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Jannath A, Sundaram R, Selvarangam S, Viswanathan K, Sivapragasam S. Efficacy of ultrasonics and Er,Cr:YSGG laser on root surface calculus removal: A comparative in vitro field emission scanning electron microscope study. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:9-14. [PMID: 39027208 PMCID: PMC11252148 DOI: 10.34172/japid.2024.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/06/2024] [Indexed: 07/20/2024]
Abstract
Background Scaling and root planing (SRP) is an inevitable primary step in non-surgical periodontal therapy. Debridement carried out with manual instruments and ultrasonics results in the removal of tooth structure. Current research revolves around laser as an efficient adjunct to SRP. This study evaluated and compared the effectiveness of root surface calculus removal between ultrasonics and Er,Cr:YSGG laser. Methods Twenty-eight single-rooted teeth extracted due to periodontal disease were selected for the study. The specimens were randomly assigned to two groups (n=14). Group I underwent ultrasonic instrumentation using a piezo ultrasonic scaler, and group II was subjected to laser instrumentation using Er,Cr:YSGG laser (Waterlase). The specimens were processed, fixed, viewed under a field emission scanning electron microscope and evaluated using the remaining calculus index (RCI) and loss of tooth substance index (LTSI). Results Ultrasonics-treated specimens revealed more remaining calculus (1.57±0.65) and lost tooth substance (1.71±0.61) compared to the Er,Cr:YSGG laser-treated specimens, with significantly lower RCI (0.71±0.61) and LTSI (1.00±0.56). There was a statistically significant difference (P<0.05) in the efficacy of root surface calculus removal between the two groups. Conclusion Compared to ultrasonics, Er,Cr:YSGG laser demonstrated superior results by causing precise removal of root surface calculus without significantly affecting tooth structure and aiding in new attachment.
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Affiliation(s)
- Afreen Jannath
- Department of Periodontology, Government Dental College and Hospital, Cuddalore District, Annamalai Nagar, Chidambaram, Tamil Nadu, India
| | - Rajasekar Sundaram
- Department of Periodontology, Government Dental College and Hospital, Cuddalore District, Annamalai Nagar, Chidambaram, Tamil Nadu, India
| | | | - Krishnan Viswanathan
- Department of Periodontology, Government Dental College and Hospital, Cuddalore District, Annamalai Nagar, Chidambaram, Tamil Nadu, India
| | - Srinivasan Sivapragasam
- Department of Periodontology, Government Dental College and Hospital, Cuddalore District, Annamalai Nagar, Chidambaram, Tamil Nadu, India
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Aoki A, Mizutani K, Mikami R, Ohsugi Y, Kobayashi H, Akizuki T, Taniguchi Y, Takeuchi Y, Katagiri S, Sasaki Y, Komaki M, Meinzer W, Izumi Y, Iwata T. Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol 2023; 94:1187-1199. [PMID: 37015852 DOI: 10.1002/jper.22-0552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. METHODS Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12 months. RESULTS Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs. 1.89 mm on average; p = 0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs. 1.06 mm; p = 0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p = 0.031), compared with SRP alone. CONCLUSION The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Taniguchi Dental Clinic, Sapporo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiyuki Sasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University (KDU), Yokosuka, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Soundarajan S, Rajasekar A. Comparative evaluation of combined efficacy of methylene blue mediated antimicrobial photodynamic therapy (a-PDT) using 660 nm diode laser versus Erbium-chromium-yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser as an adjunct to scaling and root planing on clinical parameters in supportive periodontal therapy: A randomized split-mouth trial. Photodiagnosis Photodyn Ther 2022; 39:102971. [PMID: 35738551 DOI: 10.1016/j.pdpdt.2022.102971] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/03/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
AIM The aim of this study was to evaluate combined efficacy of methylene blue mediated antimicrobial photodynamic therapy (a-PDT) using 660 nm diode laser versus Er, Cr: YSGG laser as an adjunct to scaling and root planing on improving the Probing depth (PD), Clinical attachment level (CAL), Plaque Index (PI) and Gingival Index (GI).clinical parameters in Supportive periodontal therapy. MATERIALS AND METHOD In this split-mouth, double-blind, randomized controlled trial, we compared a-PDT versus Er,Cr:YSGG as an adjunct to scaling and root planning (SRP) with SRP alone in Supportive periodontal therapy. A total of 36 subjected were enrolled. In each patient, two quadrants constituted the control group (Group I - Scaling and root planing SRP alone), one site in other quadrant constituted the test group 1 (Group II - SRP followed by application of Er, Cr: YSGG laser), and another site in different quadrant constituted the test group 2 (Group III - SRP followed by antimicrobial Photodynamic therapy using diode laser). The diode laser was operated at a peak power of 70 mW using a 0.6 mm diameter fiber-optic tip. Each site was irradiated with a power density of 28 mW/cm2, for 10 s, thus delivering a total energy of 16.72 J/cm2 per tooth. Whereas, the Er,Cr:YSGG laser's parameters were set to 1 W of power, 10% air, and 15% water. The same procedure was repeated at 1st, 2nd and 3rd week for both the laser therapies. Plaque index (PI), Gingival index (GI), Probing depth (PD,) and Clinical attachment level (CAL) were measured by a single examiner at baseline and 3 months follow up. Inter group analysis of the parameters were done using One-way ANOVA and pairwise comparison was carried out by Tukey's post hoc test. Intra group analysis was performed using Students's paired t test. Statistical significance was set to p < 0.05. RESULTS There were no significant differences between participants for clinical parameters at baseline. PI, GI PD, and CAL significantly improved at 3 months follow up compared to baseline in both the study groups (Group II - SRP + Er,Cr:YSGG, Group III - SRP + a-PDT) with P < 0.05. Adjunctive use of Er,Cr:YSGG laser with SRP showed better clinical outcomes than a-PDT with SRP. CONCLUSION Nonsurgical periodontal therapy of chronic periodontitis using Er, Cr: YSGG, and a-PDT as an adjunct to SRP was significantly more effective than SRP alone in reducing PD, CAL, GI, and PI at 3 months follow up. Adjunctive use of Er,Cr:YSGG laser with SRP showed better clinical outcomes than a-PDT with SRP. However, the long-term positive benefits of the laser therapies are yet unknown and more research with longer follow-ups are required.
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Affiliation(s)
- Subasree Soundarajan
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 600077, India
| | - Arvina Rajasekar
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 600077, India.
