Comparative Evaluation of the Effects of Different Photoablative Laser Irradiation Protocols on the Gingiva of Periodontopathic Patients (original) (raw)
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Histological Examination of Gingiva Treated with Low-level Laser in Periodontal Therapy
Journal of Laser Applications
P eriodontitis is defined as "inflammatory disease of supportive tissue of teeth caused by specific mi-croorganisms which lead to progressive destruction of periodontal membrane and alveolar bone, with forma-tion of periodontal pockets and gingival recession". 1 The microorganisms found in the gingival sulcus are re-sponsible for the first pathological changes in the in-flamed gingiva. The initial damage consists of widening of the intracellular spaces, which, during the early phase of gingival inflammation, enables aggressive bac-teria and their products to penetrate into connective gingival tissue. 2 In response to dental plaque, healthy periodontium brings about significant changes in the tissue. The changes depend on the interaction between the host response (defense mechanisms) and microbial flora in the plaque, which causes the appearance of various clinical forms of periodontal disease. However, this in-teraction does not greatly affect the histological changes in t...
The journal of contemporary dental practice, 2024
Aim: This split-mouth randomized trial (RCT) aimed to assess the effect of diode laser on the clinical parameters in patients with periodontitis, compare the results with scaling and root planing (SRP) alone, and assess the implications of diode laser (DL) on plaque bacteria. Materials and methods: Seventeen periodontitis patients were randomly assigned into two equal groups based on the therapy delivered. Group I (control site) received just SRP at baseline, while group II (test site) received both SRP and DL irradiation. For both groups, the clinical periodontal parameters probing pocket depth (PPD), and clinical attachment level (CAL) were measured at baseline, 30 days, and 90 days. Microbiological amount was also measured at baseline, 30, and 90 days after periodontal treatment. The amounts of Aggregatibacter actinomycetemcomitans (A.a), Prevotella intermedia (Pr. intermedia), and Porphyromonas gingivalis (P. gingivalis) were determined using real-time PCR probing with specific bacterial primers. Results: In both groups, PPD and CAL showed statistically significant reductions at different time intervals (p < 0.05). No significant difference were observed in CAL values after 1 and 3 months in both test and control groups (p > 0.05). The mean values of the concentration of A.a, Pr. intermedia and P. gingivalis were lower in the case group as compared to the control group and the difference was statistically significant after 1 month (*p = 0.001). Clinical significance: According to this study, non-invasive laser treatment has the potential to improve clinical outcomes by lowering the quantity of A.a, Pr. intermedia and P. gingivalis. Conclusion: In both groups, a considerable decrease in the periodontal pathogens A.a, Pr. intermedia and P. gingivalis were discovered; however, the intergroup comparison was insignificant in relation to PD and CAL. The adjunctive treatment with diode laser showed better efficacy in ensuring a better periodontal treatment than SRP alone.
The Effects of Low Level Laser Irradiation on Gingival Inflammation
Photomedicine and Laser Surgery, 2010
Objective: The goal of this study was to analyze the effects of low level laser irradiation treatment and conservative treatment on gingival inflammation. Background: It is widely accepted today that the primary etiological factor for the onset of periodontitis is dental plaque, although the exact mechanism of damage remains unknown. Inflammation is a basic response of periodontal tissue to damage and serves as a fast first line of defense against damage and infections. The treatment of gingivitis and periodontitis has gone through various stages: from the simplest, classical treatment methods, through improved radical interventions, to a new era marked by laser technology. Low level laser irradiation has an anti-inflammatory effect, both general and local. Materials and methods: The research was done on patients who had chronic periodontal disease (mild periodontitis) with expressed clinical symptoms of gingival inflammation. All patients in the study underwent conservative treatment. After conservative therapy, the patients from the experimental group were subjected to 10 low level laser treatment sessions. Both groups underwent regular follow-up visits 1, 3, and 6 months after treatment, which involved only clinical examination using plaque index (PI), gingival index (GI), and bleeding on probing index (BOP index). Results: A considerable decrease in all three indexes after the application of both therapies was noticed. The follow-up visits revealed the difference in index values. With laser therapy, the values of indexes decreased steadily, whereas with conservative therapy they increased up to a certain point, but did not reach the pre-therapy values. Conclusions: A general conclusion can be drawn that low level laser irradiation (semiconductor, 670 nm) can be used as a successful physical adjuvant method of treatment, which, together with traditional periodontal therapy, leads to better and longer-lasting therapeutic results.
