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V V, Sk B, Krishnakumar D, Kumar D, Lavu V. Assessment of clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in the management of periodontitis - a split mouth randomized clinical trial. Lasers Med Sci 2024; 39:82. [PMID: 38418665 DOI: 10.1007/s10103-024-04032-z] [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: 09/06/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
Aim of this study is to assess the clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in management of periodontitis. Type of study is a Split mouth clinical trial in which a total of 13 patients were recruited based on specific inclusion and exclusion criteria. In each participant, random allocation of selected sites into test and control in contralateral quadrants was done. Clinical parameters such as probing depth and clinical attachment loss was measured in control and test sites using occlusal stents. Flap surgery was carried out 6 weeks after phase I therapy and the selected contralateral sites with a probing depth of > 5mm were subjected to surgical therapy. In a test quadrant, 445 nm diode laser with a power of 0.8 W, CW mode, 320 µm fiber, in non-contact mode was used as an adjunct to flap surgery. Primary outcome variable assessed was change in PPD between baseline, pre-operative, 1-, 3- and 6-months post-surgery. Secondary outcomes variables assessed were Clinical attachment loss at baseline, pre-operative, 1, 3 and 6 months, visual analog scale at days 3 and 7 and patient satisfaction index at day 7 post surgery. Surgery for the second site (Test/control) in the contralateral quadrants was performed 1 week after the first surgery. A higher reduction in probing depth and gain in CAL was observed in test site at 1, 3 and 6 months follow up amongst all the included participants. VAS score was lower at the test site as compared to the control sites. PSI scores were similar in both the sites. The adjunctive use of 445nm diode laser to surgical periodontal therapy contributed to improved short term clinical outcomes as assessed at the end of 6 months post- surgery. VAS score indicative of post -surgical discomfort were also lower for the laser treated sites. Hence adjunctive use of laser (445 nm wavelength) can be recommended for achieving more predictable clinical outcomes.
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Affiliation(s)
- Vineet V
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Balaji Sk
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Dhanadivya Krishnakumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Divya Kumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Vamsi Lavu
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India.
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Altindal D, Alkan EA, Calisir M. Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis. J Periodontal Implant Sci 2023; 53:376-387. [PMID: 37038829 PMCID: PMC10627738 DOI: 10.5051/jpis.2203140157] [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: 06/30/2022] [Revised: 11/19/2022] [Accepted: 12/21/2022] [Indexed: 02/11/2023] Open
Abstract
PURPOSE Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI. METHODS Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1β [IL-1β] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1β levels were determined using the enzyme-linked immunosorbent assay method. RESULTS The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1β level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG. CONCLUSIONS The diode laser enabled improvements in clinical parameters in the peri-implant tissue. However, it did not reduce IL-1β levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.
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Affiliation(s)
- Dicle Altindal
- Department of Periodontology, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey.
| | - Eylem Ayhan Alkan
- Department of Periodontology, Faculty of Dentistry, Yildirim Beyazit University, Ankara, Turkey
| | - Metin Calisir
- Department of Periodontology, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
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Lu JW, Huang SH, Lei XX, Deng L, Luo LJ. Clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy for residual periodontal pockets in mandibular second molars-a randomized controlled clinical trial. Clin Oral Investig 2023; 27:4493-4501. [PMID: 37219608 DOI: 10.1007/s00784-023-05071-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy (NSPT) for residual periodontal pockets in mandibular second molars. MATERIALS AND METHODS Sixty-seven mandibular second molars (154 residual periodontal pockets) were recruited into the study and randomly assigned to the Laser + NSPT group and the NSPT group. The Laser + NSPT group underwent NSPT adjunct with diode laser radiation (wavelength: 810 nm, power: 1.5 W, 40 s maximum), while the NSPT group underwent nonsurgical periodontal therapy alone. Clinical parameters were measured at baseline (T0) and 4(T1), 12(T2), and 24(T3), weeks after treatment. RESULTS Periodontal pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) in both groups showed significant improvements at the end of study compared to baseline. The reductions of PPD, CAL, and BOP in the Laser + NSPT group were significantly greater than NSPT group. At T3, the Laser + NSPT group had a mean PPD of 3.06 ± 0.86 mm, CAL of 2.58 ± 0.94 mm and BOP of 15.49%, while the NSPT group had a mean PPD of 4.46 ± 1.57 mm, CAL of 3.03 ± 1.25 mm and BOP of 64.29%. CONCLUSIONS The diode laser as an adjunct to nonsurgical periodontal therapy may contribute to clinical outcomes for residual periodontal pockets. However, the approach may cause reduction of keratinized tissue width. TRIAL REGISTRATION NUMBER This study was registered in the Chinese Clinical Trial Registry ChiCTR2200061194. CLINICAL RELEVANCE Diode laser as an adjunct to nonsurgical periodontal therapy may contribute to the clinical outcomes for residual periodontal pockets in mandibular second molars.
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Affiliation(s)
- Jia-Wei Lu
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Yan Chang Road, Shanghai, 20072, China
| | - Shi-Hui Huang
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Yan Chang Road, Shanghai, 20072, China
| | - Xiao-Xiao Lei
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Yan Chang Road, Shanghai, 20072, China
| | - Li Deng
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Yan Chang Road, Shanghai, 20072, China
| | - Li-Jun Luo
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Yan Chang Road, Shanghai, 20072, China.
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Comparative Evaluation of Azadirachta indica (Neem) Chip and Soft Tissue Diode Lasers as a Supplement to Phase I Periodontal Therapy in Localized Chronic Moderate Periodontitis: A Randomized Controlled Clinical Trial. Int J Dent 2022; 2022:6109040. [PMID: 35756957 PMCID: PMC9217592 DOI: 10.1155/2022/6109040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The current trial aimed to assess and compare the efficacy of neem chip and diode laser as a local drug delivery (LDD) agent as a supplement to phase I periodontal therapy in treatment of localized chronic moderate periodontitis. Materials and Methodology. Fourteen systemically healthy participants with 4-6 mm deep periodontal pockets at least in three quadrants (with no alveolar bony defect amenable to respective or regenerative osseous surgery, as seen in orthopantomograph) were selected for the trial. One week after phase I therapy, 10% absorbable chip of neem (commercially prepared by staff of a pharmacy college, Sheriguda, India) was placed in the periodontal pocket on one site, and soft tissue diode laser pocket sterilization was performed on the other site of the arch. Remaining one site was considered as a control. Parameters recorded clinically were plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and relative attachment level (RAL) measured at baseline, 21st day, and one month postoperatively. Results Statistically significant improvements were observed in all clinical parameters at one month as compared to baseline for both treatment groups. Conclusion Neem chip supplemented with phase I therapy showed best improvement in clinical parameters followed by laser supplemented with phase I therapy in comparison to phase I therapy alone at one month follow-up. Clinical Significance. Neem chips are nature's products, affordable without side effects, with a potential to be used as a local drug delivery agent in treating moderate chronic periodontitis.
