (supplementary analysis) | SMD -0.152 [-0.636, 0.332] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts All timepoints combined (baseline, 3 and 6 months) · Non-surgical treatment of peri-implantitis · Mixed-effects model (supplementary analysis) | SMD 0.067 [-0.223, 0.356] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts 3 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -1.645 [-2.328, -0.962] GRADE not reported 2 studies · 89 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts 6 months · Non-surgical treatment of peri-implantitis | SMD -0.476 [-1.444, 0.492] Very low Downgraded: imprecision, inconsistency, indirectness 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts Baseline · Non-surgical treatment of peri-implantitis | SMD 0.058 [-0.529, 0.646] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts 6 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -0.512 [-0.894, -0.13] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Porphyromonas gingivalis counts 3 months · Non-surgical treatment of peri-implantitis · Fixed-effect model (supplementary analysis) | SMD -0.837 [-1.253, -0.421] GRADE not reported 3 studies · 189 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Fusobacterium nucleatum counts 3 months · Non-surgical treatment of peri-implantitis | SMD -0.044 [-0.525, 0.436] GRADE not reported 2 studies · 125 participants |
| Laser-assisted non-surgical treatment (Er:YAG, diode, photodynamic therapy), alone or adjunctive to mechanical debridement | Conventional non-surgical mechanical debridement without laser | Treponema denticola counts Baseline · Non-surgical treatment of peri-implantitis | SMD 0.085 [-0.445, 0.614] GRADE not reported 2 studies · 89 participants |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Almohareb 2020 Clinical efficacy of photodynamic therapy as an adjunct to mechanical debridement in the treatment of per-implantitis with abscess. PMID:32545150 | 2020 | 1 other review | not stated | not extracted yet |
| Labban 2021 Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among… PMID:34033934 | 2021 | 1 other review | Porphyromonas gingivalis counts; Treponema denticola counts | not extracted yet |
| Arisan 2015 A randomized clinical trial of an adjunct diode laser application for the nonsurgical treatment of peri-implantitis. PMID:26382562 | 2015 | this review only | not stated | not extracted yet |
| Bassetti 2013 Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized… PMID:23560645 | 2014 | this review only | not stated | not extracted yet |
| Chen 2021 Efficacy of Er:YAG laser for the peri-implantitis treatment and microbiological changes: a randomized controlled trial. PMID:35951124 | 2022 | this review only | not stated | not extracted yet |
| Persson 2011 Microbiologic results after non-surgical erbium-doped:yttrium, aluminum, and garnet laser or air-abrasive treatment of peri-implantitis: a… PMID:21417591 | 2011 | this review only | Fusobacterium nucleatum counts; Porphyromonas gingivalis counts | not extracted yet |
| Roccuzzo 2022 Non-surgical mechanical therapy of peri-implantitis with or without repeated adjunctive diode laser application. A 6-month double-blinded… PMID:35775311 | 2022 | this review only | Fusobacterium nucleatum counts; Porphyromonas gingivalis counts; Treponema denticola counts | not extracted yet |
| Tribble 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients (18 years or older) diagnosed with peri-implantitis, at least 10 participants per study | Adults with peri-implantitis (8 RCTs, 266 patients, 335 implants) |
| Intervention | Non-surgical peri-implantitis treatment using lasers (diode, Nd:YAG, erbium, photodynamic therapy, low-level laser therapy), alone or adjunctive to mechanical debridement | Er:YAG laser (2 studies), 810 nm diode laser (2 studies), photodynamic therapy with various photosensitizers (4 studies, one combined with LLLT) |
| Comparison | Conventional non-surgical treatment without lasers (plastic or titanium curettes, ultrasonic scalers, air-abrasive devices) with or without local or systemic antimicrobials | Mechanical debridement (ultrasonic scaler, plastic or titanium curettes, air-abrasive), sometimes with systemic antibiotics or minocycline microspheres; non-activated laser as placebo in 2 trials |
| Outcomes | Microbiological changes, including quantitative shifts in peri-implant pathogens | Bacterial counts: F. nucleatum (n=2 studies), P. gingivalis (n=3), T. denticola (n=2) pooled; other bacteria, anaerobic counts and 16S profiles reported narratively |
| Study designs | Randomized controlled trials | RCTs (n=8; 7 parallel-arm, 1 split-mouth) |
| Timing | Minimum follow-up of one month | Follow-up 1 to 12 months; pooled at baseline, 3 and 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |