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Volk M, Molan K, Šavli D, Terlep S, Levičnik-Höfferle Š, Gašpirc B, Lukač M, Jezeršek M, Stopar D. Biofilm removal from Difficult-to-Reach places via secondary cavitation within a constrained geometry mimicking a Periodontal/Peri-Implant pocket. ULTRASONICS SONOCHEMISTRY 2024; 104:106832. [PMID: 38429168 PMCID: PMC10985801 DOI: 10.1016/j.ultsonch.2024.106832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/26/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
Biofilm removal from the apical region of the periodontal or peri-implant pocket, which is very difficult to achieve with mechanical instruments, is a major unresolved issue in dentistry. Here, we propose the use of photoacoustically induced streaming and secondary cavitation to achieve superior cleaning efficacy in the apical region of the periodontal and peri-implant pocket. We have used a prefabricated narrow wedge system that mimics the consistency of periodontal and peri-implant pockets of both healthy and severely inflamed tissue. We studied the effect of single-pulse modality Er:YAG on Pseudomonas aeruginosa biofilm removal. We used different laser energies, fiber-tip positions, and laser treatment durations. The cleaning process was monitored in real-time with a high-speed camera after each individual laser pulse application. The obtained results suggest that biofilm cleaning efficacy in a difficult-to-reach place in healthy model tissue is directly related to the onset of secondary cavitation bubble formation, which correlates with a significant improvement of biofilm removal from the apical region of the periodontal or peri-implant pocket. In comparison to the healthy tissue model, the laser energy in inflamed tissue model had to be increased to obtain comparable biofilm cleaning efficacy. The advantage of photoacoustic cavitation compared to other methods is that laser-induced cavitation can trigger secondary cavitation at large distances from the point of laser application, which in principle allows biofilm removal at distant locations not reachable with a laser fiber tip or other mechanical instruments.
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Affiliation(s)
- Marko Volk
- University of Ljubljana, Biotechnical Faculty, Department of Microbiology, Večna pot 111, Ljubljana 1000, Slovenia
| | - Katja Molan
- University of Ljubljana, Biotechnical Faculty, Department of Microbiology, Večna pot 111, Ljubljana 1000, Slovenia
| | - Dominik Šavli
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva cesta 6, Ljubljana 1000, Slovenia
| | - Saša Terlep
- Fotona d.o.o., Stegne 7, Ljubljana 1000, Slovenia
| | | | - Boris Gašpirc
- University of Ljubljana, Medical Faculty, Department of Oral Medicine and Periodontology, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Matjaž Lukač
- Fotona d.o.o., Stegne 7, Ljubljana 1000, Slovenia; Institut Jozef Stefan, Jamova 39, Ljubljana 1000, Slovenia; University of Ljubljana, Faculty of Mathematics and Physics, Jadranska 19, Ljubljana 1000, Slovenia
| | - Matija Jezeršek
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva cesta 6, Ljubljana 1000, Slovenia
| | - David Stopar
- University of Ljubljana, Biotechnical Faculty, Department of Microbiology, Večna pot 111, Ljubljana 1000, Slovenia.
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Zhang Y, Tang P, Yang Q, Li C, Li L, Han M. Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial. Clin Oral Investig 2024; 28:143. [PMID: 38349450 DOI: 10.1007/s00784-024-05510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE The study aims to determine the effects of Nd:YAG laser-assisted with subgingival scaling and root planing (SRP) treatment on glucose control and the dynamic changes of subgingival microbiome in periodontitis with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Twenty-two patients were split into Nd:YAG group (n = 11) and SRP group (n = 11). Patients in the Nd:YAG group received SRP and auxiliary Nd:YAG laser treatment; patients in the SRP group received SRP treatment only. Periodontal tissue inflammation and glycemic control were assessed and analyzed during the treatment period and the changes of subgingival microbiome were analyzed by full-length 16S rRNA sequencing. RESULTS After 3 months of treatment, PD and CAL values improved significantly in the Nd:YAG group compared to the SRP group. BOP in both groups improved significantly after treatment. FPG levels in the Nd:YAG group were significantly reduced after treatment. Porphyromonas and Porphyromonadaceae were enriched in the Nd:YAG group at baseline, and Fusobacteriota, Fusobacteriia, Fusobacteriales, Leptotrichiaceae, and Leptotrichia were enriched after treatment. CONCLUSION Nd:YAG laser-assisted SRP therapy has additional benefits in improving periodontal tissue inflammation and blood glucose control in periodontitis patients with T2DM compared with SRP therapy alone and there was a trend towards a decrease in disease-associated taxa and an increase in health-associated taxa following auxiliary Nd:YAG laser treatment. CLINICAL RELEVANCE The effects of Nd:YAG laser-assisted SRP treatment on inflammation, glucose control, and subgingival microbiome in periodontitis patients with T2DM were elucidated, and new ideas for the treatment of T2DM periodontitis were provided.
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Affiliation(s)
- Yifei Zhang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chen Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China.