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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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Alizadeh Tabari Z, Pournasir L, Mohammadreza S, Anbari F. Clinical Efficacy of the 940-nm Diode Laser in the Treatment of Recurrent Pockets in the Periodontal Maintenance Phase. J Lasers Med Sci 2021; 12:e68. [DOI: 10.34172/jlms.2021.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/27/2021] [Indexed: 11/09/2022]
Abstract
Introduction: The basis of periodontal treatments is the mechanical removal of bacterial biofilm, which is often not sufficient. Therefore, laser therapy can be effective as an adjunct treatment. The aim of the present study was to evaluate the clinical efficacy of the 940-nm diode laser in the treatment of recurrent pockets of patients in the periodontal maintenance phase. Methods: The present clinical trial study was performed on 20 patients. Clinical indices, including bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) of the studied teeth were recorded before the test. The different quadrants were randomly divided into two experimental (scaling and root planing (SRP)+Laser) and control groups (SRP alone). Both groups were matched in terms of plaque index (PI). Clinical indices were re-recorded using therapeutic methods 30 and 90 days after the treatment, and data analysis was carried out using the t test and LSD. Results: There were no significant differences in PI, PPD, CAL, and BI in both groups before the treatment (P>0.05). However, there were significant differences in PPD, CAL, and BI in the two groups one month after the treatment (P<0.05); it means that improvements were more significant in the experimental group than in the control group. Comparing experimental and control groups, we found that there were no significant differences in PPD and CAL indices three months after the treatment (P>0.05); however, there were significant improvements in the BI index in both groups (P<0.05), so that the improvement was better in the experimental group than the control group. Conclusion: Both SRP+Laser and SRP alone improved clinical indices in patients. In short-term follow-up, the effect of SRP+Laser treatment on BI, CAL, PPD was significantly superior to SRP treatment alone, but in long-term follow-up, SRP+laser was more effective than SRP alone in improving the BI index.
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Affiliation(s)
- Zahra Alizadeh Tabari
- Department of Periodontics, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Sadegh Mohammadreza
- Post Graduate Student of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Anbari
- Oral Medicine Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mokhtari MR, Ahrari F, Dokouhaki S, Fallahrastegar A, Ghasemzadeh A. Effectiveness of an 810-nm Diode Laser in Addition to Non-surgical Periodontal Therapy in Patients With Chronic Periodontitis: A Randomized Single-Blind Clinical Trial. J Lasers Med Sci 2021; 12:e37. [PMID: 34733760 DOI: 10.34172/jlms.2021.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/06/2021] [Indexed: 11/09/2022]
Abstract
Introduction: This study evaluated the effectiveness of an 810-nm diode laser as an adjunct to scaling and root planning (SRP) in improving periodontal parameters in patients with chronic periodontitis. Methods: This randomized clinical trial consisted of 36 patients (16 females and 20 males) with chronic periodontitis and pocket depths of 4-6 mm. The quadrants were randomly divided into two sides; one side of each patient was selected as the laser group (SRP + laser) and the other side served as the control group (SRP alone). An 810-nm diode laser was applied in the laser side to remove the outer gingival epithelium (1.5 W, CW) as well as the inner epithelium of the periodontal pockets (1 W, CW). The clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index (PI), and clinical attachment level (CAL) were measured at baseline and 6 and 18 weeks after therapy. Results: In both groups, there was a significant improvement in BOP, PD, PI and CAL over the course of the experiment (P < 0.001). Significantly lower BOP was found in the SRP + laser group than the SRP alone group after 6 and 18 weeks of intervention (P < 0.05). The difference in other parameters was not significant between the two groups, neither at 6 nor at 18 weeks after the treatment (P > 0.05). Conclusion: Within the limitations of this study, the association of the diode laser with standard non-surgical periodontal therapy (SRP) provided minimal additional benefits for patients with moderate chronic periodontitis.
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Affiliation(s)
- Majid Reza Mokhtari
- Department of Periodontontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokoufeh Dokouhaki
- Student Research Committee, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Ghasemzadeh
- Student Research Committee, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Theodoro LH, Marcantonio RAC, Wainwright M, Garcia VG. LASER in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res 2021; 35:e099. [PMID: 34586213 DOI: 10.1590/1807-3107bor-2021.vol35.0099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.
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Affiliation(s)
- Letícia Helena Theodoro
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Diagnostic and Surgery, Araçatuba, SP, Brazil
| | | | - Mark Wainwright
- Liverpool John Moores University, School of Pharmacy & Biomolecular Sciences, Liverpool, UK
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education - Ilapeo, Curitiba, PR, Brazil
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Yu S, Zhao X, Zhang Y, Liu Y, Li A, Pei D. Clinical effectiveness of adjunctive diode laser on scaling and root planing in the treatment of periodontitis: is there an optimal combination of usage mode and application regimen? A systematic review and meta-analysis. Lasers Med Sci 2021; 37:759-769. [PMID: 34536183 DOI: 10.1007/s10103-021-03412-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 09/05/2021] [Indexed: 11/29/2022]
Abstract
This review aims to evaluate the adjunctive clinical effectiveness of diode laser (DL) to scaling and root planing (SRP) in the treatment of periodontitis, and identify the optimal combination of usage mode and application regimen of DL. Eight electronic databases were searched up to January 2021. Probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), and gingival index (GI) were assessed at short-term (4-6 weeks), 3-month, and 6-month follow-ups. Based on DL usage mode, studies were divided into three groups: inside, outside pocket, and combined modes. As for application regimen, studies in each group were further subdivided into single- and multiple-session subgroups. Thirty randomized controlled trials with 825 participants were included. For inside mode, single-session DL showed significant improvements for PPD (short-term, and 3-month, p < 0.05), CAL (short-term, and 3-month, p < 0.05), PI (3- and 6-month, p < 0.05), and GI (short-term, 3-month, and 6-month, p < 0.05). For outside mode, multiple-session DL showed notable improvements for most clinical outcomes (p < 0.05). The effect of combined mode was still uncertain. Adjunctive DL had additional clinical benefits in the treatment of periodontitis. One session laser treatment is suggested when DL is applied inside pocket in future clinical practice. Meanwhile, more than one session laser treatment presents better outcomes when DL is used outside pocket. PROSPERO: CRD42020156162.
