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Lin Z, Strauss FJ, Lang NP, Sculean A, Salvi GE, Stähli A. Efficacy of laser monotherapy or non-surgical mechanical instrumentation in the management of untreated periodontitis patients. A systematic review and meta-analysis. Clin Oral Investig 2020; 25:375-391. [PMID: 33170372 PMCID: PMC7819921 DOI: 10.1007/s00784-020-03584-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 09/11/2020] [Indexed: 01/16/2023]
Abstract
Objective To evaluate and compare the effects of laser monotherapy with non-surgical mechanical instrumentation alone in untreated periodontitis patients. Materials and methods A focused question was formulated based on the Population, Intervention, Comparison, Outcome, and Study design criteria (PICOS): in patients with untreated periodontitis, does laser mono-therapy provide adjunctive effects on pocket probing depth (PPD) changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. The results of the meta-analyses are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. Results The search yielded 1268 records, out of which 8 articles could be included. With respect to PPD changes, a meta-analysis including 5 articles (n = 148) failed to identify statistically significant differences in favor of laser monotherapy for PPD change (WMD = 0.14 mm; 95% CI: − 0.04/0.32; z = 1.51; p = 0.132) nor for clinical attachment level (CAL) (WMD = 0.04 mm; 95% CI: − 0.35/0.42; z = 0.19; p = 0.850). Data on cost-effectiveness are lacking. One study reported patient-related outcome measures (PROMS). Conclusions In untreated periodontitis patients, laser monotherapy does not yield superior clinical benefits compared with non-surgical mechanical instrumentation alone. Clinical relevance In untreated periodontitis patients, mechanical instrumentation with hand and/or ultrasonic instruments remains the standard of care.
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Affiliation(s)
- Zhikai Lin
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.,Department of Periodontology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry Faculty of Dentistry , University of Chile , Santiago, Chile
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
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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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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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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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Campos L, Gallottini M, Pallos D, Simões A, Martins F. High-power diode laser on management of drug-induced gingival overgrowth: Report of two cases and long-term follow-up. J COSMET LASER THER 2018; 20:215-219. [PMID: 29351498 DOI: 10.1080/14764172.2017.1400165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Drug-induced gingival overgrowth (DIGO) is attributed mainly to the prolonged use of calcium channel blocking agents, anticonvulsants, and anti-calcineurin inhibitors . The management of DIGO depends on the severity of the disease and includes surgical intervention and plaque control. Compared to conventional surgical treatment, the recent literature data have shown that gingivectomy using a high-power laser (HPL) is a short and easy procedure, which results in minimal postoperative discomfort and greater patient accep- tance. OBJECTIVE AND METHODS The purpose of this study was to report two cases of recurrent DIGO treated surgically using HPL (λ 808nm, 1.5W). RESULTS Minimal bleeding and discomfort were observed during surgery, and patients reported no pain or bleeding after the procedure. After 1 year of follow-up, patients presented a minimal increase of gingival volume, indicating that laser technology can improve the efficiency and prognosis of DIGO. CONCLUSIONS The HPL was able to preventing hemorrhage and improving the patient's collaboration with the treatment and quality of life.
