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Peri-implant MucositisNCT05772299

Treatment of Inflammation Around Implants With a Laser or an Ultrasonic Device

A study testing Er:Yag laser and EMS ultrasound in people with Peri-implant Mucositis, run by Kristianstad University at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of the clinical trial is to compare laser therapy with ultrasonic therapy in patients with inflammation in the tissue surrounding single implants (peri-implant mucositis). Read more about this study

Who is it for?
Ages 23 to 100 years
Conditions the study is for
Peri-implant Mucositis
What is being tested?
Er:Yag laser and EMS ultrasound
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteSweden
Study dates
31 Aug 2021to 17 Aug 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 23 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥ 1 peri-implant site with probing depth ≥ 4 mm combined with bleeding and or pus on probing
  • bone loss ≤ 2 mm measured from the implant shoulder (as a consequence of remodelling during the healing process)

Who cannot join

  • Subjects with uncontrolled diabetes HbA1c >6.5
  • Subjects requiring prophylactic antibiotics
  • Subjects taking prednisolone
  • Subjects taking medications known to have effects on gingival overgrowth

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • University of Kristianstad

    Kristianstad, 29893

Other trials in Sweden

About this study

Official title: Treatment of Peri-implant Mucositis Using an Er:Yag Laser or an Ultrasonic Device. A Randomized Clinical Trial

The goal of the clinical trial is to compare laser therapy with ultrasonic therapy in patients with inflammation in the tissue surrounding single implants (peri-implant mucositis). The outcomes are bleeding on probing (BOP), pocket depth, suppuration, recession of the peri-implant mucosal margin, the treatment time and changes in bone levels before and after treatment in the test, and control group respectively. The quality of life will be measured from a standardized protocol.

The hypothesis is that treatment with laser therapy in patients with peri-implant mucositis will show less inflammation with less bleeding and a better pocket closure compared to the treatment with the ultrasound.

Read the detailed description

Data from the clinical treatment will be registered in medical records. In parallel, clinical data will be documented in a study protocol and saved in a safe together with a code list in accordance with a standard operation procedure at the clinic.The protocol with the specific treatment procedure (test or control) will not be opened until the study is completed and only by authorized persons with access to the data in the study such as, the principal investigator and the statisticians.

Variables used in the study originates from an international world workshop on the classification of periodontal and peri-implant diseases and conditions in 2018. In accordance with the working group a diagnosis of peri-implant mucositis should include bleeding on probing and or pus and no bone loss (X-ray). In this study the primary outcomes are bleeding on probing (BOP) and or pus and pocket depth,

The aim is to assess the clinical outcome over 6 months following treatment with non-surgical debridement using an Er:Yag laser device (AdvErL EVO, Morita corporation, Japan) (Test group) or with the use of mechanical therapy using an ultrasonic device with a specially designed tip (EMS, Switzerland) (Control group). An active comparator (Control group) was compared to an experimental arm (Test group).

Patients will therefore be randomized into a test or control group. Inclusion criteria will follow a full mouth routine periodontal examination, including analysis of available radiographs.

All measurements will be performed by a dental hygienist who is blinded for the specific treatment test or control. A periodontist will perform all the treatments and is therefore not blinded. Upon the final appointment the specific arm of treatment will be registered by the periodontist in the patient journal.

All patients will be given oral and written information about the study and sign a written informed consent. The patients will be informed that they could drop off whenever they want without any explanations. The ethical board approved the study.

The test group will be treated using the Er:Yag laser device.The control group will be treated using an ultrasonic device with peek coated tips (EMS, Switzerland). Following treatment all patients, independent of group, will be instructed in proper home care using a toothbrush and interproximal aids as needed.

Study design:

  • Baseline: Clinical registrations and treatment
  • 1 month: Clinical registrations
  • 3 months: Clinical registrations and treatment
  • 6 months: Clinical registrations and treatment

In addition, the instrument Oral Health Impact Profile (OHIP) will be used as a measurement of quality of life.

Adverse events will be evaluated at each visit. If a patient should require any treatment during the study the necessary treatment will be provided and according to the standard of care. If adverse events related to the treatment they will be recorded. The investigation will be performed according to the principles of the Declaration of Helsinki on experimentation involving human subjects.

Participant not fulfilling the study will be reported in the patient journal as not completed and statistically noted as missing data.

From the statistical power analysis 38 individuals were minimum to reach a clinically significant difference. The power analysis was based on: if bleeding on probing (BOP) is reduced with 30% ± 10 in the test group and with a 30% decrease in the control group is to be detected at alpha =0.05 and a power of beta= 0.2. Hence it is foreseen to incorporate 45 subjects in the study if some of the individuals will not fulfil the study.

The IBM SPSS version 28.0 statistical software package (SPSS Inc., Armonk, NY, USA) for personal computer will be used in the statistical analyses.

Statistics will be calculated as means with standard deviation (SD). Independent t-tests (equal variance not assumed) paired t-test and one-way ANOVA test will be used to compare inter and intra-group differences. Non-parametric chi-square test will be used for categorical variables. Statistical significance will be set with 80 percent at p < 0.05. Non visits will be recorded as missing data in the statistics.

Being tested
Er:Yag laser, EMS ultrasound
Keywords
Clinical study, Bleeding on probing, Pus, Er:Yag laser, Ultrasonic device
Medical subject headings
Suppuration

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Er:Yag laserRadiation

    Submucosal debridement is performed with Er:Yag laser using a P-400 tip under rinsing water.

  • EMS ultrasoundDevice

    Submucosal debridement is performed with piezoelectric ultrasound (EMS) with a PEEK (plastic coated) tip under rinsing water.