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Affiliation(s)
- Shuchen Yu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Xiaodan Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Yujiao Liu
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China. .,Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China. .,Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
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Pawelczyk-Madalińska M, Benedicenti S, Sălăgean T, Bordea IR, Hanna R. Impact of Adjunctive Diode Laser Application to Non-Surgical Periodontal Therapy on Clinical, Microbiological and Immunological Outcomes in Management of Chronic Periodontitis: A Systematic Review of Human Randomized Controlled Clinical Trials. J Inflamm Res 2021; 14:2515-2545. [PMID: 34163210 PMCID: PMC8214554 DOI: 10.2147/jir.s304946] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022] Open
Abstract
Background Due to the limitations of scaling and root planing (SRP) in chronic periodontitis (CP) management, research has been focused on utilising additional therapies to enhance conventional treatment methods. The present systematic review is aimed to appraise the accessible scientific evidence of in vivo human studies to establish the effectiveness of adjunctive diode (λ 808- λ 980nm) laser treatment to SRP in CP. Methodology This systematic review was conducted following the PRISMA statement guidelines. The review protocol is registered in PROSPERO (CRD 42021227695). The search strategies were based on structured electronic and manual (with appropriate keywords) and were conducted to collect the applicable published data on RCTs studies (in vivo human), spanning over ten years between August 2010 and August 2020. The articles were selected to address the following research focus question: “Does diode laser (λ 808- λ 980nm) therapy have superior effects as an adjunct to SPR, compared to SRP alone, in terms of clinical or microbiological or immunological profiles in the management of CP?” Results Fifteen articles met the eligibility criteria and are included in this review. A wide range of discrepancies and inconsistencies were shown in the outcomes of the laser and SPR treatment modality, compared to SRP alone. The data on standardised study protocol, optimal laser parameters and outcome measurements were inconclusive, and a high risk of bias in the majority of the studies observed, which are crucial in establishing a homogenous and reproducible protocol. Conclusion In light of the confined evidence-based data and critical evaluation of this systematic review, the efficacy of adjunctive diode laser treatment ranging between 808 and 980nm to SRP remains debatable. The observational quality of the present systematic review was emphasised after scrutinising the available data, and an attempt to propose a laser protocol for future RCTs consideration was a great challenge due to an absence of clear and standardised recommendations in delivering a reliable laser protocol which can be replicable by future investigators. RCTs with robust methodology are warranted.
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Affiliation(s)
- Magdalena Pawelczyk-Madalińska
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Periodontology, Pomeranian Medical University, Szczecin, 70-204, Poland.,FAN-DENT Centrum Stomatologii i Periodontologii, Gdańsk, 80-257, Poland
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
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Dalvi S, Benedicenti S, Hanna R. Effectiveness of Photobiomodulation as an Adjunct to Nonsurgical Periodontal Therapy in the Management of Periodontitis- A Systematic Review of in vivo Human Studies. Photochem Photobiol 2020; 97:223-242. [PMID: 33098680 DOI: 10.1111/php.13348] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/04/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022]
Abstract
Photobiomodulation therapy (PBMT) has anti-inflammatory, analgesic and regenerative properties. This systematic review aimed to critically appraise the published data of in vivo human randomized clinical trials (RCTs), and present a comprehensive overview of the efficacy of PBMT, as an adjunct to the nonsurgical periodontal therapy (NSPT) in the management of periodontitis. The systematic review protocol is registered in the Prospective Register Of Systematic Reviews (PROSPERO) (www.crd.york.ac.uk/PROSPERO/; ref CRD 42020169108). With the help of the appropriate key words, structured electronic and manual search strategies were applied to gather the relevant published data on in vivo human RCTs based on this topic. Seventeen papers that met the eligibility criteria were included in this review and subjected to a qualitative assessment. Current evidence lacks adequate information regarding the photobiomodulation (PBM) dosimetry, which is fundamental in establishing a standardized and replicable protocol for future researches. Furthermore, substantial discrepancies in the study methodology and a high risk of bias, arising from the majority of the included papers, abet to the inferior quality of these studies. Ultimately, there is an urgent necessity to conduct further well-designed RCTs in order to determine the effectiveness of PBMT, if any, by taking into consideration the abovementioned confounding factors.
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Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Oral Surgery, University of Genoa and King's College, London, UK
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Samulak R, Suwała M, Dembowska E. Nonsurgical periodontal therapy with/without 980 nm diode laser in patients after myocardial infarction: a randomized clinical trial. Lasers Med Sci 2020; 36:1003-1014. [PMID: 32885341 PMCID: PMC8222017 DOI: 10.1007/s10103-020-03136-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to evaluate the possible benefits (in terms of periodontal status improvement and periodontal bacteria count reduction) of using 980 nm diode laser in the treatment of periodontitis in patients after myocardial infarction. Thirty-six patients under 65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after myocardial infarction, were recruited for the study. The control group (n = 18) received SRP (scaling, root planing and polishing) while the test group (n = 18) received SRP followed by laser therapy of the periodontal pockets with 980 nm diode laser, 1 W, continuous wave mode, 20 s per tooth side. Procedures were repeated twice at 5-7 day intervals. Microbiological and periodontal examination, including periodontal pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP) and plaque control record (PCR), were performed before treatment, 2 weeks and 3 months after treatment. The study was registered on ClinicalTrials.gov with Identifier: NCT04145557, 29.10.2019 "retrospectively registered". Additional use of laser resulted in a significant reduction in pockets with PPD ≥ 7 mm (p = 0.0151). The diode laser reduced total bacteria count (p = 0.0154) and delayed recolonisation during a 3-month observation period. A significant increase in the number of Capnocytophaga gingivalis was observed in the control group (p = 0.048). Additional use of the diode laser after SRP had no significant effect on BOP, CAL and PCR. Within the limitations of our study, we can conclude that 980 nm diode laser can be a useful tool in the treatment of periodontitis in patients after myocardial infarction.
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Affiliation(s)
- Renata Samulak
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Mariusz Suwała
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Elżbieta Dembowska
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Sopi M, Koçani F, Bardhoshi M, Meqa K. Clinical and Biochemical Evaluation of the Effect of Diode Laser Treatment Compared to the Non-surgical and Surgical Treatment of Periodontal Diseases. Open Dent J 2020. [DOI: 10.2174/1874210602014010281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Periodontal therapy consists of eliminating the inflammation, treating periodontal pockets, motivating the patient for oral hygiene, and, if necessary, for surgical treatment. Recently, the application of a diode laser is widely being investigated for periodontal disease treatment.
Objective:
The analysis and evaluation of the clinical and biochemical impact of diode laser periodontal treatment, compared to either surgical or non-surgical, therapy, was the aim of this study.
Methods:
The study involved 80 patients older than 18 with at least 20 teeth. Evaluation of periodontal parameters was done conveniently on a single-rooted tooth (incisive, canine, premolar) on six surfaces, before the start of periodontal therapy, and after three, and six months. The laser used in the study was a diode laser with a wavelength of 980 nm. Digital X-rays were taken for bone level evaluation before and after the treatment. The presence of a bone destruction mediator (Matrix metalloproteinase-8 - MMP-8) was evaluated by the dipstick immunoassay test. Biochemical analysis and radiographic measurements were evaluated at the baseline and six months after the treatment. The statistical analysis included χ2-test and one-way ANOVA.
