Laser surgical tools in Implant Dentistry for the long-term prognosis of oral implants

Peri-implant tissue pathology may be the main reason for implant failures. Bacterial contamination of the implant surface is associated with peri-implant bone loss. In general, lasers can be used in oral implantology for second stage surgery of submerged implants as well as soft tissue surgery in order to establish peri-implant soft tissue health. Gingival hyperplasias are relatively common around implants, when they are loaded with removable prostheses. Lasers can be used for the hyperplasia removal as well as in the treatment of peri-implantitis, when the inflamed implant surrounding tissues can be irradiated. From the scientific point of view, the Nd/YAG laser can dramatically change the implant surfaces and cause melting of the implant microdesign. The CO₂ laser is not able to modify the implant surface; the temperature changes may be clinically acceptable and the bacterial reduction is significant. Moreover, of potential interest is the clinical use of the 980-nm diode laser, which is not able to change the implant surface and has excellent properties for incision, excision and coagulation of the soft tissues. The clinical indications of the use of lasers in modern oral implantology were presented in this paper based on the scientific data. Applications in the peri-implant soft tissues as well as decontamination of the implant surfaces in order to treat peri-implant bony defects were demonstrated in this report according to the clinical experience of longitudinal studies.