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Sethasathien P, Tantivitayakul P, Teparat-Burana T. The effect of Er,Cr:YSGG laser on periodontopathic bacteria elimination: an in vitro study. Lasers Med Sci 2022; 37:2763-2771. [PMID: 35652988 DOI: 10.1007/s10103-022-03573-5] [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: 02/11/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
In vitro bacterial elimination using the erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser against periodontopathic bacteria was investigated. Bacterial suspensions of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were spread on agar plates and the Er,Cr:YSGG laser was applied at 40 mJ pulse energy for durations of 30 s, 60 s, and 90 s. The agar plates were incubated, and growth inhibition zones were assessed. Optimal laser irradiation durations to achieve maximal bacterial elimination were evaluated using laser ablation on the bacterial colonies. The remaining viable bacteria were determined by the colony-forming unit (CFU) counting method. Growth inhibition zones were observed at all irradiation durations for both A. actinomycetemcomitans and P. gingivalis. Mean logarithmic values of CFU/ml after bacterial colony irradiation for 0 s (control), 12 s × 1 lap, 24 s × 1 lap, 48 s × 1 lap, and 24 s × 2 laps were 8.82 ± 0.35, 7.31 ± 0.94, 6.32 ± 0.61, 3.17 ± 2.90, and 0.00, respectively, for A. actinomycetemcomitans and 9.83 ± 0.50, 9.42 ± 0.11, 6.90 ± 1.60, 2.33 ± 3.19, and 0.00 for P. gingivalis. Significant differences were found between the control group and the two irradiated groups 48 s × 1 lap and 24 s × 2 laps (p < 0.05), and also between irradiated groups 12 s × 1 lap and 24 s × 2 laps (p < 0.05). An Er,Cr:YSGG laser with power setting 1.5 W and 30 Hz frequency showed potential for bacterial elimination against A. actinomycetemcomitans and P. gingivalis in vitro. Significant bacterial elimination (> 99.99%) was observed after 48 s of irradiation.
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Affiliation(s)
| | - Pornpen Tantivitayakul
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Yothi, Bangkok, 10400, Thailand
| | - Thitiwan Teparat-Burana
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Yothi, Bangkok, 10400, Thailand.
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Klokkevold PR, Damian A, Pham C, Mallya SM, Lux R. Clinical evaluation of Er,Cr:YSGG laser therapy used as an adjunct to non-surgical treatment of periodontitis: Twelve-month results from a pilot study. J Periodontol 2022; 93:1314-1324. [PMID: 35239185 DOI: 10.1002/jper.21-0443] [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: 07/28/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the results of adjunctive Er,Cr:YSGG laser therapy with scaling and root planing (SRP) as compared to SRP alone in the treatment of moderate-severe periodontitis. METHODS Fifteen adults (aged 27 to 65 years) with ninety non-adjacent sites probing ≥ 5 mm were treated in split-mouth design with SRP and laser therapy versus SRP alone. Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), plaque, and bleeding on probing were collected at baseline, 1, 3, 6, 9, and 12 months. Patient reported outcomes were measured to assess pain, sensitivity and satisfaction. RESULTS Clinical improvements were similar for test and control sites with no statistically significant difference. At twelve months, the average PPD reduced from 6.1mm to 4.2mm for test and 6.2mm to 4.3mm for control sites. GR increased by 0.4mm at test and control sites. CAL increased from 6.8 mm to 5.3mm for test and 6.9mm to 5.5mm for control sites. Clinical outcomes were stratified by baseline PPD ( = 5mm, = 6mm and ≥7mm) and analyzed for number of sites that reduced (≤4mm). No significant difference was observed when the baseline PPD was 5mm or 6mm. Test sites with baseline PPD ≥7mm demonstrated a statistically significant difference in the percentage of reduced sites when compared to controls at 9 (p = 0.001) and 12 months (p = 0.044). CONCLUSIONS Adjunctive Er,Cr:YSGG laser therapy with SRP provides similar clinical improvement in the treatment of moderate-severe periodontitis as SRP alone and may offer some advantage for deeper (≥7mm) pockets. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Perry R Klokkevold
- Professor of Clinical Dentistry, Section of Periodontics, UCLA School of Dentistry, USA
| | - Arianna Damian
- Former Periodontics Resident, Current Lecturer, Section of Periodontics, UCLA School of Dentistry, Private Practice, Brentwood, California, USA
| | - Charlene Pham
- Former Periodontics Resident, Section of Periodontics, UCLA School of Dentistry, Private Practice, Menifee, California, USA
| | - Sanjay M Mallya
- Associate Professor, Section of Oral and Maxillofacial Radiology, UCLA School of Dentistry, USA
| | - Renate Lux
- Section of Periodontics, UCLA School of Dentistry, USA
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Erbium lasers in non-surgical periodontal therapy: an umbrella review and evidence gap map analysis. Lasers Med Sci 2022; 37:103-120. [PMID: 35029727 DOI: 10.1007/s10103-022-03504-4] [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: 10/12/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
The literature on the efficacy of erbium lasers for nonsurgical periodontal therapy is inconsistent. The objective of the umbrella review was to collate the information available in the systematic reviews to provide a comprehensive synthesis of clinical and patient reported outcomes following the use of erbium lasers for non-surgical periodontal therapy. An electronic database search was carried out, and systematic reviews/meta-analyses which assessed the efficacy of erbium lasers as monotherapy or as an adjunct to scaling and root planing were included. The methodological quality and reporting quality of the included studies were assessed. 15 Systematic reviews/meta-analyses were obtained after title, abstract, and full text search. The meta-analyses data revealed a clinical attachment level gain, reduction in probing pocket depth at 1 and 3-month follow-up, and no additional benefit at ≥ 6-month follow-up in the erbium laser group. The evidence gap map revealed lack of clinical outcome data at > 6-month follow-up and dearth in studies assessing patient reported outcome measures and adverse events. Erbium lasers may provide short-term clinical benefits, and further studies with standardized laser parameters evaluating long-term follow-up, patient-reported outcome measures, and adverse events are needed.
