Abstract
OBJECTIVE: To evaluate the effects of adjunctive low-energy erbium-doped yttrium aluminum garnet (Er:YAG) laser therapy combined with platelet-rich fibrin (PRF) on peri-implant tissue healing, implant stability, bone regeneration, and postoperative inflammation in dental implant patients. METHODS: A retrospective cohort study was conducted with 171 patients who underwent dental implant placement from November 2020 to October 2024. Patients were divided into PRF (PRF alone, n=92) and PRF-ER (PRF combined with low-energy Er:YAG laser therapy, n=79). Clinical parameters, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and implant stability quotient (ISQ) by resonance frequency analysis, were assessed at 2 weeks, 6 weeks, and 3 months post-implantation. Peri-implant crevicular fluid was collected for osteoprotegerin (OPG) quantification. Radiographic assessments of bone density (BD) and ridge measurements were performed using cone-beam computed tomography at baseline and 3 months. Postoperative inflammation and healing were evaluated by visual inspection and the Landry Index. RESULTS: At 3 months postoperatively, the PRF-ER group showed significantly lower mPI, mSBI, and PD, and higher ISQ compared to the PRF group (all P<0.05). OPG levels were significantly higher in the PRF-ER group at 3 months, as were BD, horizontal ridge, and vertical ridge measurements (all P<0.05). Soft tissue thickness remained similar. A greater proportion of PRF-ER patients showed no inflammation and optimal healing. CONCLUSION: Adjunctive low-energy Er:YAG laser therapy with PRF significantly improves peri-implant tissue healing, implant stability, bone regeneration, and reduces postoperative inflammation compared to PRF alone in dental implant patients. These findings support the clinical utility of combined modality therapy for enhancing peri-implant outcomes.