Photoactivated Disinfection Versus Laser Disinfection of Infected Sockets on the Success of Immediate Implant Placement

Background: Dental implantology offers reliable tooth replacement options, but infections in extraction sockets can compromise osseointegration. Conventional disinfection methods, such as chlorhexidine, often fail to completely eliminate pathogenic microorganisms and may impair tissue healing. Photoactivated disinfection (PAD) and laser disinfection have emerged as promising alternatives. PAD employs a light-activated photosensitizer to generate reactive oxygen species (ROS), effectively disrupting bacterial membranes while preserving host cell viability. In parallel, laser disinfection utilizes focused light energy to eliminate bacterial biofilms and contaminated tissue with minimal thermal damage. In this study, we specifically utilize the Er,Cr:YSGG laser, which operates at a water-absorbing wavelength to induce micro-explosions that mechanically disrupt biofilms and promote a cleaner socket environment for improved osseointegration. Aim of the study: To compare the effectiveness of photoactivated disinfection (PAD), Er,Cr:YSGG laser disinfection, and conventional disinfection with chlorhexidine in decontaminating infected extraction sockets prior to immediate implant placement, promoting bone healing, and improving the osseointegration and stability of immediate implants placed in infected extraction sockets.

Inclusion Criteria: * Patients having posterior tooth/teeth indicated for extraction * Patients must exhibit radiographic evidence of infection, defined as chronic periapical pathology (radiolucency) * The extraction site should have intact surrounding alveolar bone * There must be at least 2 mm of sound bone beyond the root apex * Patients must be in overall good health and free from uncontrolled systemic conditions Exclusion Criteria: * History of radiation therapy in the head and neck region * Pregnant or lactating women * Patients on long-term antibiotic therapy, as it could influence the outcomes * Heavy Smoking: More than 10-15 cigarettes per day. * Significant bruxism or parafunctional habits affecting implant stability.