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7
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Poormoradi B, Gholami L, Fekrazad R, Hooshyarfard A, Noorani AR, Loft Haghpanah Z, Farhadian M. Comparison of the Effect of Er,Cr:YSGG Laser and Halita Mouthwash on Oral Malodor in Patients With Chronic Periodontitis: A Randomized Clinical Trial. J Lasers Med Sci 2021; 12:e26. [PMID: 34733749 DOI: 10.34172/jlms.2021.26] [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: 10/30/2020] [Accepted: 03/09/2021] [Indexed: 11/09/2022]
Abstract
Introduction: Periodontal disease and tongue coatings are among the major factors associated with oral malodor. The present study, comparatively evaluated the effects of the Er,Cr:YSGG laser and Halita mouthwash as adjunctive treatments to nonsurgical periodontal debridement on oral malodor reduction in chronic periodontitis patients. Methods: Sixty patients with stage II and III chronic periodontitis and bad breath. The patients were randomly divided into two groups (n=30). After conventional scaling and root planing, patients in group 1 underwent Er,Cr:YSGG laser (Waterlase; Biolase, San Clemente, CA, USA) irradiation of the internal surface of the pockets (1.5 W, 30 Hz, 20% A, 40% W) and the dorsum of the tongue (1 W, 30 Hz, 20% A, 40% W) immediately after SRP and on the third and seventh days. Group 2 patients were asked to use Halita mouthwash twice daily for one week. Baseline, 1 and 3-month post-treatment measurements of plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and organoleptic assessment of Halitosis severity were performed. Results: Significant improvement in all parameters was noted in both groups after 1 and 3 months, compared with baseline (P < 0.05). The two groups had significant reductions which occurred in PPD, CAL and BOP levels and the organoleptic score in 1 and 3 months after the intervention (P < 0.05). Conclusion: Er,Cr:YSGG laser irradiation and Halita mouthwash as adjuncts to non-surgical periodontal therapy are both effective in the treatment of oral malodor and improvement of periodontal parameters.
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Affiliation(s)
- Banafsheh Poormoradi
- Dental Research Center, Department of Periodontology, Dentistry Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Gholami
- Assistant Professor, Dental Research Center, Department of Periodontology, Dentistry Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amirarsalan Hooshyarfard
- Dental Research Center, Department of Periodontology, Dentistry Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Noorani
- Orthodontic Department, Dentistry Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Maryam Farhadian
- Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, 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: 16] [Impact Index Per Article: 5.3] [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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Salvi GE, Stähli A, Schmidt JC, Ramseier CA, Sculean A, Walter C. Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:176-198. [PMID: 31859395 DOI: 10.1111/jcpe.13236] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/07/2019] [Accepted: 12/14/2019] [Indexed: 12/13/2022]
Abstract
AIM To compare the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical mechanical instrumentation alone in untreated periodontitis patients. MATERIALS AND METHODS Two focused questions were addressed using the Population, Intervention, Comparison and Outcome criteria as follows: in patients with untreated periodontitis, (a) does laser application provide adjunctive effects on probing pocket depth (PPD) changes compared with non-surgical instrumentation alone? and (b) does application of aPDT provide adjunctive effects on PPD changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Results of the meta-analysis are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. RESULTS Out of 1,202 records, 10 articles for adjunctive laser and 8 for adjunctive aPDT were included. With respect to PPD changes, 1 meta-analysis including 2 articles (total n = 42; split-mouth design) failed to identify a statistically significant difference (WMD = 0.35 mm; 95%CI: -0.04/0.73; p = .08) in favour of adjunctive aPDT (wavelength range 650-700 nm). In terms of adjunctive laser application, a high variability of clinical outcomes at 6 months was noted. Two articles included patient-reported outcomes and 10 reported on the presence/absence of harms/adverse effects. CONCLUSIONS Available evidence on adjunctive therapy with lasers and aPDT is limited by (a) the low number of controlled studies and (b) the heterogeneity of study designs. Patient-reported benefits remain to be demonstrated.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia C Schmidt
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
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10
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Clinical effectiveness of Er,Cr:YSGG lasers in non-surgical treatment of chronic periodontitis: a meta-analysis of randomized controlled trials. Lasers Med Sci 2020; 36:889-901. [PMID: 33037559 DOI: 10.1007/s10103-020-03156-2] [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: 03/13/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
The meta-analysis aimed to systematically evaluate all the available pieces of evidence concerning the clinical effectiveness of Er,Cr:YSGG lasers (erbium, chromium, yttrium scandium gallium garnet laser) in the non-surgical treatment of patients with chronic periodontitis, and provide guidance for clinicians about the application of Er,Cr:YSGG lasers during the process of non-surgical periodontal treatments. The meta-analysis was conducted with data extracted from 16 randomized controlled clinical trials (RCTs) that compare Er,Cr:YSGG lasers adjunct/substitute to scaling and root planing (SRP) with SRP alone for the treatment of chronic periodontitis published in English or Chinese from January 2000 to January 2020. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for probing depth (PD) reduction, clinical attachment level (CAL) gain, and visual analogue scale (VAS) score. Heterogeneity of each study was evaluated with the Q test. The publication bias was measured using Begg's adjusted rank correlation test. Sixteen RCTs with 606 patients were included in the meta-analysis. There were statistically significant differences between Er,Cr:YSGG lasers adjunct/substitute to SRP and SRP alone in the PD reduction at 1-month follow-up (WMD = ‑ 0.35, 95% CI [- 0.63, ‑ 0.07], P = 0.013), 3-month follow-up (WMD = - 0.342, 95% CI [- 0.552, - 0.132], P = 0.001), CAL gain at 3-month follow-up (WMD = - 0.17, 95% CI [- 0.31, 0.03], P = 0.017), and VAS score (WMD = - 2.395, 95% CI [- 3.327, - 1.464], P = 0.000) immediately after treatment. There were no significant differences of PD reduction and CAL change at 6-month follow-up. The present meta-analysis indicated that Er,Cr:YSGG lasers provided additional effectiveness in PD reduction and CAL gain at short-term follow-ups and there was less pain compared with SRP alone.
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11
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Patient-reported outcomes of laser-assisted pain control following non-surgical and surgical periodontal therapy: A systematic review and meta-analysis. PLoS One 2020; 15:e0238659. [PMID: 32941479 PMCID: PMC7498060 DOI: 10.1371/journal.pone.0238659] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022] Open
Abstract
Adjunctive use of laser devices as high reactive-level laser/light therapy (HLLT) or photobiomodulation therapy (PBMT) for periodontal therapy is known to be more effective on suppressing pain than conventional therapy, however, there are no systematic reviews addressed its effectiveness. This systematic review and meta-analysis aim to investigate the following clinical question (CQ): does adjunctive use of lasers with conventional therapy suppress the pain associated with periodontal treatment? A systematic and extensive literature search was performed to summarize the currently available knowledge to answer the CQ using the PubMed, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs) conducted before June 2020. Bias risk was assessed using the Cochrane tool for the risk of bias evaluation. A meta-analysis was performed on quantitative evaluation of pain control based on patient-reported outcomes. After an independent screening of 165 initial records, ten RCTs were included. Six of them focused on surgical procedures and the others on non-surgical periodontal pocket therapy. The protocols of HLLT, PBMT, and combination with HLLT and PBMT were employed in five, four and one RCTs, respectively. Following the assessment of bias risk, it is revealed that all RCTs had methodological weaknesses regarding the blinding of key personnel, although other bias risk factors were not evident. Meta-analysis showed that HLLT using erbium lasers significantly reduced the patient-reported pain immediately after treatment (two RCTs, p < 0.0001), while PBMT using diode lasers significantly reduced pain 2-7 days after treatment (two RCTs, p < 0.0001 to p = 0.03). The presented systematic review and meta-analysis suggest that the alternative use of HLLT using erbium lasers to conventional instrumentation can significantly suppress postoperative pain and that intraoperative or postoperative PBMT using diode lasers combined with periodontal surgery can significantly reduce postoperative pain. However, the evidence is still insufficient and more well-designed RCTs are required.
