Print this page Email this page Users Online: 116
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
CASE REPORT
Year : 2012  |  Volume : 6  |  Issue : 2  |  Page : 66-67

Treatment of peri-implantitis around orthodontic miniscrew using Er,Cr: YSGG Laser


1 Department of Periodontics and Oral Implantology, Maulana Azad Institute of Dental Sciences, New Delhi, India
2 Department of Orthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India

Date of Web Publication31-Jan-2013

Correspondence Address:
Kirti Chawla
Senior Resident, Department of Periodontics, Maulana Azad Institute of Dental Sciences, S-129, Greater Kailash, Part-I, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-2868.106665

Rights and Permissions
  Abstract 

Miniscrews have proven to be a useful addition to the orthodontist's armamentarium for control of skeletal anchorage in less compliant or noncompliant patients, but the risks involved with miniscrew placement must be clearly understood by both the clinician and the patient. Complications can arise during miniscrew placement and after orthodontic loading in regard to stability and patient safety. This article presents a case report of peri-implantitis around an orthodontic miniscrew implant treated with Erbium, chromium, yttrium, scandium, gallium, garnet (Er,Cr: YSGG) laser.

Keywords: Erbium, chromium, yttrium, scandium, gallium, garnet laser, orthodontic miniscrews, peri-implantitis


How to cite this article:
Chawla K, Lamba AK, Gupta M, Khanna N. Treatment of peri-implantitis around orthodontic miniscrew using Er,Cr: YSGG Laser. J Dent Lasers 2012;6:66-7

How to cite this URL:
Chawla K, Lamba AK, Gupta M, Khanna N. Treatment of peri-implantitis around orthodontic miniscrew using Er,Cr: YSGG Laser. J Dent Lasers [serial online] 2012 [cited 2017 May 26];6:66-7. Available from: http://www.jdentlasers.org/text.asp?2012/6/2/66/106665


  Introduction Top


Miniscrews have proven to be a useful addition to the orthodontist's armamentarium for control of skeletal anchorage in less compliant or noncompliant patients, but the risks involved with miniscrew placement must be clearly understood by both the clinician and the patient. [1],[2],[3] Complications can arise during miniscrew placement and after orthodontic loading in regard to stability and patient safety.

Healthy peri-implant tissue plays an important role as a biologic barrier to bacteria. [4] Tissue inflammation, minor infection, and peri-implantitis can occur after miniscrew placement. [5] Inflammation of the peri-implant soft tissue has been associated with a 30% increase in failure rate. [6] Peri-implantitis is inflammation of the surrounding implant mucosa with clinically and radiographically evident loss of bony support, bleeding on probing, suppuration, epithelia infiltrations, and progressive mobility.

This article presents a case report of peri-implantitis around an orthodontic miniscrew implant treated with Er,Cr: YSGG laser.


  Case Report Top


A 20-year-old female patient reported to the Department of Orthodontics, Maulana Azad Institute of Dental Sciences, New Delhi with the chief complaint of forwardly placed front teeth with spacing between them. On clinical examination, a Class II Div 1 malocclusion was seen [Figure 1]. As the case was one of critical anchorage, orthodontic miniscrews were placed in premolar-molar area in all the quadrants. After 1 week loading of the miniscrews was done. After 15 days, the miniscrew placed in lower right quadrant was found to be embedded in soft tissue. There was gingival overgrowth around the miniscrew along with abscess formation. There was slight mobility with pain.
Figure 1: Preoperative-Abscess in relation to the orthodontic miniscrew

Click here to view


The patient was referred to the Department of Periodontics for management. Er,Cr: YSGG laser was used to treat the lesion. Topical anesthetic was applied over the area. Patient and staff used special eye glasses for protection. The laser application was done with 600 μm sapphire tip, 1.5 W power, 13% air and 9% water in noncontact mode [Figure 2]. Once the lesion had been removed, the operation field was wiped with sterile gauze soaked in 1% normal saline solution. A laser bandage was applied with 0.5 W power with air and water switched off. The patient was advised to avoid smoking, alcohol, and spicy foods. No analgesic was prescribed. Healing was uneventful [Figure 3] and [Figure 4]. The loading of the orthodontic miniscrew was done after 4 weeks.
Figure 2: Peri-implantitis treated with Er,Cr: YSGG laser

Click here to view
Figure 3: Postoperative (Immediate)

Click here to view
Figure 4: Postoperative (After 15 days)

Click here to view



  Discussion Top


An Er,Cr: YSGG laser, operating at a wavelength of 2780 nm and using water and air sprays, ablates tissue by a hydrokinetic process that prevents a temperature increase. [7] It is highly efficient and effective in removing contaminants from the implant body with the absence of any measurable changes to the titanium surface and the lack of an organic smear layer in vitro. [8]

Although the Er,Cr: YSGG hydrokinetic laser system is widely used for dental purposes, information about its potential application for surgical peri-implantitis treatment is not available in the literature. In the present case report, an Er,Cr: YSGG laser was used to perform the drainage of the abscess and curettage of the area.

In the present case report, the treatment was considered successful because of the resolution of the abscess and successful use of the miniscrew as anchorage. The achieved results were satisfactory to the patient and the clinician.


  Conclusion Top


The Er,Cr: YSGG laser treatment of peri-implantitis around orthodontic miniscrew resulted in uneventful healing with no complications and with high patient and clinician satisfaction and confidence.

 
  References Top

1.Cope JB. Temporary anchorage devices in orthodontics: A paradigm shift. Semin Orthod 2005;11:3-9.  Back to cited text no. 1
    
2.Dual-Top® Anchor Mini Orthoscrews (seminar manual). UIC Clinical Test Protocol. In: Kravitz ND, Kusnoto B, editors. USA: Rocky Mountain Orthodontics, Inc; 2005. p. 17-40.  Back to cited text no. 2
    
3.Ohnishi H, Yahi T, Yasuda Y, Takada K. A mini-implant for orthodontic anchorage in a deep overbite case. Angle Orthod 2005;75:444-52.  Back to cited text no. 3
    
4.Sanchez-Garces MA, Gay-Escoda C. Peri-implantitis. Med Oral Patol Oral Cir Bucal 2004;9(Suppl) l:63-9.  Back to cited text no. 4
    
5.Costa A, Pasta G, Bergamaschi G. Intraoral hard and soft tissue depths for temporary anchorage devices. Semin Orthod 2005;11:10-5.  Back to cited text no. 5
    
6.Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-Yamamoto T. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop 2003;124;373-8.  Back to cited text no. 6
    
7.Wang X, Zhang C, Matsumoto K. In vivo study of the healing processes that occur in the jaws of rabbits following perforation by an Er,Cr: YSGG laser. Lasers Med Sci 2005;20:21-7.  Back to cited text no. 7
    
8.Miller RJ. Treatment of the contaminated implant surface using the Er,Cr: YSGG laser. Implant Dent 2004;13:165-70.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Case Report
Discussion
Conclusion
References
Article Figures

 Article Access Statistics
    Viewed1676    
    Printed94    
    Emailed0    
    PDF Downloaded286    
    Comments [Add]    

Recommend this journal