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Affiliation(s)
- Luana Campos
- a Department of Oral Medicine, Brazilian Institute of Cancer Control , São Paulo , Brazil
| | - Marina Gallottini
- b Special Care Dentistry Center, Dental School , University of São Paulo , São Paulo , Brazil
| | - Débora Pallos
- c School of Dentistry , Santo Amaro University , São Paulo , Brazil
| | - Alyne Simões
- d Laboratory of Oral Biology, School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Fabiana Martins
- c School of Dentistry , Santo Amaro University , São Paulo , Brazil
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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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Bozkurt SB, Hakki EE, Kayis SA, Dundar N, Hakki SS. Biostimulation with diode laser positively regulates cementoblast functions, in vitro. Lasers Med Sci 2017; 32:911-919. [PMID: 28332131 DOI: 10.1007/s10103-017-2192-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/08/2017] [Indexed: 12/13/2022]
Abstract
The aim of this study was to evaluate the effects of diode laser biostimulation on cementoblasts (OCCM.30). A total of 40 root plates were obtained from healthy third molar teeth and assigned to the following two groups: (1) control group and (2) laser-treated group. Root plates were placed into the cell culture inserts, and OCCM.30 cells were seeded onto root plates. Cells were irradiated with a low level of diode laser (power: 0.3 W in continuous wave, 60 s/cm2). Proliferation and mineralized tissue-associated gene's and BMP's messenger RNA (mRNA) expressions of cementoblasts were evaluated. Total RNAs were isolated on day 3 and integrin-binding sialoprotein (Ibsp), bone gamma-carboxyglutamate protein (Bglap), Type I collagen (Col1a1), osteoblastic transcription factor, runt-related transcription factor (Runx2), and Bone Morphogenetic Protein (BMP)-2, 3, 4, 6, and 7 mRNA expressions were determined using quantitative RT-PCR. von Kossa staining was performed to evaluate biomineralization of OCCM.30 cells. In the proliferation experiment, while there was no significant difference until 96 h, laser irradiation retarded the decrease in cell proliferation trend after 96 h compared to the untreated control group. Statistically significant increase in Ibsp, Bglap, and BMP-2,3,6,7 mRNA expressions were noted in the laser groups when compared to the untreated control group (p < 0.05). Laser irradiation induced mineralized nodule formation of cementoblasts. The results of this study reveal that the biostimulation setting of diode laser modulates the behavior of cementoblasts inducing mineralized tissue-associated gene's mRNA expressions and mineralization. Therefore, biostimulation can be used during regenerative periodontal therapies to trigger cells with periodontal attachment apparatus.
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Affiliation(s)
| | - Erdogan E Hakki
- Faculty of Agriculture, Department of Soil Science and Plant Nutrition, Molecular Genetics & Biotechnology Laboratories, Selcuk University, Konya, Turkey
| | - Seyit Ali Kayis
- Faculty of Medicine, Department of Biostatistics, Karabuk University, Karabuk, Turkey
| | - Niyazi Dundar
- Faculty of Dentistry, Research Center, Selcuk University, Konya, Turkey
| | - Sema S Hakki
- Faculty of Dentistry, Research Center, Selcuk University, Konya, Turkey. .,Faculty of Dentistry, Department of Periodontology, Selcuk University, 42079, Konya, Turkey.
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Abstract
Practical relevance: Periodontal disease is commonly encountered in feline practice. Gingivitis, followed by inflammation of the rest of the periodontal tissues, can lead to chronic oral infection, bacteraemia, pain and ultimately tooth loss. Given adequate plaque control and thorough, consistent dental home care, gingivitis is a reversible and controllable condition. Periodontitis, however, is an essentially irreversible and progressive condition. Treatment aims to control tissue inflammation, returning the gingiva to clinical health and preventing destruction of the periodontium in other parts of the mouth. Clinical challenges: Diagnosis must be established using a combination of oral examination under anaesthesia and dental radiography. Periodontitis leads to tooth attachment loss, and given the short length of most cat teeth, probing depths of 1 mm or more should alert the clinician to the presence of periodontitis. The decision of whether to extract or preserve affected teeth needs careful consideration. In practice, as periodontitis is often associated with type 1 tooth resorption, extraction is often required, but the slender and delicate nature of feline tooth roots, compounded by the destructive nature of tooth resorption, can frustrate extraction attempts. As highlighted in this article, iatrogenic damage to teeth is also a real risk if periodontal therapy procedures (including scaling and polishing) are not performed carefully. The challenges of providing home care in the cat are additionally discussed. Evidence base: The authors have drawn upon, wherever possible, an evidence base relating strictly to the feline patient. Where there is a lack of published research, evidence from canine and human studies is assessed.
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Affiliation(s)
- Rachel Perry
- Perrydental Vet Ltd, Grove Lodge Veterinary Hospital, Upper Brighton Road, Worthing, West Sussex, BN14 9DL, UK
| | - Cedric Tutt
- Cape Animal Dentistry Service, 78 Rosmead Avenue, Kenilworth, 7708, Cape Town, South Africa
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