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Coluzzi D, Anagnostaki E, Mylona V, Parker S, Lynch E. Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? A Systematic Review. Dent J (Basel) 2020; 8:dj8030093. [PMID: 32824321 PMCID: PMC7558016 DOI: 10.3390/dj8030093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022] Open
Abstract
(1) Background: dental lasers have numerous applications for periodontal therapy which include surgical procedures of soft tissue and osseous structures, and non-surgical treatments such as pathogen reduction, removal of surface accretions, and photobiomodulation. The aim of this review was to evaluate the scientific literature to ascertain whether lasers have a beneficial role when used adjunctively in initial non-surgical periodontal therapy. (2) Methods: A PubMed search was performed specifically for randomized clinical trials where a dental laser was used adjunctively for initial periodontal therapy on human patients published from January 2010–April 2020. The first search identified 1294 eligible studies. After additional criteria and filters were applied, 20 manuscripts were included in this review. (3) Results: The chosen manuscripts reported on investigations into initial therapy for patients diagnosed with chronic periodontitis. After periodontal charting, conventional instrumentation such as hand and ultrasonic scaling was performed on all patients in the studies, and then a test group or groups of patients were treated adjunctively with a laser. That adjunctive laser group’s periodontal findings showed various degrees of improved health compared to the group treated with only conventional methods. (4) Conclusion: This systematic review found that 70% of the included studies reported significantly better outcomes in certain clinical parameters, but no improvement in others. The remaining 30% of the manuscripts reported no significant difference in any of the measurements. With consideration to correct parametry, lasers have an adjunctive role in initial non-surgical periodontal therapy.
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Affiliation(s)
- Donald Coluzzi
- School of Dentistry, University of California, San Francisco, CA 94143, USA
- Correspondence:
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
- School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV 89106, USA
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Clem D, Heard R, McGuire M, Scheyer ET, Richardson C, Toback G, Gwaltney C, Gunsolley JC. Comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Six-month results of a multicenter, randomized, controlled study. J Periodontol 2020; 92:496-506. [PMID: 32613664 DOI: 10.1002/jper.20-0028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of this publication is to report on the six-month clinical results and patient-reported outcomes (PROs) comparing the surgical use of the erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. METHODS Fifty-three adults (29 females and 24 males; aged 19 to 73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Recession, probing depth (PD), clinical attachment level (CAL), treatment time, and PROs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4 to 6 weeks following SRP, and 6 months following surgical therapy. RESULTS The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.6 mm (p = 0.05), PD with a non-inferiority margin of 0.5 mm (p = 0.05). Recession with a non-inferiority margin of 0.4 mm (p = 0.05). Faster procedure times were found for ERL (16.39 ± 6.21 minutes) versus MIST (20.17 ± 5.62 minutes), p = 0.0002. In the first 2 to 3 days of post-therapeutic diary outcomes, subjects reported less bruising, facial swelling, and use of ice pack for the ERL group. CONCLUSIONS This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST in terms of clinical outcomes but is superior in PROs for the surgical treatment of intrabony defects.
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Affiliation(s)
- Donald Clem
- Private practice, Fullerton, CA.,A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX
| | - Rick Heard
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Victoria, TX
| | - Michael McGuire
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Houston, TX
| | - E Todd Scheyer
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Houston, TX
| | - Chris Richardson
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA
| | - Gregory Toback
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, New London, CT.,Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT
| | | | - John C Gunsolley
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA
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Erbil D, Nazaroglu K, Baser U, İssever H, Mese S, İsik AG. Clinical and Immunological Effects of Er,Cr:YSGG Laser in Nonsurgical Periodontal Treatment: A Randomized Clinical Trial. Photobiomodul Photomed Laser Surg 2020; 38:316-322. [PMID: 32427555 DOI: 10.1089/photob.2019.4748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: The aim of this study was to compare the clinical and immunological results of nonsurgical periodontal treatment with or without the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. Background data: As lasers have begun to be used in dentistry, the Er,Cr:YSGG laser has started to attract attention in the field of periodontology. Materials and methods: Fifty-nine nonsmoking patients with advanced chronic periodontitis were randomly allocated to a test group (full-mouth ultrasonic supra- and subgingival debridement+Er,Cr:YSGG laser application) and a control group (full-mouth ultrasonic supra- and subgingival debridement+root planing with Gracey curettes). The laser parameters were set as follows: 1.5 W output power, pulse mode H (pulse duration of 140 μs), pulse frequency of 20 Hz, and an air-water spray ratio of 10% air and 15% water. The instrumentation was performed until the operator felt that the root surfaces were adequately debrided. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index, interleukin-1 beta (IL-1β), matrix metalloproteinase-8 (MMP-8), tissue inhibitor metalloproteinase-1 (TIMP-1), and MMP-8/TIMP-1 levels in gingival crevicular fluid were evaluated at baseline, 6 weeks, and 3 months postoperatively. Results: There were statistically significant differences in PD, which was our primary outcome, and BOP between the groups at both examinations [p < 0.001 and p < 0.001 (for PD) and p = 0.048 and p < 0.001 (for BOP), respectively], in favor of the laser group. However, there were no significant differences among groups at any time for CAL gain (p = 563 and p = 369, respectively). No significant differences in MMP-8, TIMP-1, and MMP-8/TIMP-1 levels were detected among groups. There was a statistically significant difference for IL-1β levels among groups at 3-month evaluations in favor of the laser group. Conclusions: Using the Er,Cr:YSGG laser instead of hand instruments in nonsurgical periodontal treatment has shown additional improvements in terms of pocket reduction and gingival bleeding compared with traditional nonsurgical therapy.