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Bechir ES. The Clinical and Microbiological Effects of LANAP Compared to Scaling and Root Planing Alone in the Management of Periodontal Conditions. Diagnostics (Basel) 2023; 13:2450. [PMID: 37510194 PMCID: PMC10378219 DOI: 10.3390/diagnostics13142450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this study was to evaluate the efficiency of two therapeutic procedures clinically and microbiologically in the management of periodontally affected teeth: scaling and root planing alone and the laser-assisted new attachment procedure (LANAP). Molecular biological determinations of bacterial markers through the polymerase chain reaction (real-time PCR) method with standard PET tests (species-specific DNA probes at a time) were used for the quantification of three of the most important periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola). Both nonsurgical periodontal therapies were proven effective in patients with chronic periodontal disease; however, LANAP was associated with a greater reduction in pocket depth and improved clinical outcomes, associated with a significant decrease in the amount of Porphyromonas gingivalis. The clinical results included a decrease in periodontal pocket depth, bleeding on probing, and dental plaque, with LANAP having better overall outcomes than SRP alone. The use of Nd:YAG lasers in LANAP therapy is a safe and effective procedure that is well accepted by patients.
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Affiliation(s)
- Edwin Sever Bechir
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
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Gong H, Li M. Short-Term Efficacy of Er:YAG Laser and Nd:YAG Laser Combined Therapy on Periodontitis. Photobiomodul Photomed Laser Surg 2022; 40:580-588. [DOI: 10.1089/photob.2022.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Huiyan Gong
- Department of Stomatology, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Meihua Li
- Department of Stomatology, Second Hospital of Jilin University, Changchun, Jilin, China
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Estrin NE, Moraschini V, Zhang Y, Romanos GE, Sculean A, Miron RJ. Combination of Nd:YAG and Er:YAG lasers in non-surgical periodontal therapy: a systematic review of randomized clinical studies. Lasers Med Sci 2022; 37:2737-2743. [PMID: 35364744 DOI: 10.1007/s10103-022-03548-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
Lasers are increasingly utilized in the non-surgical treatment of periodontal disease. The aim of the present systematic review with meta-analysis was to investigate the combination use of Nd:YAG and Er:YAG laser therapy in the treatment of severe periodontitis. A systematic review of the literature including searches in PubMed/Medline, Cochrane Library, Google Scholar, and Grey Literature databases, as well as manual searches, was performed until November 1, 2021. Only studies a combination of lasers during non-surgical treatment of pockets ≥ 6mm were included. The eligibility criteria for meta-analysis comprised randomized controlled trials (RCTs) comparing the use of combination laser therapy with/without adjunctive mechanical for the non-surgical management of periodontitis. From 57 initial articles, 6 full-text articles were assessed for eligibility. Two studies were excluded, one study was not a randomized clinical trial (case series), and one study was an in vitro study. Four RCTs were included in the meta-analysis. It was shown that combination of Nd:YAG and Er:YAG may be beneficial for non-surgical periodontal therapy with an additional average reduction in pocket depth and clinical attachment level reported at 1.01 and 0.77 mm respectively when compared to controls. The findings suggest that the combination of Nd:YAG and Er:YAG lasers may lead to additional clinical improvements compared to nonsurgical treatment alone. Future research is needed to substantiate these findings and optimize clinical guidelines including more specific laser protocols. Preliminary data suggest favorable outcomes following the combination of Nd:YAG and Er:YAG lasers for non-surgical periodontal therapy.
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Affiliation(s)
- Nathan E Estrin
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
| | - Yufeng Zhang
- Department of Oral Implantology, Wuhan University, Wuhan, China
| | - George E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Gur AT, Guncu GN, Akman AC, Pinar A, Karabulut E, Nohutcu RM. Evaluation of GCF IL-17, IL-10, TWEAK and sclerostin levels after SRP and adjunctive use of diode laser application in periodontitis patients. J Periodontol 2021; 93:1161-1172. [PMID: 34962665 DOI: 10.1002/jper.21-0494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/23/2021] [Accepted: 12/19/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the clinical efficacy of the diode laser as an adjunct to scaling and root planing (SRP) and also determine the biochemical profile by evaluating the gingival crevicular fluid (GCF) levels of interleukin (IL)-17, IL-10, TNF-related weak inducer of apoptosis (TWEAK) and sclerostin. METHODS A total of 40 systemically healthy, stage III periodontitis patients were included in this randomized controlled study. Participants were randomly divided into two groups as scaling root planning (SRP) + diode laser(L) (0.80W power, 940nm wavelength and 0.80J/s energy level) and only SRP group. Recording of periodontal parameters and collecting GCF samples were performed at baseline, 1st and 3rd months. Biomarker levels in GCF were measured with ELISA . RESULTS At baseline, no significant difference was detected between groups in terms of both clinical and biochemical parameters. All biochemical parameters (except for IL-10 in control group), presented a statistically significant difference for 3 months study period in both groups. When laser and control groups were compared, significant differences were not observed, except the lower GCF IL-17 levels (p = 0.025), bleeding on probing (p = 0.028) and clinical attachment level (CAL) (p = 0.0002) values in laser group at 3rd , 1st and 3rd months, respectively. Statistically significant correlations were also noted between biochemical parameters and clinical parameters. CONCLUSION The GCF IL-17, TWEAK and sclerostin levels may be useful for monitoring response to SRP+L therapy. However, long-term studies on higher populations are needed to evaluate the effectiveness of adjunctive use of diode laser application to SRP. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ali Tugrul Gur
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Guliz N Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Abdullah C Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Asli Pinar
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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