Journal of Dental Research, Dental Clinics, Dental Prospects, 2020
Background. Conventional mechanical debridement alone cannot eliminate bacteria and their products from periodontal pockets. Adjunctive therapies improve tissue healing through detoxification and bactericidal effects. Photodynamic therapy (PDT) is a non-invasive treatment procedure that involves the use of a dye as a photosensitizer to attach to the target cell and be activated by a photon of an appropriate wavelength. This study aimed to assess the effectiveness of PDT in treating periodontitis as an adjunct to scaling and root planing. Methods. Fifteen subjects with chronic periodontitis were treated randomly with scaling and root planing (SRP), followed by a single PDT (test) or SRP (control) episode alone. Full-mouth plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) were assessed at baseline and 1-month and 3-month intervals. Microbiological evaluation of Porphyromonas gingivalis (Pg) in subgingival plaque samples was perform...
Advances in Clinical and Experimental Medicine, 2018
Background. Laser technology in periodontal therapy could help in reducing total bacterial count. Objectives. The aim of this study was to evaluate the effects of pocket debridement using an erbium-doped yttrium aluminium garnet laser (Er:YAG laser-ERL), scaling and root planing (SRP) with photodynamic therapy (PDT), or SRP alone. Teeth vitality and soft tissue carbonization were also assessed. Material and methods. This study included 1, 169 single-rooted teeth from 84 patients divided into 3 groups (n = 28). The G1 group had ERL with 40 mJ of energy, a frequency of 40 Hz and a fluence of 63.66 J/cm 2. The G2 group had SRP + PDT (635 nm diode laser, 12 J of energy and irradiation time of 30 s) and a Toluidine Blue photosensitizer (PS) (application time of 60 s). The G3 group was administered SRP alone. In the 42 subjects (G1: n = 11, G2: n = 14 and G3: n = 17) with high amounts of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td) and Tannerella forsythia (Tf), additional 1-week antibiotic treatments with clindamycin or amoxicillin + clavulanic acid-in doses of 600 mg/day or 1000 mg/day, respectively-were prescribed 3 months after the therapy. Microbiological and clinical analyses of the probing depth (PD), recession (RC), plaque index (PI), bleeding on probing (BOP), and attachment loss (AT) were performed at baseline and at the follow-up of 3 months, 3 months and 1 week, and 6 months. Results. Plaque index decreased in G1 after 3 months, 3 months and 1 week, and 6 months (p < 0.05) and was lower in G1 vs G2 after 3 months (p < 0.05). The reduction in BOP in G1 after 3 months and 1 week was higher in comparison with G2 or G3 (p < 0.02). Probing depth decreased in all groups (p < 0.05). We found a reduction in the percentage of sites with some bacteria after 3 months-Prevotella intermedia (Pi) (G1 and G2), Capnocytophaga gingivalis (Cg) and Eubacterium nucleatum (En) (G3), and after 3 months and 1 week with En, Td, Tf (G1, G2 and G3), Pi (G1 and G2), Aa, Peptostreptococcus micros (Pm), and Cg (G3), and with Pi (G1 and G2), Tf (G2), Pg, En (G2 and G3), and Pm (G3) after 6 months (p < 0.05). We observed no signs of carbonization or teeth injury. Conclusions. Scaling and root planing + PDT and ERL may be an alternative therapy for chronic periodontitis.