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Affiliation(s)
- Deniz Erbil
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | | | - Ulku Baser
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Halim İssever
- Department of Public Health, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Mese
- Department of Virology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysen G İsik
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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15
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Sezen D, Hatipoğlu M, Üstün K. Evaluation of the clinical and biochemical efficacy of erbium, chromium:ytrium-scandium-gallium-garnet (ER,CR:YSGG) laser treatment in periodontitis. Lasers Med Sci 2020; 35:1567-1575. [DOI: 10.1007/s10103-020-02990-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/26/2020] [Indexed: 12/14/2022]
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16
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Effects of Er,Cr:YSGG and Diode Lasers on Clinical Parameters and Gingival Crevicular Fluid IL-1 β and IL-37 Levels in Generalized Aggressive Periodontitis. Mediators Inflamm 2019; 2019:2780794. [PMID: 31308830 PMCID: PMC6594306 DOI: 10.1155/2019/2780794] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/26/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022] Open
Abstract
Aim The objective of the current study is to analyze the correlation between cytokine levels and periodontal parameters in aggressive periodontitis patients before and after periodontal treatment that was performed by using two different laser therapies. Materials and Methods Twenty-six generalized aggressive periodontitis patients were treated with three different methods (SRP, SRP+diode laser, and SRP+Er,Cr:YSGG laser) applied to three different half-jaws in the same patients. Pre- and posttreatment clinical periodontal parameters and GCF IL-1β and IL-37 levels were measured. Results There was a statistically significant decrease (p < 0.05) between pretreatment and posttreatment clinical periodontal parameters and IL-1β and IL-37 levels. When the reduction rates of IL-37 and IL-1β levels after treatment were evaluated, the decrease in IL-37 and IL-1β levels after treatment was lowest in the SRP group and highest in the SRP+Er,Cr:YSGG group. In addition, the amount of decrease in IL-1β in SRP+diode and SRP+Er,Cr:YSGG groups was found to be higher than that in IL-37. Furthermore, there was a positive correlation between IL-37 and IL-1β in all groups (p < 0.01). Conclusion Er,Cr:YSGG laser is more effective than diode laser for the treatment of aggressive periodontitis. IL-37 and IL-1β are cytokines that function together and thus must be evaluated together.
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Zhou X, Lin M, Zhang D, Song Y, Wang Z. Efficacy of Er:
YAG
laser on periodontitis as an adjunctive non‐surgical treatment: A split‐mouth randomized controlled study. J Clin Periodontol 2019; 46:539-547. [PMID: 31069833 DOI: 10.1111/jcpe.13107] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 03/03/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Xuan Zhou
- Department of Stomatology Beijing Chao‐Yang Hospital Capital Medical University Beijing China
| | - Mei Lin
- Department of Stomatology Beijing Chao‐Yang Hospital Capital Medical University Beijing China
| | - Dongxue Zhang
- Department of Stomatology Beijing Chao‐Yang Hospital Capital Medical University Beijing China
| | - Yiqing Song
- Department of Epidemiology Richard M. Fairbanks School of Public Health Indiana University Indianapolis Indiana USA
| | - Zuomin Wang
- Department of Stomatology Beijing Chao‐Yang Hospital Capital Medical University Beijing China
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18
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Yanli Y, Chunmei X, Yafei W, Lei Z. [Clinical and microbiologic follow-up evaluations after non-surgical periodontal treatment with Nd: YAG laser and scaling and root planning]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 35:618-624. [PMID: 29333776 DOI: 10.7518/hxkq.2017.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Our research aimed to detect the efficacy of non-surgical periodontal treatment with Nd: YAG laser and scaling and root planning (SRP) for chronic periodontitis. METHODS We recruited chronic periodontitis patients who have more than four teeth with clinical pocket depth of 4-8 mm. These teeth were distributed in four different zones within the oral cavity. Moreover, the teeth were single root teeth and not adjacent to each other. The subordinated teeth were randomized into four groups, as follows: no treatment (C group), simple SRP (SRP group), Nd: YAG laser after SRP treatment (SRP+L group), and SRP after Nd: YAG laser treatment (L+SRP group). The four experimental observation points were as follows: before treatment (baseline) and 1 week, 1 month, and 3 months after treatment. We measured clinical indicators and collected subgingival deposits in the four time points to analyze changes of red complex in periodontitis. RESULTS The clinical indicators were better in all treatment groups than in the control group. Comparison among treatment groups indicated that the value of bleeding on probing, periodontal probing depth, and clinical attachment loss showed no difference. However, the value of plaque index in SRP+L and L+SRP presented a significant reduction at 3 months after treatment. The percentages of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola in all treatment groups decreased after clinical treatment, and differences were observed among the treatment groups at different time points. CONCLUSIONS Non-surgical periodontal treatment with SRP and Nd: YAG laser is not more effective than SRP monotherapy. The sequence of laser treatment and SRP has no significant effect on the treatment. However, SRP with Nd: YAG laser was beneficial for plaque control. Non-surgical periodontal treatment with Nd: YAG laser may be used as an alternative to reduce and control the proliferation of microorganisms in persistent periodontitis, but it still needs further verification.
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Affiliation(s)
- Yin Yanli
- Dept. of Periodontics, Stomatological Hospital of Xiangyang, Xiangyang 441000, China;State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xu Chunmei
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wu Yafei
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhao Lei
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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19
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Ma L, Zhang X, Ma Z, Shi H, Zhang Y, Wu M, Cui W. Clinical Effectiveness of Er: YAG Lasers Adjunct to Scaling and Root Planing in Non-Surgical Treatment of Chronic Periodontitis: A Meta-Analysis of Randomized Controlled Trials. Med Sci Monit 2018; 24:7090-7099. [PMID: 30289123 PMCID: PMC6186153 DOI: 10.12659/msm.911863] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Er: YAG lasers (ERLs) show suitable characteristics for scaling and root planing, but previous studies have drawn conflicting conclusions. This meta-analysis aimed to systematically appraise the available evidence concerning the effectiveness of ERLs as an adjunct to scaling and root planing (SRP) for non-surgical periodontal treatment. MATERIAL AND METHODS Randomized controlled trials (RCTs) comparing ERLs+SRP with SRP alone for the treatment of chronic periodontitis were searched in 9 electronic biomedical databases up to January 2018. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for probing depth (PD) reduction, clinical attachment level (CAL) gain, and visual analog scale (VAS) score. Heterogeneity was evaluated with the I² statistic for interstudy comparisons and the χ²-based Q statistic for intra-study comparisons. Sensitivity analysis was conducted by switching to a random or fixed effect model based on the heterogeneity. Publication bias was measured by Begg's test. RESULTS Ten related RCTs met the inclusion criteria. There were statistically significant differences in the assessed clinical parameters at the three-month follow-up: PD reduction (WMD=0.32, 95%CI range from 0.14 to 0.51, p<0.001; p=0.003, I²=69.7%); CAL gain (WMD=0.31, 95%CI range from 0.22 to 0.40, p<0.001; p=0.209, I²=28.8%); and VAS scores (WMD=-1.38, 95%CI range from -2.45 to -0.31, p<0.001; p=0.182, I²=44%). There were no significant differences at the six- and twelve-month follow-ups. Sensitivity analysis revealed that the results were consistent. No evidence of publication bias was detected. CONCLUSIONS This systematic analysis demonstrated that ERLs+SRP provides additional short-term effectiveness and that patients experience less pain compared to SRP. There were no significant differences at the medium-term and long-term follow-ups. Long-term well-designed RCTs are required.
