Antimicrobial photodynamic therapy as an adjunct to treatment of periimplant diseases

Implantološka terapija u suvremenoj stomatologiji predstavlja svakodnevnu rutinsku proceduru kojom se nadoknađuje izgubljen zub. Iako je prema istraživanjima uspješnost ugradnje dentalnih implantata razmjerno visoka, ipak postoji mogućnost za nastajanje komplikacija poput periimplantatnog mukozitisa i periimplantitisa. Periimplantatna oboljenja infektivne su bolesti koje kao krajnju posljedicu mogu imati gubitak potporne kosti oko implantata što dovodi i do gubitka samog implantata. Sama terapija oboljenja koja prema današnjim znanstvenim istraživanjima nije u potpunosti definirana, premda je slična terapiji kod parodontoloških oboljenja, temelji se na uspostavi pravilne oralne higijene, kontroli infekcije i eventualnoj korekciji protetskih dijelova. Iako postoje razni pristupi u liječenju periimplantatnih bolesti bilo kirurški ili nekirurški, ipak možemo reći da antimikrobna fotodinamska terapija svakako spada u jednu od važnijih pomoćnih neinvazivnih metoda. Redukcija patogenih mikroba jedan je od glavnih uvjeta za uspješnost implantološke terapije, pa samim time izbor fotodinamske terapije može biti opravdan. Naime, ona djeluje lokalno i baktericidno na patogene mikroorganizme dobivenim kisikovim radikalima uz pomoć fotoaktivatora i odgovarajućeg izvora svjetlosti. No, uza sve koristi fotodinamska terapija još se uvijek smatra pomoćnim sredstvom liječenja periimplantatnih oboljenja.In modern dentistry implant therapy is a daily routine procedure which replaces a missing tooth. According to recent research the success rate of dental implant placement is high, but there is still a probability of complications such as peri-implant mucositis and periimplantitis. Peri-implant diseases are classified as infectious diseases that can ultimately result in the loss of the supporting bone in the vicinity of the implant, which leads to the loss of the implant itself. The therapy of the disease itself, which according to today's scientific studies is not fully defined and also regarded similar to the periodontal diseases therapy, is based on establishing good oral hygiene, infection control and possible correction of prosthetic parts. Although there are various approaches in the treatment of peri-implant diseases, both surgical and non-surgical, we can say that photodynamic therapy, which will be discussed in more detail in this paper, is certainly one of the most important adjuvant non-invasive and effective methods. Reduction of pathogenic microbes is one of the key conditions for the success of implant therapy, so the choice of photodynamic therapy may be justified. Photodynamic therapy acts locally and bactericidal on pathogenic microorganisms obtained by oxygen radicals with the help of photoactivators and a suitable light source. But with all the benefits, photodynamic therapy is still considered an adjunct in the treatment of peri-implant diseases