Effect of Photoactivated Disinfection Versus Laser Disinfection of Infected Sockets on the Success of Immediate Implant Placement (a Randomized Controlled Clinical Trial)

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.