The use of a gel based on a liposomal antioxidant-phospholipid complex in combination with low-intensity laser radiation in the complex treatment of patients with peri-implantitis

Relevance. Peri-implantitis is one of the common problems in modern dentistry. Methods of prevention and treatment of patients with implantitis do not provide high efficiency. Objective: to increase the efficiency of treatment of patients with peri-implantitis by developing a method of using a gel based on a liposomal antioxidant-phospholipid complex in combination with low-intensity laser radiation.

Materials and methods. A retrospective and prospective study of 90 patients with peri-implantitis and 12 patients without inflammatory phenomena aged 25 to 55 years was conducted with control after treatment and after 1, 3, 6, 12 months. The hygiene index OHI-S, PI, PMA, bleeding indices and the Schiler – Pisarev test were assessed. Laser Doppler flowmetry (LDF), determination of implant stability (IS), laser fluorescence diagnostics (LFD) of the hygiene level were performed; radiographic examination. In group IA – application of a gel based on a liposomal antioxidant-phospholipid complex, in IB – exposure to low-intensity laser radiation in the infrared range with an output power of 25 mW, in IB – application of gel (similar to IA) in combination with exposure to low-intensity laser radiation (similar to IB); group II (control) without inflammation around the implant.

Results. After 12 months, the greatest decrease in OHI-S, on average, by 80.8% (p<0.05) was observed in IB and IB. A significant decrease in LDF by 45.21% (p<0.05), PI by 53.3% (p<0.05), PMA by 46.9% (p<0.05), bleeding index by 39.8% (p<0.05) and predominant normalization of microcirculation, oxygen consumption and oxidative metabolism indices were revealed in patients in Group IB.

Conclusion. The use of the physico-pharmacological method of treating patients with peri-implantitis provided the greatest reduction in subjective manifestations withmaximum correction of periodontal indices against the background of progressive normalization of microcirculation and the level of oxidative metabolism with a remission of 12 months.

1. Tursunaliev Z.Z. Dental implantation // Theory and analytical aspects of recent research. – 2024. – Vol. 2. – No. 21. – P. 229–233.

2. Rybalko A.S., Orlov A.A. Inflammation as a Risk Factor for Loss of Osseointegration of Dental Implants // Modern Medicine: New Approaches and Current Research: Collection of Articles Based on the Proceedings of the LXII-LXIII International Scientific and Practical Conference «Modern Medicine: New Approaches and Current Research.» – 2022. – No. 7 – 8(58). – DOI: 10.32743/25419854.2022.7-8.58.344594.

3. Tsigarida, A. Peri-Implant Diseases and Biologic Complications at Implant-Supported Fixed Dental Prostheses in Partially Edentulous Patients / A. Tsigarida, K. Chochlidakis, D. Fraser, E. Lampraki, E.R. Einarsdottir, A.B. Barmak, P. Papaspyridakos, C. Ercoli // Journal of Prosthodontics. – 2020. – Vol. 29. – № 5. – P. 429–435.

4. Iminzhanova, G.R. Modern approaches to the diagnosis and treatment of peri-implantitis /G.R. Iminzhanova, T.V. Melkumyan, A.D. Dadamova// Journal of Dentistry and Craniofascial Research. – 2021. – No. 2. – P. 53–57.

5. Mukimov, O.A. Application of the perio-flow® method for the treatment of periimplantitis / O.A. Mukimov, A.B. Olimov // Dentistry. – 2018. – No. 2. – P. 29–32.

6. Toledano-Osorio, M. A Systematic Review and Meta-Analysis of Systemic Antibiotic Therapy in the Treatment of Peri-Implantitis / M. Toledano-Osorio, C. Vallecillo, R. Toledano, F.S. Aguilera, M.T. Osorio, E. Muñoz-Soto, F. García-Godoy, M. Vallecillo-Rivas // International Journal of Environment Research and Public Health. – 2022. – Vol. 19. – № 11 – P. 6502. doi: 10.3390/ijerph19116502.

7. Baus-Domínguez, M. А Systematic Review and Meta-Analysis of Systemic and Local Antibiotic Therapy in the Surgical Treatment of Peri-Implantitis / M. Baus-Domínguez, S. Bakkali, P. Hermida-Cabrera, M.A. Serrera-Figallo, J.L. Gutiérrez-Pérez, D. Torres-Lagares // Antibiotics (Basel). – 2023. – Vol. 12. – № 7. – Р. 1223. doi: 10.3390/antibiotics12071223.

8. Heo, S. Simplifi nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride / S. Heo, H.J. Kim, J.Y. Joo, J. Lee, S.J. Kim // Journal of Periodontal and Implant Science. – 2018. – Vol. 48. – № 5. – P. 326–333. doi: 10.5051/jpis.2018.48.5.326.

