铒激光辅助治疗种植体周炎的疗效及机制初探

doi:10.13591/j.cnki.kqyx.2025.12.009

Abstract

Abstract:

Objective To evaluate the clinical efficacy of Er, Cr: YSGG laser-assisted treatment for peri-implantitis (PI) and to preliminarily explore the differences in the levels of inflammatory factors before and after treatment. Methods This study included 19 patients with peri-implantitis, involving a total of 22 implants, which were randomly divided into three groups. The SRP group received subgingival debridement with a titanium scaler; the SRPL1 group underwent subgingival debridement followed by 1.5 W Er, Cr: YSGG laser-assisted treatment; and the SRPL2 group received subgingival debridement followed by 2.0 W Er, Cr: YSGG laser-assisted treatment. Clinical parameters, including probing depth (PD), modified sulcus bleeding index (mSBI), and modified plaque index (mPLI), were recorded and compared before treatment and 1 and 3 months post-treatment. Peri-implant sulcular fluid was collected for ELISA detection of inflammatory factors, including interleukin (IL)-17, vascular endothelial growth factor (VEGF), and IL-1ra, and the correlations between clinical parameters and inflammatory factors were analyzed. Pain levels were recorded using the visual analogue scale (VAS) at 2 h after treatment. Results All three groups showed significant improvement in PD and mSBI at post-treatment compared to pre-treatment values (P<0.05). However, there was no significant improvement in mPLI, and no differences were observed among the groups (P>0.05). At 1 month post-treatment, both the SRPL1 and SRPL2 groups had significantly lower PD and mSBI values than the SRP group (P<0.05), but no statistically significant difference was found between the SRPL1 and SRPL2 groups (P>0.05). At 3 months post-treatment, only PD was significantly lower in the SRPL1 and SRPL2 groups compared to the SRP group (P<0.05). No significant difference was observed between the two groups (P>0.05). One and three months post-treatment, IL-17 and VEGF levels were significantly reduced (P<0.05). At 1 month post-treatment, compared to the SRP group, the SRPL1 and SRPL2 groups showed a significant decrease in IL-17 and VEGF levels (P<0.05) and a significant increase in IL-1ra levels (P<0.05). At 3 months post-treatment, no significant differences were observed among the three groups (P>0.05). PD were positively correlated with IL-17 and VEGF (P<0.05), while IL-1ra was negatively correlated with PD and mSBI (P>0.05). The VAS scores were significantly higher in the SRP group compared to the SRPL1 and SRPL2 groups (P<0.05). Conclusion Er, Cr: YSGG laser-assisted SRP treatment for peri-implantitis demonstrates excellent clinical outcomes, including improvements in clinical parameters, regulation of inflammatory factor levels, and reduced postoperative pain. The levels of IL-17, VEGF, and IL-1ra in peri-implant sulcular fluid can provide valuable information for the diagnosis, treatment, and evaluation of peri-implantitis.

Key words: Er, Cr:YSGG, peri-implantitis, clinical efficacy, inflammatory factors

CLC Number:

R781.4

CHENG Chang, CHEN Wu. Efficacy and preliminary mechanisms of Er,Cr:YSGG laser-assisted therapy for peri-implantitis[J]. Stomatology, 2025, 45(12): 927-931.

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References 20

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组别	术前	术后1个月	术后3个月	F	P
SRP组	6.63±1.51	4.88±0.99^a	4.63±0.52^a	11.043	0.004
SRPL1组	6.13±0.99	3.75±0.71^ab	3.25±0.71^ab	14.889	0.001
SRPL2组	5.83±0.75	3.17±0.75^ab	2.50±1.05^ab	11.273	0.004
F	1.978	9.110	13.445
P	0.372	0.011	0.001

组别	术前	术后1个月	术后3个月	χ²	P
SRP组	2.00(2.00,2.75)	1.00(1.00,1.75)^a	1.00(1.00,1.00)^a	12.091	0.002
SRPL1组	2.00(2.00,2.75)	1.00(0,1.00)^ab	0(0,1.00)^a	14.000	0.001
SRPL2组	2.00(1.75,3.00)	0.50(0,1.00)^ab	0(0,1.00)^a	9.500	0.009
H	0.547	6.776	5.926
P	0.761	0.034	0.052

组别	术前	术后1个月	术后3个月	χ²	P
SRP组	1.00(0.25,1.00)	1.00(0,1.00)	0.50(0,1.00)	1.500	0.472
SRPL1组	1.00(0,1.00)	0.50(0,1.00)	0(0,1.00)	1.500	0.472
SRPL2组	1.00(0.75,1.00)	0(0,1.00)	0(0,1.00)	6.000	0.050
H	0.747	1.114	0.434
P	0.688	0.573	0.805

组别	术前	术后1个月	术后3个月	F	P
SRP组	36.80±4.62	29.20±3.94^a	25.36±4.69^ab	21.851	<0.001
SRPL1组	34.34±6.59	23.26±3.60^ac	21.30±3.00^a	28.017	<0.001
SRPL2组	33.11±2.66	22.49±4.08^ac	20.34±4.66^a	20.097	<0.001
F	0.981	6.794	3.065
P	0.393	0.006	0.070

组别	术前	术后1个月	术后3个月	F	P
SRP组	55.37±3.19	43.40±9.88^a	37.32±4.65^a	18.865	<0.001
SRPL1组	56.20±5.56	33.92±5.07^ab	33.05±5.00^a	31.971	<0.001
SRPL2组	53.81±5.70	32.81±3.10^ab	31.71±7.31^a	21.716	<0.001
F	0.418	5.307	2.009
P	0.664	0.015	0.162

Efficacy and preliminary mechanisms of Er,Cr:YSGG laser-assisted therapy for peri-implantitis

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组别	术前	术后1个月	术后3个月	F	P
SRP组	356.12±39.22	492.07±40.19^a	559.44±98.47^a	25.989	<0.001
SRPL1组	332.62±107.75	599.34±87.59^ab	645.68±75.91^a	75.655	<0.001
SRPL2组	324.50±35.42	623.95±56.39^ab	657.11±54.27^a	67.780	<0.001
F	0.380	8.542	3.302
P	0.689	0.002	0.059

变量	IL-17		VEGF		IL-1ra
变量	r	P	r	P	r	P
PD	0.483	0.017	0.446	0.029	-0.459	0.024
mSBI	0.714	<0.001	0.352	0.092	-0.536	0.007

变量	IL-17		VEGF		IL-1ra
变量	r	P	r	P	r	P
PD	0.538	0.007	0.701	<0.001	-0.870	<0.001
mSBI	0.848	<0.001	0.513	0.010	-0.592	0.002

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