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Affiliation(s)
- Lei Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University; Hebei Province Center for Disease Prevention and Control, Shijiazhuang, Hebei, China (mainland)
| | - Zhe Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Hong Shi
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yanning Zhang
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Mingxuan Wu
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wei Cui
- Department of Stomatology, No. 2 Hospital of Baoding, Baoding, Hebei, China (mainland)
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20
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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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Everett JD, Rossmann JA, Kerns DG, Al-Hashimi I. Laser Assisted Non-surgical Periodontal Therapy: A Double Blind, Randomized Clinical Trial. Open Dent J 2017; 11:79-90. [PMID: 28357001 PMCID: PMC5345326 DOI: 10.2174/1874210601711010079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/18/2016] [Accepted: 12/22/2016] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.
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Affiliation(s)
- Joseph D. Everett
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Jeffrey A. Rossmann
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - David G. Kerns
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Ibtisam Al-Hashimi
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2017; 146:508-24.e5. [PMID: 26113099 DOI: 10.1016/j.adaj.2015.01.028] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. METHODS A panel of experts convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence. RESULTS The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers). CONCLUSIONS AND PRACTICAL IMPLICATIONS With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive therapies. The panel provides clinical recommendations in the associated clinical practice guideline.
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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: 195] [Impact Index Per Article: 27.9] [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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Minimally Invasive Treatment of Infrabony Periodontal Defects Using Dual-Wavelength Laser Therapy. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2016; 2016:7175919. [PMID: 27366790 PMCID: PMC4912985 DOI: 10.1155/2016/7175919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 01/08/2023]
Abstract
Introduction. Surgical management of infrabony defects is an invasive procedure, frequently requiring the use of adjunctive material such as grafts or biologics, which is time-consuming and associated with expense and morbidity to the patient. Lasers in periodontal regeneration have been reported in the literature, with each wavelength having potential benefits through different laser-tissue interactions. The purpose of this case series was to assess the efficacy of a new dual-wavelength protocol in the management of infrabony defects. Materials and Methods. 32 defects (one in each patient) were treated using ultrasonic debridement, followed by flapless application of Erbium, Chromium:Yttrium, Scandium, Gallium, Garnet (Er,Cr:YSGG) laser (wavelength 2780 nm), and final application of diode laser (wavelength 940 nm). Pocket depths (PD) were measured after 6 months and repeat radiographs taken after one year. Results. The mean baseline PD was 8.8 mm (range 6–15 mm) and 6 months later was 2.4 mm (range 2–4 mm), with mean PD reduction being 6.4 ± 1.7 mm (range 3–12 mm). There was a significant gain in relative linear bone height (apical extent of bone), with mean percentage bone fill of 39.7 ± 41.2% and 53% of sites showing at least 40% infill of bone. Conclusion. The results compare favourably with traditional surgery and require further validation through randomised clinical controlled trials.
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Al-Falaki R, Hughes F, Wadia R, Eastman C, Kontogiorgos E, Low S. The Effect of an Er,Cr:YSGG Laser in the Management of Intrabony Defects Associated with Chronic Periodontitis Using Minimally Invasive Closed Flap Surgery. A Case Series. Laser Ther 2016; 25:131-139. [PMID: 27721565 DOI: 10.5978/islsm.16-or-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aims: This is an extended case series of patients treated with an Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser as an adjunct to scaling for the management of intrabony defects. Materials & methods: 46 patients with 79 angular intrabony defects associated with pocket depths of >5mm, and a mean age of 53 ± 9 years presenting with chronic periodontitis were included in the analysis. All patients underwent a localized minimally invasive closed flap surgery utilizing Er,Cr:YSGG laser therapy. Final radiographs and pocket depths were compared to pretreatment measurements with a time period of 8 ± 3 months. Results: Treatment resulted in significant overall pocket depth reduction. The mean pre-op probing depth was 8.1 ± 1.9mm, reducing to 2.4 ± 0.9mm post-treatment. Bony infill of the defects was visible radiographically and there was an increase in overall radiographic coronal osseous height compared to a pre-treatment baseline. Radiographs of 15 of the defects were available for further measurements after >12 months, and showed in these sites there was a significant reduction in intrabony defect depth, but no change in suprabony bone height. 9 of the 15 sites showed 50% or more, bony infill of the intrabony defect. Conclusions: The results demonstrate that the utilization of an Er,Cr:YSGG laser in a closed flap approach with chronic periodontitis may be of significant clinical benefit. Further studies using this laser surgical protocol are required to test these observations in well-designed randomized controlled trials.
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Affiliation(s)
| | - Francis Hughes
- Dept of Periodontology, Kings College London Dental Institute, University of London
| | - Reena Wadia
- Dept of Periodontology, Kings College London Dental Institute, University of London
| | - Christie Eastman
- Department of Periodontology, University of Florida, College of Dentistry
| | - Elias Kontogiorgos
- Department of Restorative Sciences, Baylor College of Dentistry, Texas A&M University
| | - Samuel Low
- Department of Periodontology, University of Florida, College of Dentistry
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Al-Falaki R, Cronshaw M, Parker S. The Adjunctive Use of the Erbium, Chromium: Yttrium Scandium Gallium Garnet Laser in Closed Flap Periodontal Therapy. A Retrospective Cohort Study. Open Dent J 2016; 10:298-307. [PMID: 27350796 PMCID: PMC4906144 DOI: 10.2174/1874210601610010298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 01/28/2023] Open
Abstract
Objectives: The current periodontal literature has been inconsistent in finding an added advantage to using lasers in periodontal therapy. The aim of this study was to compare treatment outcomes following root surface instrumentation alone (NL group), or with adjunctive use of Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser (L group). Material and Methods: Patients diagnosed with generalized chronic periodontitis, having a minimum of 1 year follow up were selected by a blinded party for inclusion in a retrospective analysis from patients treated prior to and after integration of laser in a single clinic setting. Probing depths (PD) of all sites ≥5 mm and full mouth bleeding scores were analyzed. Further analysis was carried out on the treatment outcomes of only the molar teeth and of pockets >6mm. Results: 53 patients were included (25 NL,28 L). There was no significant difference between baseline PDs (NL=6.19mm, L=6.27mm, range 5-11mm). The mean PD after one year was 2.83mm (NL) 2.45mm (L), with the mean PD reductions being 3.35mm (NL) and 3.82mm (L) (p<0.002). The mean PD reduction for the molars were 3.32mm (NL) and 3.86mm (L) (p< 0.007), and for ≥7mm group were 4.75mm (NL) compared to 5.14mm (L) (p< 0.009). There was significantly less bleeding on probing in the laser group after one year (p<0.001) Conclusion: Both treatment modalities were effective in treating chronic periodontitis, but the added use of laser may have advantages, particularly in molar tooth sites and deeper pockets. Further research with RCTs is needed to test this hypothesis further.