Results:
The results of this study showed that diode laser treatment was more effective in reducing periodontal clinical parameters, lowering MMP-8 levels and reducing the bone loss, compared to the group treated with scaling and root planning, or with a surgical approach.
Conclusion:
Diode laser may be considered as an effective alternative for periodontal treatment, with benefits in clinical and biochemical parameters.
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Odor AA, Bechir ES, Forna DA. Effect of Hydrogen Peroxide Photoactivated Decontamination Using 940 nm Diode Laser in Periodontal Treatment: A Pilot Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:614-624. [PMID: 32503390 DOI: 10.1089/photob.2019.4718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study was to compare the antimicrobial effects of hydroxyl radical generation by photoactivation of hydrogen peroxide (H2O2) with diode laser (λ = 940 nm) in combination with conventional nonsurgical periodontal therapy. Materials and methods: Thirty-eight patients and 114 teeth were included in this study. The test teeth were randomly assigned to one of the three treatment groups: Group 1 (control group): scaling and root planning (SRP); and the following experimental groups: Group 2: SRP +940 nm diode laser; Group 3: SRP+photoactivation of H2O2 with 940 nm diode laser. Clinical examinations, such as periodontal probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BoP) were performed before and after the treatment. The microbiological evaluation included nine periodontal bacterial species investigated by means of real-time polymerase chain reaction assay before and after the treatment. The clinical and bacterial differences were assessed between the investigated groups. Results: The total bacteria load was reduced for all three studied groups and all periodontal indexes (PPD, CAL, and BoP) were improved after each treatment. Group 3 showed significant bacterial reduction of the major periodontal bacteria such as Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Eubacterium nodatum (p < 0.001) in contrast to the other two groups (p > 0.001). Differences between tested groups showed significant results with regard to Group 3. Conclusions: The synergistic effect of SRP and photoactivation of H2O2 with 940 nm diode laser offers an efficient and reliable antimicrobial effect in the nonsurgical periodontal treatment approach.
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Affiliation(s)
- Alin Alexandru Odor
- Department of Periodontology, Faculty of Dental Medicine, University of Titu Maiorescu, Bucharest, Romania
| | - Edwin Sever Bechir
- Department of Oral Rehabilitation and Oclusology, Faculty of Dental Medicine, University of Medicine, Pharmacy, Science and Technology of Târgu-Mureş, Târgu-Mureş, Romania
| | - Doriana Agop Forna
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy Gr.T. Popa Iaşi, Iaşi, Romania
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Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci 2020; 35:1403-1410. [PMID: 32193820 DOI: 10.1007/s10103-020-02997-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
Bactericidal and detoxification effects of diode laser (DL) have been reported in periodontal treatment. The objective of this study was investigating the additional effect of DL with nonsurgical periodontal treatment on the red complex bacteria in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Sixty type 2 DM patients with chronic periodontitis (CP) were randomly assigned in two parallel groups to receive scaling root planning (SRP, n = 30) or SRP followed by DL periodontal pocket irradiation (SRP + DL, n = 30). Recording of clinical parameters and subgingival plaque sampling were performed at baseline, and post therapy (1 and 3 months after treatment). Amounts of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia were evaluated with quantitative RT-PCR. Significant reductions for numbers of all three bacterial species were observed at 1 and 3 months compared with baseline for both treatments (p < 0.001), but no significant differences were found between two groups regarding bacterial reductions at these follow-up time points. No additional benefit of DL as an adjunct to nonsurgical periodontal therapy was recognized in the reduction of P. gingivalis, T. denticola, and T. forsythia for type 2 DM patients with CP. Further studies are required to clarify the effects of diode laser on the other periodontopathogens.
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Photonic Therapy in Periodontal Diseases an Overview with Appraisal of the Literature and Reasoned Treatment Recommendations. Int J Mol Sci 2019; 20:ijms20194741. [PMID: 31554277 PMCID: PMC6801906 DOI: 10.3390/ijms20194741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/13/2019] [Accepted: 09/21/2019] [Indexed: 12/26/2022] Open
Abstract
Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the many physical, molecular, biological, anatomical, and technical variables of photonic treatments, which can differ in light-emitting devices (laser or LED), wavelengths, irradiation power and modes, clinical objectives, follow-up times, disease grading, and assessment methods. This multi-faceted, controversial scenario has led practitioners to underestimate the actual potential of photonic therapy in periodontal diseases. In this critical appraisal of the literature, we have briefly summarized the main photonic therapies and instruments used in Periodontology, highlighting their main characteristics and limitations. Then, we have tried to identify and discuss the key methodological issues which can have an impact on the outcome of photonic therapies. Our main goal was to identify the best parameters, settings, and methodologies to perform effective periodontal photonic treatments and to extrapolate some recommendations for clinical use. Should these recommendations find a consensus among periodontologists and be adopted in future clinical studies, they will hopefully contribute to dissipate the present confusion and uncertainty on this complex matter.
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Wenzler JS, Böcher S, Frankenberger R, Braun A. Feasibility of transgingival laser irradiation for antimicrobial photodynamic therapy. Photodiagnosis Photodyn Ther 2019; 28:75-79. [PMID: 31470119 DOI: 10.1016/j.pdpdt.2019.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 08/08/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
AIM Diode lasers are commonly used for antimicrobial photodynamic therapy (aPDT). This study aimed to assess the feasibility of transgingival laser irradiation during aPDT and evaluate whether the photosensitizer can be activated. MATERIALS AND METHODS Four diode laser settings were assessed for transgingival irradiation: 120 mW, 80 mW, 60 mW, and 40 mW. Fifteen soft-tissue pieces from a pig's lower jaw were prepared. The specimens' thickness was measured and transgingival laser irradiation was performed. A digital power meter measured laser power on the other side of the tissue. The power outcome after staining of the nonbuccal aspect of the tissue with photosensitizer dye was assessed similarly. RESULTS Transgingival laser irradiation (average soft-tissue thickness: 0.84 ± 0.06 mm) resulted in different power transmission depending on the power settings and photosensitizer. The lowest values were observed with the 40 mW setting and photosensitizer (median 3.3 mW, max. 5.0 mW, min. 2.3 mW, interquartile range 1.2), and the highest at 120 mW without photosensitizer (median 41.3 mW, max. 42.7 mW, min. 38.0 mW; interquartile range 1.5). CONCLUSIONS This study indicates that transgingival irradiation may be suitable for aPDT, since power transmission through the gingival tissue was observed in all specimens. However, the decrease in laser power caused by both the soft tissue and the photosensitizer has to be taken into account.
