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Alghafri M, Fadhul I, Shah M, Hakam A, Tawse-Smith A, Alsabeeha NHM, Atieh MA. Diode laser as an adjunctive treatment for periodontitis: Arandomized controlled trial. Int J Dent Hyg 2024. [PMID: 38659231 DOI: 10.1111/idh.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The aim of this randomized controlled trial was to assess clinical and patient reported outcomes of subgingival instrumentation (SI) with adjunctive use of diode laser (DL) versus SI alone in the treatment of periodontitis. METHODS Participants requiring non-surgical periodontal treatment were randomly allocated into two treatment groups: SI with DL or SI alone. Clinical parameters [full mouth bleeding and plaque scores (FMBS and FMPS), probing pocket depth and clinical attachment level] were recorded at baseline, three and 6 months post-treatment. Visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at 6 months. RESULTS A total of 22 participants with stage III/IV periodontitis completed the 6-month follow-up. SI with or without DL resulted in statistically significant reduction in FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at 3- and 6-month follow-up visits (p = 0.001 to <0.001). The participants in SI/DL group had a greater reduction in the percentage of deep PPDs (≥5 mm) compared to those receiving SI alone, but statistically significant differences between the two groups were not observed (16.40 ± 9.57 vs. 32.50 ± 38.76 at 3 months and 7.20 ± 6.86 vs. 19.50 ± 35.06 at 6 months). The difference in the mean total GOHAI scores was not statistically significant at 6 months with total GOHAI scores of 7.25 ± 2.45 and 5.40 ± 3.06 for SI and SI/DL groups, respectively. CONCLUSION Within the limitations of this study, the use of DL as an adjunct to SI in the treatment of stage III/IV periodontitis did not produce significant additional improvement in clinical parameters or patient reported outcomes in the 6-month observation period.
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Affiliation(s)
- Meera Alghafri
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Israa Fadhul
- Department of Health, Abu Dhabi, United Arab Emirates
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Abeer Hakam
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
| | - Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- School of Dentistry, University of Jordan, Amman, Jordan
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Anwar SK, Hafez AM, Roshdy YS. Clinical and microbiological efficacy of intra-pocket application of diode laser in grade C periodontitis: a randomized controlled clinical trial. BMC Oral Health 2024; 24:270. [PMID: 38395824 PMCID: PMC10893689 DOI: 10.1186/s12903-024-04031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Periodontitis is a microbially induced disease destroying structures anchoring teeth to jaw bones. Although metronidazole in combination with spiramycin is the effective conventional treatment of stage III grade C periodontitis, it has several systemic side effects. Laser therapy is widely used nowadays as an adjunct to scaling and root planing (SRP) to modulate inflammatory host response and eradicate microbes, due to bactericidal and detoxifying effects. Since microbiological analysis is one of the diagnostic methods identifying periodontal risk; our research aimed to investigate the efficacy of intra-pocket application of diode laser (980 nm) versus antibiotic therapy in enhancing clinical and microbiological parameters in stage III grade C periodontitis. METHODS A randomized controlled clinical trial was conducted on fifty patients with stage III grade C periodontitis, divided equally into two groups. We managed test group by SRP with intra-pocket application of diode laser (980 nm) and the control group by SRP with systemic antibiotic administration (spiramycin and metronidazole). Then, we measured periodontal pocket depth (PPD) and clinical attachment loss (CAL) for both groups, before treatment (baseline), four and twelve weeks after. Moreover, we collected gingival crevicular fluid from both groups at baseline, four and twelve weeks after treatment and analyzed by real-time polymerase chain reaction to detect the relative count of Aggregatibacter actinomycetemcomitans and Porhyromonas gingivalis. RESULTS Compared to baseline, all assessed clinical and microbiological parameters attested improvement at the end of the study period in each group individually with no significant difference between the two studied groups. Although, at twelve weeks, flare up of bacterial levels was detected with systemic antibiotic administration. CONCLUSION Laser therapy can be considered as an effective treatment modality in stage III grade C periodontitis, avoiding the systemic antibiotic side effects and solving the recurrence problems due to bacterial resistance by long term usage. TRIAL REGISTRATION NCT05222737 retrospectively on 03/02/2022, Clinicaltrial.gov.