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Affiliation(s)
- Rana Al-Falaki
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | - Mark Cronshaw
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | - Steven Parker
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
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Dereci Ö, Hatipoğlu M, Sindel A, Tozoğlu S, Üstün K. The efficacy of Er,Cr:YSGG laser supported periodontal therapy on the reduction of peridodontal disease related oral malodor: a randomized clinical study. Head Face Med 2016; 12:20. [PMID: 27145828 PMCID: PMC4855779 DOI: 10.1186/s13005-016-0116-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/20/2016] [Indexed: 12/22/2022] Open
Abstract
Background This study aims to evaluate the efficacy of Er,Cr:YSGG laser assisted periodontal therapy on the reduction of oral malodor and periodontal disease. Methods Sixty patients with chronic periodontitis were included in the study and allocated into two groups each containing 30 patients. The study was planned in a double blind fashion. Conventional periodontal therapy was performed in group 1 and conventional periodontal therapy was performed in association with Er,Cr:YSGG application in group 2. Periodontal parameters of probing depth, clinical attachment level, plaque index and bleeding on probing were measured with a periodontal probe. Quantitative analysis of volatile sulphure compunds (VSCs) were measured with a calibrated halimeter at baseline level and at post-treatment 1st, 3rd and 6th months. P values <0.05 were accepted as statistically significant. Results There was a statistical significant reduction in VSC values in group 2 at post-treatment 3rd and 6th months (p < 0.05). Pocket depth values at post-treatment 1st month and bleeding on probing values at post-treatment 3rd and 6th months were significantly decreased in group 2 (p < 0.05). Intragroup statistical analysis revealed that there were statistically significant differences for all parameters (p < 0.01). Conclusions Er,Cr:YSGG laser assisted conventional periodontal therapy is more effective in reducing oral malodor and improving periodontal healing compared to conventional periodontal therapy alone.
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Affiliation(s)
- Ömür Dereci
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Eskişehir Osmangazi University, Meşelik Campus, 26480, Eskişehir, Turkey.
| | - Mükerrem Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Sinan Tozoğlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Kemal Üstün
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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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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Mizutani K, Aoki A, Coluzzi D, Yukna R, Wang CY, Pavlic V, Izumi Y. Lasers in minimally invasive periodontal and peri-implant therapy. Periodontol 2000 2016; 71:185-212. [DOI: 10.1111/prd.12123] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/28/2022]
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Elavarasu S, Suthanthiran T, Thangavelu A, Mohandas L, Selvaraj S, Saravanan J. LASER curettage as adjunct to SRP, compared to SRP alone, in patients with periodontitis and controlled type 2 diabetes mellitus: A comparative clinical study. J Pharm Bioallied Sci 2015; 7:S636-42. [PMID: 26538934 PMCID: PMC4606676 DOI: 10.4103/0975-7406.163579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: To compare the effect of scaling and root planning (SRP) alone, and laser curettage as an adjunct to SRP, on the clinical parameters of patients with periodontitis and controlled type 2 diabetes mellitus. Materials and Methods: Ten patients were divided into two equal groups in a split-mouth design - Group I: SRP alone, Group II: SRP + laser curettage. The following clinical parameters were recorded: (i) Gingival index (ii) plaque index (iii) sulcular bleeding index (iv) probing depth (PD) and (v) clinical attachment level (CAL). SRP was done in one quadrant using Gracey curettes and in another quadrant SRP plus laser curettage was done. Three weeks after the therapy, the clinical parameters were recorded and the results were analyzed and the percentage of improvement were evaluated. Results: The results of this study indicated that both SRP and SRP + laser curettage were efficient for reducing gingival inflammation and PD. Group II showed more reduction in PD and more gain in CAL than Group I. Mean reduction in PD was 20.22% in Group I and 26.76% in Group II. Mean CAL gain is 32.5% in Group II and 22.34% in Group I. Conclusion: In both the groups, gingival inflammation was reduced. When laser curettage was used as adjunct to SRP more reduction in PD and CAL was seen.
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Affiliation(s)
- Sugumari Elavarasu
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalyam, Namakkal, Tamil Nadu, India
| | | | - Arthiie Thangavelu
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalyam, Namakkal, Tamil Nadu, India
| | - Lakshmi Mohandas
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalyam, Namakkal, Tamil Nadu, India
| | - Saranya Selvaraj
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalyam, Namakkal, Tamil Nadu, India
| | - Jayashakthi Saravanan
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalyam, Namakkal, Tamil Nadu, India
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Cheng Y, Chen JW, Ge MK, Zhou ZY, Yin X, Zou SJ. Efficacy of adjunctive laser in non-surgical periodontal treatment: a systematic review and meta-analysis. Lasers Med Sci 2015; 31:151-63. [PMID: 26329272 DOI: 10.1007/s10103-015-1795-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 08/10/2015] [Indexed: 02/05/2023]
Abstract
To evaluate the efficacy of the adjunctive laser therapy in conventional non-surgical treatment of chronic periodontitis, an electronic search was performed through the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, EMBASE, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), and China Biology Medicine (CBM) Disc, for relevant randomized controlled trials (RCTs) or quasi-RCTs. All the 12 included studies (11 RCTs and 1 quasi-RCT) were qualified for descriptive and quantitative analysis. Outcomes were divided into two groups according to the length of follow-ups (long term and short term). Subgroup analyses were performed based on the mode of laser (inside and outside mode). Among all included researches, reduction in probing depth (PD) and gain in clinical attachment level (CAL) were presented with the mean value and 95 % confidence interval, while bleeding on probing (BOP) was assessed descriptively. Meta-analysis suggested that adjunctive laser therapy reduced PD at 3 months [mean difference (MD) = -0.26, 95 % confidence interval (CI) range = -0.43 to -0.09, p = 0.003] but did not demonstrate significant effect on the CAL at either 3 months (MD = -0.03, 95 % CI range = -0.25 to 0.19, p = 0.79) or 6 months (MD = -0.11, 95 % CI range = -0.38 to 0.16, p = 0.43). Subgroup analyses indicated that laser therapy would be more effective when the probes were set up outside the periodontal pockets.
