|Year : 2012 | Volume
| Issue : 2 | Page : 66-67
Treatment of peri-implantitis around orthodontic miniscrew using Er,Cr: YSGG Laser
Kirti Chawla1, Arundeep Kaur Lamba1, Manak Gupta1, Neha Khanna2
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 Publication||31-Jan-2013|
Senior Resident, Department of Periodontics, Maulana Azad Institute of Dental Sciences, S-129, Greater Kailash, Part-I, New Delhi
Source of Support: None, Conflict of Interest: None
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 Sep 19];6:66-7. Available from: http://www.jdentlasers.org/text.asp?2012/6/2/66/106665
| Introduction|| |
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.
Healthy peri-implant tissue plays an important role as a biologic barrier to bacteria.  Tissue inflammation, minor infection, and peri-implantitis can occur after miniscrew placement.  Inflammation of the peri-implant soft tissue has been associated with a 30% increase in failure rate.  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|| |
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.
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.
| Discussion|| |
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.  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. 
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|| |
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.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]