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Affiliation(s)
- Johannes-Simon Wenzler
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Aachen, Aachen, Germany.
| | - Sarah Böcher
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Aachen, Aachen, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Andreas Braun
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Aachen, Aachen, Germany
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The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial. Clin Oral Investig 2019; 24:1821-1827. [DOI: 10.1007/s00784-019-03045-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 08/05/2019] [Indexed: 02/05/2023]
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Çayan T, Hasanoğlu Erbaşar GN, Akca G, Kahraman S. Comparative Evaluation of Diode Laser and Scalpel Surgery in the Treatment of Inflammatory Fibrous Hyperplasia: A Split-Mouth Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:91-98. [PMID: 31050932 DOI: 10.1089/photob.2018.4522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: This study aimed to compare the efficacy of diode laser surgery and the scalpel surgery in the removal of inflammatory fibrous hyperplasia (IFH). Background data: Diode laser systems are proposed as an alternative to scalpel surgery on surgeries involving oral soft tissues. Some of the advantages of the laser systems are ease of application, adequate coagulation, reduced postoperative pain, and decreased scarring. In addition, there are increasing data on the antibacterial effects of the diode lasers in dentistry; however, the direct bactericidal role of the diode laser in oral soft tissue procedures has not yet been investigated. Materials and methods: A total of 22 patients were enrolled in this study. One side of IFH was randomly assigned for excision with scalpel blade or with diode laser. Perioperative bleeding, postoperative pain, wound healing, and bacterial counts were evaluated for both methods. Results: The bleeding on the side treated by diode laser was found significantly lower (p < 0.05). A notable reduction in total bacterial counts was observed in the laser group after the first postoperative day. However, this trend did not reach statistical significance. No significant differences were recorded regarding subjective postoperative pain between the groups (p = 0.065). The healing of the postoperative wounds was significantly faster in the conventional group at each time point. Conclusions: Diode laser has offered some advantages over conventional method in the management of IFH. However, large-cohort comparative studies are required to provide additional data regarding the wound healing capacity of the diode laser.
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Affiliation(s)
- Timuçin Çayan
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Güzin Neda Hasanoğlu Erbaşar
- 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gülçin Akca
- 3 Department of Medical Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sevil Kahraman
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Uslu MÖ, Eltas A, Marakoğlu İ, Dündar S, Şahin K, Özercan İH. Effects of diode laser application on inflammation and mpo in periodontal tissues in a rat model. J Appl Oral Sci 2018; 26:e20170266. [PMID: 30020350 PMCID: PMC6089569 DOI: 10.1590/1678-7757-2017-0266] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/13/2017] [Indexed: 12/26/2022] Open
Abstract
Objective In this study, we aimed to histologically and immunologically evaluate the effect of diode laser treatment when applied adjunctive to scaling and root planing (SRP) in an experimental periodontitis model. Materials and methods We used Wistar-Albino rats (n=60) with average weight of 230 g. Experimental periodontitis was induced by ligature at the right and left first mandibular molar teeth in all rats. After 11 days, the ligature was removed and rats were divided into two groups. The control group (n=30) received only SRP treatment, while the laser group (n=30) received a diode laser (GaAlAs, 810 nm, 1 W, 10 J, 20 s) treatment adjunctive to SRP. Ten rats in each group were sacrificed after 7, 15, and 30 days. Histopathological examination was performed in the left mandible of rats. Myeloperoxidase (MPO) was evaluated by western blot in the gingival specimens from the right mandible. Results MPO levels in the laser group were statistically significantly lower compared with the control group (p≤0.05). There was no statistically significance at any time between MPO levels in the control group (p>0.05). MPO levels in the laser group at the 7th day were statistically significantly higher compared to the 15th (p≤0.05) and the 30th day (p≤0.05). Inflammatory cell infiltration decreased over time in both groups and was statistically significantly lower in the laser group than in the control group at all times (p≤0.01). Conclusions Within the limits of this study, we suggest that diode laser application is an adjunctive treatment because it reduced inflammation and MPO when applied in addition to SRP. On the other hand, more studies are needed for the assessment of the effects of diode laser application to periodontal tissues.
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Affiliation(s)
- Mustafa Özay Uslu
- Inonu University, Faculty of Dentistry, Department of Periodontology, Malatya, Turkey
| | - Abubekir Eltas
- Inonu University, Faculty of Dentistry, Department of Periodontology, Malatya, Turkey
| | - İsmail Marakoğlu
- Selcuk University, Faculty of Dentistry, Department of Periodontology, Konya, Turkey
| | - Serkan Dündar
- Firat University, Faculty of Dentistry, Department of Periodontology, Elazığ, Turkey
| | - Kazım Şahin
- Firat University, Veterinary Medicine, Department of Animal Nutrition, Elazığ, Turkey
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HATİPOĞLU M, AYTEKİN Z, DALTABAN Ö, FELEK R, FIRAT MZ, ÜSTÜN K. THE EFFECT OF DIODE LASER AS AN ADJUNCT TO PERIODONTAL TREATMENT ON CLINICAL PERIODONTAL PARAMETERS AND HALITOSIS: A RANDOMIZED CONTROLLED CLINICAL TRIAL. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.369035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yadwad KJ, Veena HR, Patil SR, Shivaprasad BM. Diode laser therapy in the management of chronic periodontitis - A clinico-microbiological study. Interv Med Appl Sci 2017; 9:191-198. [PMID: 29951284 PMCID: PMC6016204 DOI: 10.1556/1646.9.2017.38] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction Chronic periodontitis (CP) is an infectious disease resulting in inflammation of the supporting tissues of the teeth with progressive attachment loss and bone loss. This study aimed to evaluate the effect of 980-nm diode laser, as an adjunct to scaling and root planing (SRP) in the management of CP. Methodology A total of 40 systemically healthy subjects diagnosed with CP were randomly assigned into two groups G1 (SRP and sham application of laser) and G2 (SRP and laser irradiation) with equal numbers in each. The levels of Porphyromonas gingivalis (Pg) were estimated from plaque samples using real-time polymerase chain reaction. Clinical and microbiological parameters were assessed at baseline, 4–6, and 12–14 weeks posttreatment in both groups. Results A gradual reduction in the levels of Pg and improvement in clinical parameters were observed from baseline to 4–6 and 12–14 weeks in both groups. However, the comparison between groups, although clinically relevant, was not found to be statistically significant. Conclusion Although a 980-nm diode laser may not have any added benefit compared with SRP, it may emerge as an effective non-surgical treatment option in advanced periodontitis with complex inaccessible subgingival niches where comprehensive periodontal care may not be feasible.
