YAG laser combined with mechanical debridement enhances pain relief and inflammation control in the management of periodontitis with peri-implantitis

Abstract

Objective: To evaluate the efficacy of Er: YAG laser combined with mechanical debridement in treating periodontitis with peri-implantitis. Methods: A retrospective analysis was conducted on 292 patients treated between 2018 and 2024. The patients were divided into an observation group (n=139, Er: YAG laser + mechanical debridement) and a control group (n=153, mechanical debridement only). Outcome measures included Visual Analog Scale (VAS) scores, periodontal probing depth (PD), clinical attachment level (CAL), bleeding index (BI), gingival index (GI), and TNF-α/IL-6 levels. Clinical efficacy and risk factors for treatment failure were analyzed using logistic regression. Results: The observation group exhibited a significantly higher total efficacy rate than the control group (89.21% vs. 64.71%, P<0.001). Additionally, VAS scores, PD, CAL, BI, GI, and TNF-α/IL-6 levels were significantly lower at 1 week, 2 weeks, and 1 month post-treatment in the observation group (all P<0.05). Multivariate logistic regression identified age (OR=1.12, 95% CI: 1.07-1.18, P<0.001), smoking (OR=6.21, 95% CI: 2.96-13.82, P<0.001), and diabetes (OR=5.74, 95% CI: 2.71-12.94, P<0.001) as independent risk factors for treatment failure, while postprandial gargling (OR=0.28, P=0.002) was identified as a protective factor. Conclusion: Er: YAG laser combined with mechanical debridement significantly reduced pain and inflammation, improving peri-implant health. Smoking, diabetes, and age increased treatment failure risk, while postprandial gargling was protective, underscoring the importance of personalized treatment strategies.