Study groups in NCT05772299
Study groupRoleWhat they receive
Er:Yag laser treatmentExperimentalThe experimental (test) group will receive the following treatment: The submucosal debridement will be performed with an Er:Yag laser (AdvErL EVO, Morita Corporation, Japan). The P-400 tip is placed into the peri-implant mucositis pockets mesially, lingually, distally and buccally while rinsing water. Careful attempts are to cover the full circumference of the implant.
Receives: Radiation: Er:Yag laser
Ultrasonic device treatmentActive comparatorThe active comparator (control) group will receive the following treatment: The submucosal debridement will be performed by a piezoelectric ultrasonic device with a PEEK coated tip (EMS, Switzerland). The tip is placed into the peri-implant mucositis pockets mesially, lingually, distally and buccally while rinsing water. Careful attempts are to cover the full circumference of the implant.
Receives: Device: EMS ultrasound

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Bleeding on probing (BOP)

    millimeter

    Measured: Baseline

  2. Bleeding on probing (BOP)

    millimeter

    Measured: 1 month

  3. Bleeding on probing (BOP)

    millimeter

    Measured: 3 months

  4. Bleeding on probing (BOP)

    millimeter

    Measured: 6 months

  5. Probing pocket depth (PPD)

    millimeter

    Measured: Baseline

  6. Probing pocket depth (PPD)

    millimeter

    Measured: 1 month

  7. Probing pocket depth (PPD)

    millimeter

    Measured: 3 months

  8. Probing pocket depth (PPD)

    millimeter

    Measured: 6 months

  9. Pus

    Presence or abscence

    Measured: Baseline

  10. Pus

    Presence or abscence

    Measured: 1 month

  11. Pus

    Presence or abscence

    Measured: 3 months

  12. Pus

    Presence or abscence

    Measured: 6 months

Secondary outcomes (13)
  1. Recession of the peri-implant mucosal margin

    millimeter

    Measured: Baseline

  2. Recession of the peri-implant mucosal margin

    millimeter

    Measured: 6 months

  3. Bone level (peri-apical radiographs)

    millimeter on Xray

    Measured: Baseline

  4. Bone level (peri-apical radiographs)

    millimeter on Xray

    Measured: 6 months

  5. Implant loss

    Prevalence

    Measured: Baseline

  6. Implant loss

    Prevalence

    Measured: 1 month

  7. Implant loss

    Prevalence

    Measured: 3 months

  8. Implant loss

    Prevalence

    Measured: 6 months

  9. Treatment time

    minutes

    Measured: Baseline

  10. Treatment time

    minutes

    Measured: 3 months

  11. Treatment time

    minutes

    Measured: 6 months

  12. Quality of life (QoL)

    Questionnaire "Oral Health Impact Proflie" (OHIP-14) on a 5 -point Likert scale 0=never (best) ; 5=very often (worst)

    Measured: Baseline

  13. Quality of life (QoL)

    Questionnaire "Oral Health Impact Profile" (OHIP-14) on a 5 -point Likert scale 0=never (best) ; 5=very often (worst)

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2023
  2. Study start31 Aug 2021
  3. Primary completion17 Aug 2023
  4. Study completion17 Aug 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Test group: will be treated using the Er:Yag laser device (AdvErL EVO, Morita Corporation, Japan). The tip is placed in the pocket mesially, lingually, distally and buccally. Control group: will be treated using an ultrasonic device with PEEK coated tips (EMS, Switzerland). The tip is placed in the pocket mesially, lingually, distally and buccally.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05772299
Sponsor's protocol ID
P-I mucositis
Status last verified
Oct 2023
First submitted
6 Mar 2023
Last updated
10 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Aoki A, Sasaki KM, Watanabe H, Ishikawa I. Lasers in nonsurgical periodontal therapy. Periodontol 2000. 2004;36:59-97. doi: 10.1111/j.1600-0757.2004.03679.x. No abstract available.

    PubMed 15330944
  • Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hammerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45 Suppl 20:S286-S291. doi: 10.1111/jcpe.12957.

    PubMed 29926491
  • Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015 Apr;42 Suppl 16:S158-71. doi: 10.1111/jcpe.12334.

    PubMed 25495683
  • Lin GH, Suarez Lopez Del Amo F, Wang HL. Laser therapy for treatment of peri-implant mucositis and peri-implantitis: An American Academy of Periodontology best evidence review. J Periodontol. 2018 Jul;89(7):766-782. doi: 10.1902/jop.2017.160483.

    PubMed 30133748
  • Renvert S, Lessem J, Dahlen G, Lindahl C, Svensson M. Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial. J Clin Periodontol. 2006 May;33(5):362-9. doi: 10.1111/j.1600-051X.2006.00919.x.

    PubMed 16634959
  • Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Periodontol. 2018 Jun;89 Suppl 1:S304-S312. doi: 10.1002/JPER.17-0588.

    PubMed 29926953
  • Takasaki AA, Aoki A, Mizutani K, Kikuchi S, Oda S, Ishikawa I. Er:YAG laser therapy for peri-implant infection: a histological study. Lasers Med Sci. 2007 Sep;22(3):143-57. doi: 10.1007/s10103-006-0430-x. Epub 2007 Jan 12.

    PubMed 17219255
  • Bengtsson VW, Aoki A, Mizutani K, Lindahl C, Renvert S. Treatment of peri-implant mucositis using an Er:YAG laser or an ultrasonic device: a randomized, controlled clinical trial. Int J Implant Dent. 2025 Jan 24;11(1):6. doi: 10.1186/s40729-025-00591-0.

    PubMed 39853624

Questions about this trial

What is this clinical trial studying?

A study testing Er:Yag laser and EMS ultrasound in people with Peri-implant Mucositis, run by Kristianstad University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Bleeding on probing (BOP) (time frame: Baseline). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05772299, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Oct 2023.

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