Abstract / Summary
Purpose: To evaluate the effect of MD combined with ECL on radiographic marginal bone level (MBL) and clinical outcomes in patients with peri-implantitis. Methods: This retrospective, non-randomized cohort study included 180 patients with peri-implantitis (104 in MD group, 76 in MD + ECL group) whose treatment allocation was based on clinical judgment and patient preference rather than randomized assignment. Clinical parameters (probing depth [PD], bleeding on probing [BoP], plaque index [PI], gingival index [GI], modified plaque index [mPI], modified bleeding index [mBI], suppuration on probing [SOP]), radiographic MBL, microbiological counts (aerobic and anaerobic), and biochemical markers (RANKL and OPG) were assessed at baseline and 6 months post-treatment. Results: At 6 months, the MD + ECL group showed significantly greater improvements in PD (3.68 ± 0.82 vs. 4.15 ± 0.89 mm, P < 0.001), BoP (24.38 ± 11.96% vs. 32.56 ± 14.28%, P < 0.001), PI (P = 0.015), GI (P = 0.005), mPI (P = 0.007), and mBI (P = 0.002) compared to the MD group. While absolute 6-month MBL values did not differ significantly between groups (4.02 ± 0.94 vs. 3.83 ± 0.89 mm, P = 0.163), the MD + ECL group demonstrated significantly less MBL reduction from baseline (0.09 ± 0.06 vs. 0.21 ± 0.12 mm, a difference of 0.12 mm, P < 0.001). The MD + ECL group demonstrated significantly lower aerobic and anaerobic bacterial counts (P = 0.005 and P = 0.002), lower RANKL (P = 0.002), and higher OPG levels (P = 0.006). Complete resolution (35.53% vs. 16.35%, P = 0.003) and short-term composite treatment success rates (68.42% vs. 36.54%, P < 0.001) were significantly higher in the MD + ECL group. SOP positivity (12.5% vs. 6.58%, P = 0.191) and implant survival (98.08% vs. 100%, P = 0.509) did not differ significantly between groups. Conclusion: Adjunctive ECL therapy may improve clinical parameters, reduced bacterial load, and slowed marginal bone loss compared to MD alone in patients with peri-implantitis at 6-month follow-up, but further prospective studies are necessary to validate these findings and assess long-term efficacy and safety.