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Fig 4: The abutment was removed for examination Fig 5: The infected soft tissue was Fig 6: The bone defect was circumferential to the
of the site removed with erbium YAG laser implant
treatment

Fig 7: Implant decontamination proceeded with the Fig 8: The bone graft comprised a mix of Fig 9: Bone grafting was carried out
Litetouch all-tissue laser autograft and xenograft material

The abutment was then removed to expose the infected site (Figure IMPLANT SURFACE DECONTAMINATION
4). There was no evidence of abutment fractures. The setting on the Litetouch laser was changed to gentle treatment
Treatment commenced using the Litetouch erbium YAG all- mode, 40mJ per pulse at 20Hz and total power of 0.80W.
tissue laser. The granulation tissue around the implant was carefully Decontamination of the exposed implant surface commenced
removed (Figure 5) with the machine set to soft tissue mode, 150mJ (Figure 7). The machine’s gentle treatment package delivers a sub-
per pulse at 20Hz and total power of 3W. ablative low energy setting with selective targeting of the area of focus.
The implant was checked to ensure there was no residual tethering According to Shibli (2018): ‘Laser irradiation... removes
of the granulation soft tissue. contaminates from the implant surface without damaging or altering
Baudot (2017) concludes that one of the main advantages of the titanium surface topography’. This helps to improve blood clot
erbium YAG laser treatment compared to conventional approaches stabilisation.
is the ability to thoroughly remove all of the granulation tissue from The Litetouch laser is easy to use and, because the entire mechanism
peri-implant lesions. is integrated into the hand piece, the machine is able to produce a
The bone defect presented circumferentially around the implant direct energy delivery system. There is almost no limitation of hand
(Figure 6). It was noted that there was good blood pooling at the movement, facilitating good access to all areas of the patient’s mouth,
site. Good vascularisation indicated conditions were favourable for particularly the posterior region.
the healing process. With an unimpeded view of the implant and Bone grafting then took place. With the aid of a bone scraper, a
surrounding tissue, we concluded that the outlook for the bone health small amount of cortical bone was taken from around the implant
was good, which meant our plan would be to try to save the implant. site and mixed with a xenograft bovine-derived material (Figure 8).
The patient was then consulted and was very relieved, wanting to The autograft and xenograft mix was then packed into the site
avoid losing the implant if at all possible. (Figure 9). A collagen membrane was placed, before primary closure

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