9. A. Amodeo A.A. Consensus Report of the Technical-Scientific Associations of Italian Dental Hygienists and the Academy of Advanced Technologies in Oral Hygiene Sciences on the Non-Surgical Treatment of Peri-Implant Disease / A.A. Amodeo, Butera, M. Lattari, G. Stablum, A. Abbinante, M.T. Agneta, J. Lanzetti, D. Tomassi, S. Piscicelli, M. Luperini, [et al.] // International Journal of Environmental Research and Public Health. – 2023. – Vol. 20. – № 3. – Р. 22–68. doi: 10.3390/ijerph20032268.

10. Garunov M.M. Remodeling of the peri-implant zone of the jawbone during dental implantation (clinical and experimental study): author’s abstract. dis. … candidate of medical sciences: 3.1.7 / Garunov Musa Magomedovich; – Moscow, 2023. – 25 p.

11. Grigoryants L.A. Assessment of the condition of bone tissue around dental implants before and after surgery to remodel the peri-implant zone / L.A. Grigoryants, S.V. Sirak, M.M. Garunov, Z.M. Kochkarova, A.A. Andreev, A.G. Stepanov, S.V. Apresyan. // Institute of Dentistry. – 2022. – No. 2. – P. 30–32.

12. Solderer, A. Regenerative Surgical Therapy of Peri-implantitis: An Umbrella Review of Answered/Unanswered Questions and Future Perspectives / A. Solderer, P.R. Schmidlin // Frontiers in Dental Medicine. – 2020. – Vol. 1. – P. 614240. doi: 10.3389/fdmed.2020.614240.

13. Rahman B. Photodynamic Therapy for Peri-Implant Diseases / B. Rahman, A.B. Acharya, R. Siddiqui, E. Verron, Z. Badran // Antibiotics (Basel). – 2022, – Vol. 11. – № 7. – P. 918. doi: 10.3390/antibiotics11070918.

14. Sánchez-Martos, R. Comparison of Photothermal and Photodynamic Diode Laser Therapy in Patients with Peri-implant Mucositis: A Systematic Review / R. Sánchez-Martos, N.A. Kronkah, S. Arias-Herrera // Journal of Clinical and Experimental Dentistry. – 2023. – Vol. 15. – № 9. – P. e760–e772.

15. A. Hakobyan, G. The Effectiveness of Magnetic-Laser Therapy as a Supportive Treatment of Peri-Implantitis / G. Hakobyan, L. Yessayan, G. Khachatrayn, Seyranyan // American Journal of Dental and Medical Problems. – 2020. – Vol. 1. – P. 1001.

16. Livshits V.I. Dynamics of the clinical condition of patients with peri-implantitis in the context of the complex use of physiotherapeutic technologies / V.I. Livshits, S.N. Nagornev, V.K. Frolkov, R.Sh. Gvetadze // Physiotherapist. – 2021.No. 4. P. 42–52.

17. Lazar L. Is Laser Therapy an Adjuvant in the Treatment of Peri-Implant Mucositis? A Randomized Clinical Trial / L. Lazar, T. Dakó, I.E. Muresan, M. Suciu, G.A. Maftei, M. Tatarciuc, A.P. Lazar // Diagnostics (Basel). – 2023. – Vol. 13. – № 6. – P. 1192. doi: 10.3390/diagnostics13061192.

18. Atieh M.A. Diode Laser as an Adjunctive Treatment for Peri-implant Mucositis: A Systematic Review and Meta-analysis / M.A Atieh, I. Fadhul, M. Shah, H. Hannawi, N.H.M. Alsabeeha // International Dental Journal. – 2022. – Vol. 72. – № 6. – P. 735–745.

19. Poddubnaya O.A. Low-intensity laser therapy in clinical practice (part No. 1) / O.A. Poddubnaya // Bulletin of Restorative Medicine. – 2020. – No. 6. – P. 92–99.

20. Razina I.N. Non-surgical methods of treating complications of dental implantation. Prospects for the use of infrared laser radiation in the treatment of mucositis and peri-implantitis / I.N. Razina, L.M. Lomiashvili, V.B. Nedoseko // Laser medicine. – 2020. – Vol. 24 (Issue 1). – P. 49–56.

21. Prikuls V.F. Medicinal photophoresis in restorative treatment of patients with chronic generalized periodontitis: author’s abstract. diss. … Dr. of Medicine: 14.01.14, 14.00.51/Prikuls Vladislav Frantsevich; – Moscow, 2009. – 48 p.

22. Grudyanov A.I. Clinical efficacy of a new dental gel based on dihydroquercetin in the treatment of patients with inflammatory periodontal diseases / A.I. Grudyanov, E.V. Fomenko, A.A. Lepikhova, V.F. Prikuls // Dentistry for everyone. – 2022. – № 3. – P. 46–52.

23. Levitsky A.P. Application of quercetin in dentistry / A.P. Levitsky, K.V. Skidan, M.I. Skidan // Visnik Stomatologiii. – No. 1. – 2010. – P. 81–87.

24. Tukhtaeva F.Sh. Antiradical activity of quercetin and dihydroquercetin / F.Sh. Tukhtaeva, A.M. Zulaykho, U.G. Gayibov // UNIVERSUM: Chemistry and Biology. – No. 11(65). – 2019. – P. 42–46.