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Affiliation(s)
- Kausar Jaha Yadwad
- Department of Periodontology, KLE Society's Institute of Dental Sciences, Bangalore, India
| | - H R Veena
- Department of Periodontology, KLE Society's Institute of Dental Sciences, Bangalore, India
| | - Sudhir R Patil
- Department of Periodontology, KLE Society's Institute of Dental Sciences, Bangalore, India
| | - B M Shivaprasad
- Department of Periodontology, Rajarajeshwari Dental College and Hospital, Bangalore, India
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Matarese G, Ramaglia L, Cicciù M, Cordasco G, Isola G. The Effects of Diode Laser Therapy as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A 1-Year Randomized Controlled Clinical Trial. Photomed Laser Surg 2017; 35:702-709. [PMID: 28945145 DOI: 10.1089/pho.2017.4288] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate and compare the clinical, microbial, and inflammatory effects of a diode laser as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of generalized aggressive periodontitis (GAgP). METHODS Using a split-mouth design, 31 patients with GAgP were enrolled in the study. The maxillary right and left quadrants were randomly assigned to SRP+diode laser or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable chosen. In addition, subgingival biofilm samples and gingival crevicular fluid (GCF) inflammatory mediators were analyzed at each follow-up session. RESULTS Compared to baseline, both treatments demonstrated an improvement in periodontal parameters at 1 year. However, SRP+diode laser produced a significant improvement in probing depth (PD; 2.56 ± 0.44 vs. 3.36 ± 0.51 mm, p < 0.05) and CAL (3.47 ± 0.25 vs. 4.11 ± 0.26 mm, p < 0.05) values compared to SRP alone. Similarly, in the SRP+diode laser group, the bacteria of orange complex group were significantly reduced at 30 and 60 days compared to SRP alone. Moreover, SRP+diode laser determined a reduction in mean GCF level of interleukin (IL)-1β and IL-1β/IL-10 ratio at 15 and 30 days compared to SRP alone (p < 0.05). CONCLUSIONS At 1 year, SRP+diode laser yielded a significant reduction in some clinical parameters, while microbial and inflammatory mediator changes were not significantly reduced compared to SRP alone.
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Affiliation(s)
- Giovanni Matarese
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Luca Ramaglia
- 2 Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II" , Naples, Italy
| | - Marco Cicciù
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Giancarlo Cordasco
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Gaetano Isola
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
- 2 Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II" , Naples, Italy
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Cobb CM. Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 2017; 75:205-295. [DOI: 10.1111/prd.12137] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ertugrul AS, Tekin Y, Talmac AC. Comparing the efficiency of Er,Cr:YSGG laser and diode laser on human β-defensin-1 and IL-1β levels during the treatment of generalized aggressive periodontitis and chronic periodontitis. J COSMET LASER THER 2017; 19:409-417. [DOI: 10.1080/14764172.2017.1334923] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
| | - Yasin Tekin
- Faculty of Dentistry, Department of Periodontology, Trakya University, Edirne, Turkey
| | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Yuzuncu Yil University, Van, Turkey
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Pamuk F, Lütfioğlu M, Aydoğdu A, Koyuncuoglu CZ, Cifcibasi E, Badur OS. The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoki. J Periodontal Res 2017; 52:872-882. [DOI: 10.1111/jre.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 01/24/2023]
Affiliation(s)
- F. Pamuk
- Department of Periodontology; Faculty of Dentistry; Yeditepe Univesity; Istanbul Turkey
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - M. Lütfioğlu
- Department of Periodontology; Faculty of Dentistry; Ondokuzmayis University; Samsun Turkey
| | - A. Aydoğdu
- Department of Periodontology; Faculty of Dentistry; Istanbul Research and Application Center; Baskent University; Istanbul Turkey
| | - C. Z. Koyuncuoglu
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - E. Cifcibasi
- Department of Periodontology; Faculty of Dentistry; Istanbul University; Istanbul Turkey
| | - O. S. Badur
- Division of Virology and Immunology; Department of Microbiology; Faculty of Medicine; Istanbul University; Istanbul Turkey
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Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y. Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 2017; 68:217-69. [PMID: 25867988 DOI: 10.1111/prd.12080] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 12/18/2022]
Abstract
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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Cobb CM. Commentary: Is There Clinical Benefit From Using a Diode or Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Periodontitis? J Periodontol 2016; 87:1117-31. [PMID: 27181116 DOI: 10.1902/jop.2016.160134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Despite a quarter of a century of laser research, there is a persistent debate regarding the efficacy of dental lasers in the treatment of periodontitis or periodontal maintenance therapy. There are many claims and much hyperbole surrounding the use of lasers, either as a monotherapy or adjunctive to scaling and root planing, to treat periodontitis. There is little evidence that using a diode or neodymium:yttrium-aluminum-garnet laser adds clinical value over and above conventional non-surgical or surgical periodontal treatment. There is a significant need for better designed human clinical trials. Data from such trials should be analyzed according to initial probing depth and characteristics of the treated sites, such as non-molar, molar flat surfaces, and molar furcations, and evaluated for long-term post-treatment results.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, University of Missouri-Kansas City, Kansas City, MO
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Hatipoğlu M, Barutcigil Ç, Harorlı OT, Ulug B. Effect of the lasers used in periodontal therapy on the surfaces of restorative materials. SCANNING 2016; 38:227-233. [PMID: 26340579 DOI: 10.1002/sca.21264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/12/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
The present study aimed to reveal potential damage of the lasers, which are used as an alternative to manual instruments in periodontal therapy, might cause to the surface of restorative materials. Four different restorative materials were used: a glass-ionomer cement (GIC), a flowable composite (FC), a universal composite (UC) and an amalgam. Ten cylindrical samples (8 mm × 2 mm) were prepared for each restorative material. Two laser systems were used in subgingival curettage mode; an 940 nm diode laser (Epic Biolase, Irvine, CA) and an Er,Cr:YSGG laser (Waterlase iPlus, Biolase, Irvine, CA). After laser irradiation, roughness of the sample surfaces was measured using a profilometer. Additionally, atomic force microscopy (AFM) and scanning electron microscopy (SEM) analyses were performed to evaluate the morphology and surface deformations of the restorative materials and surfaces. The laser irradiation did not affect the surface roughness of any restorative materials relative to that of the control group (p > 0.05) except for the Er,Cr:YSGG treatment on GIC (p < 0.05). SEM and AFM images verified the results of the surface roughness tests. Within the limitations of the present study, it was demonstrated that Er,Cr:YSGG and diode lasers, aside from the Er;Cr:YSGG treatment on GIC, caused no harmful surface effects on adjacent restorative materials. SCANNING 38:227-233, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Mükerrem Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Çağatay Barutcigil
- Department of Restorative Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Osman Tolga Harorlı
- Department of Restorative Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Bülent Ulug
- Department of Physics, Faculty of Science, Akdeniz University, Antalya, Turkey
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Talebi M, Taliee R, Mojahedi M, Meymandi M, Torshabi M. Microbiological Efficacy of Photodynamic Therapy as an Adjunct to Non-surgical Periodontal Treatment: A Clinical Trial. J Lasers Med Sci 2016; 7:126-30. [PMID: 27330709 DOI: 10.15171/jlms.2016.21] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The efficiency of routine scaling and root planning is negatively influenced by the tooth anatomy and residual bacteria all possibly affecting the treatment outcomes in future. The present study compared the microbiologic effectiveness of the photodynamic therapy (PDT) as an adjunctive treatment modality for nonsurgical treatment in chronic periodontitis. METHODS In this randomized controlled clinical trial, 18 chronic periodontitis patients were selected. Four quadrants were randomly treated by scaling and root planning (SRP), diode laser (810n m wavelength, 1.5 W and 320 μm fiber, contact and sweeping technique), SRP + PDT (with diode laser 808 nm, 0.5 W) and laser + SRP (with diode laser 808 nm, 1 W) in each patient. Presence of periodontal pathogen species in the treated areas were measured before the treatment, at 1 and 3 months afterwards. The identification and reproduction of the specific genes of pathogen bacteria were done by means of polymerase chain reaction (PCR) technique. Presence of oral pathogen bacteria in the treatment groups were analyzed by chi-square test. A semi quantitative analysis was used to measure the intensity of white light in each band. This was calculated by number of pixels in each band. RESULTS In the qualitative analysis, Fusobacterium nucleatum (Fn) and Treponema denticola (Td) species were killed after 1 month in all treatment modalities. PDT had more effects to decrease Prevotella intermedia (Pi) species than SRP while Tannerella forsythensis count (Tf) species increased in all treatments. Furthermore, Actinobacillus actinomycetemcomitans (Aa) species decreased in all treatments and Porphyromonas gingivalis (P.g) species increased in all treatments after 1 and 3 months. CONCLUSION It can be concluded that PDT was more effective as an adjunctive treatment to SRP than SRP alone; however, no distinct differences were found between both treatment modalities regarding reduction of certain pathogen bacteria.
