Clinical Efficacy of Low-Level Laser Therapy as an Adjunct to Non-Surgical Treatment of Peri-implantitis: A Systematic Review and Meta-Analysis

Title : Clinical Efficacy of Low-Level Laser Therapy as an Adjunct to Non-Surgical Treatment of Peri-implantitis: A Systematic Review and Meta-Analysis Purpose: To evaluate the clinical effectiveness of low-level laser therapy (LLLT) modalities and antimicrobial photodynamic therapy (aPDT) as adjuncts to non-surgical mechanical debridement for peri-implantitis management. Materials and Methods: An electronic search of PubMed/MEDLINE, and the Cochrane Library was conducted for randomized controlled trials (RCTs) published up to May 2025. Meta-analyses were performed for Probing Depth (PD), Bleeding on Probing (BOP), Plaque Index (PI), and Radiographic Marginal Bone Loss (RMBL) at approximately 6 months (range 3–9 months). Mean differences (MD) with 95% confidence intervals (CI) were calculated using random-effects models. Results: Fifteen RCTs (644 patients; 742 implants) met the inclusion criteria. Adjunctive laser therapy was associated with significant reductions in PD (MD − 0.34 mm; 95% CI − 0.67 to − 0.01; p = 0.044), BOP (MD − 0.28; 95% CI − 0.53 to − 0.03; p = 0.03), and PI (MD − 0.44; 95% CI − 0.55 to − 0.33; p < 0.0001). No significant difference was observed for RMBL (MD 0.16 mm; 95% CI − 0.24 to 0.55; p = 0.43). Substantial heterogeneity was present for PD (I² = 91.3%) and PI (I² = 86%). Conclusions: Adjunctive LLLT, particularly Er,Cr:YSGG and aPDT, improves short-term clinical outcomes in non-surgical peri-implantitis treatment. Clinical effectiveness is highly dependent on laser modality and applied protocol, highlighting the need for standardized, evidence-based treatment protocols.