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Affiliation(s)
- Y Cheng
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China
| | - J W Chen
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China
| | - M K Ge
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China
| | - Z Y Zhou
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China
| | - X Yin
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China
| | - S J Zou
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14, Section 3, Ren Min Nan Road, 610041, Chengdu, China.
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015; 146:525-35. [DOI: 10.1016/j.adaj.2015.01.026] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 10/23/2022]
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de Oliveira GJPL, Cominotte MA, Beraldo TPP, Sampaio JEC, Marcantonio RAC. A microscopic analysis of the effects of root surface scaling with different power parameters of Er,Cr:YSGG laser. Microsc Res Tech 2015; 78:529-35. [PMID: 25951453 DOI: 10.1002/jemt.22505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 02/19/2015] [Accepted: 03/22/2015] [Indexed: 11/12/2022]
Abstract
The aim of this study was to evaluate the effects of different power parameters of an Erbium, Cromium: Yttrium, Scandium, Gallium, Garnet laser (Er,Cr:YSGG laser) on the morphology, attachment of blood components (ABC), roughness, and wear on irradiated root surfaces. Sixty-five incisive bovine teeth were used in this study, 35 of which were used for the analysis of root surface morphology and ABC. The remaining 30 teeth were used for roughness and root wear analysis. The samples were randomly allocated into seven groups: G1: Er,Cr:YSGG laser, 0.5 W; G2: Er,Cr:YSGG laser, 1.0 W; G3: Er,Cr:YSGG laser, 1.5 W; G4: Er,Cr:YSGG laser, 2.0 W; G5: Er,Cr:YSGG laser, 2.5 W; G6: Er,Cr:YSGG laser, 3.0 W; G7: scaling and root planning (SRP) with manual curettes. The root surfaces irradiated by Er,Cr:YSGG at 1.0 W and scaling with manual curettes presented the highest degrees of ABC. The samples irradiated by the Er,Cr:YSGG laser were rougher than the samples treated by the manual curette, and increasing the laser power parameters caused more root wear and greater roughness on the root surface. The Er,Cr:YSGG laser is safe to use for periodontal treatment, but it is not appropriate to use irradiation greater than 1.0 W for this purpose.
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Treatment of periodontal disease with an Er,Cr:YSGG laser in rats exposed to cigarette smoke inhalation. Lasers Med Sci 2015; 30:2095-103. [DOI: 10.1007/s10103-015-1731-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 02/24/2015] [Indexed: 12/14/2022]
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Treatment outcome following use of the erbium, chromium:yttrium, scandium, gallium, garnet laser in the non-surgical management of peri-implantitis: a case series. Br Dent J 2014; 217:453-7. [DOI: 10.1038/sj.bdj.2014.910] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/08/2022]
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Pavone C, Perussi LR, de Oliveira GJPL, Scardueli CR, Cirelli JA, Cerri PS, Junior EM, Spolidorio LC, Marcantonio RAC. Effect of Er,Cr:YSGG laser application in the treatment of experimental periodontitis. Lasers Med Sci 2014; 30:993-9. [PMID: 24477391 DOI: 10.1007/s10103-014-1526-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 01/13/2014] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to evaluate the influence of an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser in the absence or presence of manual scaling and root planning (SRP) for the treatment of induced periodontitis in rats. Ligatures were placed in the subgingival region of the maxillary first molar. After a 7-day period, the ligatures were removed, and 40 rats were randomly divided into four groups (G), as follows: (GI) no treatment, (GII) scaling and root planning (SRP) with curettes, (GIII) Er,Cr:YSGG laser irradiation and (GIV) SRP with curettes followed by Er,Cr:YSGG laser irradiation. Seven and 30 days after the treatment, the animals were sacrificed and histologic, histometric and immunohistochemistry analyses were performed. All groups showed similar histopathological characteristics during the evaluation period. The histometric analysis was confirmed using Bonferroni and paired t tests. At 7 and 30 days, groups II, III and IV exhibited greater bone formation in the furcation area when compared to group I (p < 0.0001; p < 0.05). During the 7-day period, the groups irradiated with the laser (III and IV) showed a statistically larger new bone area than the group treated with SRP (II) (p < 0.01). Immunohistochemistry analysis revealed that the control group exhibited a higher expression of tartrate-resistant acid phosphatase (TRAP) and the receptor activator of nuclear factor κΒ ligand (RANKL) when compared to groups II, III and IV (p < 0.05). All treatments were able to reduce the inflammatory processes, consequently enabling the repair of periodontal tissues. The results achieved with the application of the Er,Cr:YSGG laser suggest that this laser can stimulate greater bone formation, especially over a shorter period of time.
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Affiliation(s)
- Chaine Pavone
- Araraquara Dental School-São Paulo State University "Júlio de Mesquita Filho", Araraquara, São Paulo, Brazil
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Perio DNDC. Periodontal Bone Regeneration and the Er,Cr:YSGG Laser: A Case Report. Open Dent J 2013; 7:16-9. [PMID: 23524914 PMCID: PMC3601343 DOI: 10.2174/1874210601307010016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/08/2012] [Accepted: 11/06/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Traditional methods of regenerating bone in periodontal bone defects have been partially successful and have involved numerous protocols and materials. More recently, it has been proposed that Er,Cr:YSGG laser energy may also be beneficial in the treatment of periodontal pockets, particularly in the regeneration of bone lost due to periodontal disease. CASE DESCRIPTION The purpose of this paper is to present a case report of the Er,Cr:YSGG laser being used to conservatively treat a recalcitrant periodontal pocket in the presence of a periodontal bone defect and that resulted in successful resolution of the pocket and significant radiographic bone fill at the 1 year recall visit. CLINICAL IMPLICATIONS This protocol using the Er,Cr:YSGG laser for the treatment of periodontal loss of attachment and periodontal bone loss may represent a less invasive alternative than traditional open-flap periodontal surgery or the intrasulcular use of other more penetrating laser wavelengths.
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Affiliation(s)
- Douglas N Dederich Cert Perio
- Room 5-531 ECHA, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 1C9; Canada
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Surface area and volume determination of subgingival calculus using laser fluorescence. Lasers Med Sci 2012; 29:519-24. [DOI: 10.1007/s10103-012-1242-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 11/18/2012] [Indexed: 10/27/2022]
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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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