Australian Dental Journal, 2016
Background: Inflammatory periodontal diseases are initiated by microbial biofilms. The reduction of the biofilm is important in the management of the disease. This study compares periodontopathogen levels following the treatment of chronic periodontitis using Er:YAG laser (ERL) debridement and mechanical scaling and root planing (SRP). Methods: Using a split-mouth design, two quadrants were randomly allocated for treatment. Two hundred and fifty-two subgingival plaque samples were collected from 21 patients, before treatment (baseline) and at 6 and 12 weeks posttherapy. Multiplex qPCR was used to determine relative levels of Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythensis (Tf), and Aggregatibacter actinomycetemcomitans (Aa). Results: Tf and Pg were significantly reduced post-treatment for both ERL and SRP. ERL treatment resulted in a reduction of Td at 12 weeks. Following SRP treatment Aa was significantly reduced at 12 weeks. No statistically significant difference was seen when treatments were compared at 6 and 12 weeks. Conclusions: A comparable reduction in the level of the four periodontal pathogens assayed was achieved with Er:YAG laser debridement and mechanical scaling and root planing.
Conventional Versus Laser-Assisted Therapy with Aggressive Periodontitis
Aim of the study To evaluate tissue response in aggressive periodontitis (AgP) after conventional and conventional supplemented with laser-assisted therapy. Material and methods This study included 50 subjects with AgP, aged 10 -24 year, which were divided into two subgroups. Firs subgroup 25 subjects treated only with conventional therapy (CP) and second subgroup of 25 subjects which were treated with laser assisted therapy (CP-LA). Low-level diode laser (630-670 nm, 1.875 J/cm) was applied, each sextant for 4 minutes, Scorpion C-405 7A (Optica Laser, Sofia, Bulgaria). The control group consisted of 20 individuals, aged 13-24 years, without signs of periodontal disease. Gingival tissue biopsies were obtained from the controls and from the study group before and after conventional and with laser assisted treatment. Tissue specimens were embedded in paraffin and cryostat procedures were performed. Results Gingival tissue specimens from study group compared to controls showed dense in...
Antimicrobial properties of laser treatment in periodontal therapy
Journal of Physics: Conference Series, 2018
Periodontitis is a multifactorial disease with complex inflammatory responses caused by the disruption of normal homeostatic processes by oral bacteria in the periodontal tissue. In periodontal therapy, the clinical-microbiological properties of the laser therapy may positively affect wound healing. This study involves extensive literature review to examine the antimicrobial impact of laser therapy on the progression of post-treatment periodontal tissue responses. The literature we reviewed was searched and compiled from Pub Med using the following terms: antimicrobial properties, laser technology, periodontal therapy, periodontitis, laser therapy, and periodontal wound healing. As per the literature review, the laser treatment exhibits antimicrobial activity, indicated by the decrease in biofilm formation and enhanced wound healing of the periodontal tissue. Laser technology is a recent approach employed for the management of periodontal disease. Various wavelengths are effective and have antibacterial effect. The comparison of different lasers and their effects on the periodontal tissue is difficult because of the availability of a wide range of treatment protocols for using laser.
Photomedicine and Laser Surgery, 2009
The aim was to compare the effect of scaling and root planing (SRP) alone, diode laser treatment (LAS) alone, and SRP combined with LAS (SRP ϩ LAS) on clinical and microbial parameters in patients with aggressive periodontitis. Materials and Methods: Thirty patients with aggressive periodontitis were assessed for plaque, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL). Four plaque samples were randomly obtained, one from each quadrant that was randomly assigned to SRP alone, SRP ϩ LAS, LAS alone, and control (CRL). A 980-nm diode laser was used in continuous mode at 2 W power. Plaque samples were collected 2 wk, 12 wk, and 6 mo post-treatment. The levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Treponema denticola, and total bacterial load (TBL) were evaluated using ssrRNA probes. Results: Bacterial counts were decreased with all three treatment modalities and they did not reach baseline levels at 6 mo post-treatment. The SRP ϩ LAS group showed statistically significantly lower TBL and bacterial levels of P. gingivalis and T. denticola at 6 mo post-treatment compared to SRP or LAS treatments alone. At the end of the observation period significant differences were observed for PPD and CAL between the SRP ϩ LAS group and both the SRP alone and LAS alone groups. No differences were detected for percentage of plaque and percentage of BOP between any of the treatment groups at 6 mo post-treatment. Conclusions: Within the limits of this study, diode laser-assisted treatment with SRP showed a superior effect over SRP or LAS alone for certain microbial and clinical parameters in patients with aggressive periodontitis over the 6-mo monitoring period.