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Affiliation(s)
- Mohammadreza Talebi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rojin Taliee
- Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mojahedi
- Laser Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meymandi
- Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Torshabi
- Department of Dental Biomaterials, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Koçak E, Sağlam M, Kayış SA, Dündar N, Kebapçılar L, Loos BG, Hakkı SS. Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial. Lasers Med Sci 2016; 31:343-53. [PMID: 26754181 DOI: 10.1007/s10103-016-1868-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/03/2016] [Indexed: 12/16/2022]
Abstract
In order to evaluate whether nonsurgical periodontal treatment with/without diode laser (DL) decontamination improves clinical parameters, the levels of IL-1β, IL-6, IL-8, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) in gingival crevicular fluid and metabolic control (HbA1c) in chronic periodontitis (CP) patients with diabetes mellitus type 2 (DM2). Sixty patients with DM2 and CP were randomly assigned into two groups to receive scaling and root planing (SRP, n = 30) or SRP followed by diode laser application (SRP + DL, n = 30). Clinical periodontal and gingival crevicular fluid (GCF) parameters were assessed at baseline, 1, and 3 months after periodontal treatment. HbA1c levels were evaluated at baseline and 3 months post-therapy. Total amounts of cytokines and molecules were analyzed by ELISA. Nonsurgical periodontal treatment with/without DL appeared to improve clinical, biochemical parameters, and glycemic control in DM2 patients (BMI < 25 kg/m(2)) with CP. The SRP + DL group provided better reductions in probing depth (PD) and clinical attachment level (CAL) parameters compared to the SRP group (P < 0.05). Significant reductions were found in the total amounts of GCF levels of IL-1, IL-6, IL-8, ICAM, and VCAM after treatment (P < 0.05). HbA1c levels decreased significantly at 3 months after treatment (P < 0.05). SRP + DL reduced HbA1c levels more significantly compared to SRP alone (0.41 vs. 0.22 %, P < 0.05). SRP, especially in combination with DL, shows improvement of glycemic control for DM2 patients with CP.
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Affiliation(s)
- Emrah Koçak
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.
| | - Seyit Ali Kayış
- Department of Biostatistics, Faculty of Medicine, Karabük University, Karabuk, Turkey
| | - Niyazi Dündar
- Research Center of Dental Faculty, Selcuk University, Konya, Turkey
| | - Levent Kebapçılar
- Department of Endocrinology and Metabolism Disease, School of Medicine, Selcuk University, Konya, Turkey
| | - Bruno G Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Sema S Hakkı
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
- Research Center of Dental Faculty, Selcuk University, Konya, Turkey
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Qadri T, Javed F, Johannsen G, Gustafsson A. Role of Diode Lasers (800–980 Nm) as Adjuncts to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Systematic Review. Photomed Laser Surg 2015; 33:568-75. [DOI: 10.1089/pho.2015.3914] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Talat Qadri
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Gunnar Johannsen
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Anders Gustafsson
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
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Birang R, Shahaboui M, Kiani S, Shadmehr E, Naghsh N. Effect of Nonsurgical Periodontal Treatment Combined With Diode Laser or Photodynamic Therapy on Chronic Periodontitis: A Randomized Controlled Split-Mouth Clinical Trial. J Lasers Med Sci 2015; 6:112-9. [PMID: 26464778 DOI: 10.15171/jlms.2015.04] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The optimum removal of bacteria and their toxins from periodontal pockets is not always obtained by conventional mechanical debridement. Adjunctive therapies may improve tissue healing through detoxification and bactericidal effects. The purpose of the present study was to evaluate the impact of adjunctive laser therapy (LT) and photodynamic therapy (PDT) on patients with chronic periodontitis. METHODS Twenty patients with at least three quadrants involved and each of them presenting pockets 4-8 mm deep were included in the study. Periodontal treatment comprising scaling and root planning (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (group A), SRP with LT (group B), and SRP with PDT (group C). The clinical indices were measured at baseline 6 weeks and 3 months after treatment. Microbiological samples were taken and evaluated at baseline and 3-month follow-up. RESULTS All groups showed statistically significant improvements in terms of clinical attachment level (CAL) gain, periodontal pocket depth (PPD) reduction, papilla bleeding index and microbial count compared to baseline (P < .05). The results showed more significant improvement in the 6-week evaluation in terms of CAL in groups B and C than in group A (P < .05). Group B also revealed a greater reduction in PPD than the other treatment modalities (P < .05). CONCLUSION The obtained data suggested that adjunctive LT and PDT have significant short-term benefits in the treatment of chronic periodontitis. Furthermore, LT showed minimal additional advantages compared to PDT.
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Affiliation(s)
- Reza Birang
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Shahaboui
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Kiani
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Shadmehr
- Department of Endodontics, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Naghsh
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Slot DE, Jorritsma KH, Cobb CM, Van der Weijden FA. The effect of the thermal diode laser (wavelength 808-980 nm) in non-surgical periodontal therapy: a systematic review and meta-analysis. J Clin Periodontol 2014; 41:681-92. [PMID: 24460795 DOI: 10.1111/jcpe.12233] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/28/2022]
Abstract
FOCUSED QUESTION What is the adjunctive effect of a diode laser (DL) following non-surgical periodontal debridement (SRP) during the initial phase of periodontal therapy on the clinical parameters of periodontal inflammation. MATERIAL AND METHODS The MEDLINE-PubMed, Cochrane-Central Register of Controlled Trials and EMBASE databases were searched up to September 2013. Probing pocket depth (PPD) and clinical attachment loss (CAL) were selected as outcome variables. Also plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were considered outcome measures. Data were extracted and a meta-analysis (MA) was performed where appropriate. RESULTS Independent screening of 416 unique papers resulted in nine eligible publications. The MA evaluating PPD, CAL and PS showed no significant effect. The only significance favouring adjunctive use of the DL was observed for the outcome parameters GI and BS. CONCLUSION The collective evidence regarding adjunctive use of the DL with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. That is for PPD and CAL. The body of evidence considering the adjunctive use of the DL is judged to be "moderate" for changes in PPD and CAL. With respect to BS, the results showed a small but significant effect favouring the DL, however, the clinical relevance of this difference remains a question. This systematic review questions the adjunctive use of DL with traditional mechanical modalities of periodontal therapy in patients with periodontitis.
