Efficacy of non-surgical laser therapy for the management of peri-implantitis: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to evaluate the efficacy of non-surgical laser therapies compared to other treatment modalities for managing peri-implantitis and to analyze post-treatment outcomes of different interventions. A comprehensive search was conducted across Medline (PubMed), Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), identifying 4675 studies published between January 1953 and November 2023. A total of 15 randomized controlled trials (RCTs) involving 540 patients and 658 implants met the inclusion criteria, with 10 studies eligible for meta-analyses. Meta-analyses revealed that Er:YAG laser therapy significantly reduced bleeding on probing (BOP) by 35.6% (95% CI: 17.3% to 53.9%; I2 = 83%) and probing depth (PD) by 0.65 mm (95% CI: 0.33 to 0.97; I2 = 0%). The combination of mechanical debridement (MD) and Er,Cr:YSGG laser therapy improved PD by 1.23 mm (95% CI: 0.76 to 1.70; I2 = 0%) and reduced BOP by 47.3% (95% CI: 38.4% to 56.1%; I2 = 0%). However, none of the therapies showed any significant advantage in preventing crestal bone loss (CBL). Laser therapies did not demonstrate any significant superiority over traditional therapies (p > 0.05). Non-surgical laser therapies, including Er:YAG, Er,Cr:YSGG, Nd:YAG and diode lasers, demonstrated effectiveness in reducing inflammation and probing depths but did not consistently outperform MD alone or in combination with other treatments. The findings emphasize the need for further research and standardized protocols, as no modality significantly prevented CBL. These results provide evidence-based insights into optimizing non-surgical management strategies for peri-implantitis. Non-surgical laser therapies demonstrate significant reductions in inflammation and probing depths in peri-implantitis treatment. However, their comparable outcomes to mechanical debridement highlight the need for further studies to establish their role and develop standardized protocols for optimized clinical use.