Antimicrobial Photodynamic Therapy Mediated by Papain Gel on Peri-Implantitis Lesions

Antimicrobial Photodynamic Therapy Mediated by Papain Gel on Peri-implantitis Lesions: A Randomized Controlled Clinical Trial

The elimination of pathogenic microorganisms from the muco-gingival tissue and implant pockets system is one of the main aspects for success in the treatment of peri-implantitis. The purpose of this study is to conduct a blinded and randomized clinical trial to evaluate the effectiveness of photodynamic therapy in the treatment of peri-implantitis. Twenty implants with peri-implantitis will be selected. Implants will be randomly divided into two groups (n = 10), Group 1: control - conventional treatment and Group 2: conventional treatment and antimicrobial photodynamic therapy (aPDT). aPDT will be performed after the purse removal service in sites with pockets greater than or equal to 5 mm. The photosensitizer will be PapaMblue®, which will be deposited in the peri-implant pockets, with pre-irradiation time of 1 min. Next, the laser emitting a wavelength of 660 nm, with power of 100 mW, for 2 min, radiant exposure of 30 J/cm2 and power density of 250 mW/cm2 in the buccal and mesial regions will be applied. The distribution of the data within each group will be evaluated and the variances will be checked to choose a more appropriate statistical analysis. The sample calculation is based on the literature and the significance level of 5% will be adopted.

Inclusion Criteria:

• Have peri-implantitis;
• Have at least one implant with a clinical depth of probing equal to or greater than 5 mm;
• Age range of 18 to 65 years.

Exclusion Criteria:

• Smokers or ex-smokers who stopped the habit less than 12 months before the screening;
• Have decompensated diabetes;
• Anemia;
• Cancer;
• Pregnant;
• Use antibiotics in the last 3 months12;
• Make use of anti-inflammatories or have coagulation disorders (use of anticoagulants, presence of liver diseases, thrombocytopenia, immunosuppression);
• In orthodontic treatment;
• Patients who maintained a biofilm index higher than 25%.