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Affiliation(s)
- Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Bolyarova-Konova T, Dencheva-Garova M, Kisselova-Yaneva A. Application of Diode Laser Fotona XD-2 as Adjunctive Therapy in Non-Surgical Treatment of Periodontal Infections Among Patients on Renal Replacement Therapy. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.5504/bbeq.2012.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Theodoro LH, Caiado RC, Longo M, Novaes VCN, Zanini NA, Ervolino E, de Almeida JM, Garcia VG. Effectiveness of the diode laser in the treatment of ligature-induced periodontitis in rats: a histopathological, histometric, and immunohistochemical study. Lasers Med Sci 2014; 30:1209-18. [DOI: 10.1007/s10103-014-1575-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/30/2014] [Indexed: 12/14/2022]
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Roncati M, Gariffo A. Systematic Review of the Adjunctive Use of Diode and Nd:YAG Lasers for Nonsurgical Periodontal Instrumentation. Photomed Laser Surg 2014; 32:186-97. [DOI: 10.1089/pho.2013.3695] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Marisa Roncati
- Prosthetic Department, University of Bologna, Bologna, Italy
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Üstün K, Erciyas K, Sezer U, Şenyurt SZ, Gündoğar H, Üstün Ö, Öztuzcu S. Clinical and Biochemical Effects of 810 nm Diode Laser as an Adjunct to Periodontal Therapy: A Randomized Split-Mouth Clinical Trial. Photomed Laser Surg 2014; 32:61-6. [DOI: 10.1089/pho.2013.3506] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Kemal Üstün
- Department of Periodontology, Gaziantep University, Faculty of Dentistry, Gaziantep, Turkey
| | - Kamile Erciyas
- Department of Periodontology, Gaziantep University, Faculty of Dentistry, Gaziantep, Turkey
| | - Ufuk Sezer
- Department of Periodontology, Bezmialem Vak f University, Faculty of Dentistry, İstanbul, Turkey
| | - Süleyman Ziya Şenyurt
- Department of Periodontology, Gaziantep University, Faculty of Dentistry, Gaziantep, Turkey
| | - Hasan Gündoğar
- Department of Periodontology, Gaziantep University, Faculty of Dentistry, Gaziantep, Turkey
| | | | - Serdar Öztuzcu
- Department of Medical Biology, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
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Dukić W, Bago I, Aurer A, Roguljić M. Clinical Effectiveness of Diode Laser Therapy as an Adjunct to Non-Surgical Periodontal Treatment: A Randomized Clinical Study. J Periodontol 2013; 84:1111-7. [DOI: 10.1902/jop.2012.110708] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Saglam M, Kantarci A, Dundar N, Hakki SS. Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial. Lasers Med Sci 2012; 29:37-46. [DOI: 10.1007/s10103-012-1230-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 11/01/2012] [Indexed: 12/16/2022]
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41
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Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical Treatment of Periodontitis. J Evid Based Dent Pract 2012; 12:76-86. [DOI: 10.1016/s1532-3382(12)70019-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Short-term clinical and osteoimmunological effects of scaling and root planing complemented by simple or repeated laser phototherapy in chronic periodontitis. Lasers Med Sci 2012; 28:157-66. [DOI: 10.1007/s10103-012-1104-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 04/16/2012] [Indexed: 11/26/2022]
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43
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Euzebio Alves VT, de Andrade AKP, Toaliar JM, Conde MC, Zezell DM, Cai S, Pannuti CM, De Micheli G. Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial. Clin Oral Investig 2012; 17:87-95. [DOI: 10.1007/s00784-012-0703-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/21/2012] [Indexed: 01/16/2023]
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Sgolastra F, Petrucci A, Gatto R, Marzo G, Monaco A. Photodynamic therapy in the treatment of chronic periodontitis: a systematic review and meta-analysis. Lasers Med Sci 2011; 28:1393-402. [PMID: 22002328 DOI: 10.1007/s10103-012-1181-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 07/30/2012] [Indexed: 12/14/2022]
Abstract
This meta-analysis was conducted to investigate the efficacy and safety of antimicrobial photodynamic therapy used alone or adjunctive to scaling root planing in patients with chronic periodontitis. The meta-analysis was conducted according to the QUOROM statement and recommendations of the Cochrane Collaboration. An extensive literature search was performed on seven databases, followed by a manual search. Weighted mean differences and 95% confidence intervals were calculated for clinical attachment level, probing depth and gingival recession. The I(2) test was used for inter-study heterogeneity; visual asymmetry inspection of the funnel plot, Egger's regression test and the trim-and-fill method were used to investigate publication bias. At 3 months, significant differences in clinical attachment level (p = 0.006) and probing depth reduction (p = 0.02) were observed for scaling root planing with antimicrobial photodynamic therapy, while no significant differences were retrieved for antimicrobial photodynamic therapy used alone; at 6 months no significant differences were observed for any investigated outcome. Neither heterogeneity nor publication bias was detected. The use of antimicrobial photodynamic therapy adjunctive to conventional treatment provides short-term benefits, but microbiological outcomes are contradictory. There is no evidence of effectiveness for the use of antimicrobial photodynamic therapy as alternative to scaling root planing. Long-term randomized controlled clinical trials reporting data on microbiological changes and costs are needed to support the long-term efficacy of adjunctive antimicrobial photodynamic therapy and the reliability of antimicrobial photodynamic therapy as alternative treatment to scaling root planing.
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Affiliation(s)
- Fabrizio Sgolastra
- Department of Health Sciences, University of L'Aquila, San Salvatore 1, Building Delta 6, 67100, L'Aquila, Italy.
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Zegaib S, Lage-Marques JLS, Vieira MM, Junior ARM, Feres M, Shibli JA, Figueiredo LC. Phenomenon of Laser Power Loss During Curettage of Infected Periodontal Pockets. Photomed Laser Surg 2011; 29:657-62. [DOI: 10.1089/pho.2010.2911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Silméa Zegaib
- University of São Paulo School of Dentistry (FOUSP), São Paulo, Brazil
| | | | | | | | - Magda Feres
- Guarulhos University (UnG), São Paulo, Brazil
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