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Affiliation(s)
- Souzy Kamal Anwar
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt.
| | - Amira Mohamed Hafez
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| | - Yara Safwat Roshdy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
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Pamuk F, Lütfioğlu M, Paksoy T, Koyuncuoglu CZ, Polat NG, Cifcibasi E, Yildirim S, Kantarci A. Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3-4, Grade C periodontitis patients: a split-mouth, randomized control study. Clin Oral Investig 2023; 27:6439-6449. [PMID: 37709984 DOI: 10.1007/s00784-023-05248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
AIM To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system. MATERIALS AND METHODS Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA. RESULTS Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05). CONCLUSION Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels. CLINICAL RELEVANCE LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.
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Affiliation(s)
- F Pamuk
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.
- Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey.
| | - M Lütfioğlu
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - T Paksoy
- Hamidiye Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - C Z Koyuncuoglu
- Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey
| | - N G Polat
- Clinical Laboratory, Unit of Immunology and Allergy, Koç University Hospital, Istanbul, Turkey
| | - E Cifcibasi
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul, Turkey
| | - S Yildirim
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - A Kantarci
- Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
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Narendran N, Anegundi RV, Shenoy SB, Chandran T. Autologous platelet-rich fibrin as an adjunct to non-surgical periodontal therapy-A follow up clinical pilot study. Wound Repair Regen 2021; 30:140-145. [PMID: 34687113 DOI: 10.1111/wrr.12979] [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: 03/22/2021] [Revised: 09/13/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
The aim was to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) as an adjunct to scaling and root planing (SRP) in moderate periodontal pockets. The split-mouth study involved 32 sites from 16 patients. Baseline parameters were recorded followed by complete full-mouth SRP. The test and control sites were randomly selected and autologous PRF was placed in the test site and other site served as control. The blinded examiner recorded clinical parameters at baseline, 60 days, and 90 days. No statistical significance was found at baseline in probing depth (PD) and clinical attachment level (CAL). Statistically, significant improvement was observed within test and control groups at 90 days compared to baseline values. A statistically significant difference in test sites was found in terms of reduction in PD and clinical attachment gain (CAG) compared to the control sites at the end of the study period (p value <0.05). This split-mouth pilot study emphasized a statistically significant improvement in pocket depth reduction and CAL gain when PRF was used as an adjunct to SRP in moderate periodontal pockets.
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Affiliation(s)
- Nirosha Narendran
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Raghavendra Vamsi Anegundi
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Santhosh B Shenoy
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Thara Chandran
- Department of Public Health Dentistry, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India
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Yu S, Zhao X, Zhang Y, Liu Y, Li A, Pei D. Clinical effectiveness of adjunctive diode laser on scaling and root planing in the treatment of periodontitis: is there an optimal combination of usage mode and application regimen? A systematic review and meta-analysis. Lasers Med Sci 2021; 37:759-769. [PMID: 34536183 DOI: 10.1007/s10103-021-03412-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 09/05/2021] [Indexed: 11/29/2022]
Abstract
This review aims to evaluate the adjunctive clinical effectiveness of diode laser (DL) to scaling and root planing (SRP) in the treatment of periodontitis, and identify the optimal combination of usage mode and application regimen of DL. Eight electronic databases were searched up to January 2021. Probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), and gingival index (GI) were assessed at short-term (4-6 weeks), 3-month, and 6-month follow-ups. Based on DL usage mode, studies were divided into three groups: inside, outside pocket, and combined modes. As for application regimen, studies in each group were further subdivided into single- and multiple-session subgroups. Thirty randomized controlled trials with 825 participants were included. For inside mode, single-session DL showed significant improvements for PPD (short-term, and 3-month, p < 0.05), CAL (short-term, and 3-month, p < 0.05), PI (3- and 6-month, p < 0.05), and GI (short-term, 3-month, and 6-month, p < 0.05). For outside mode, multiple-session DL showed notable improvements for most clinical outcomes (p < 0.05). The effect of combined mode was still uncertain. Adjunctive DL had additional clinical benefits in the treatment of periodontitis. One session laser treatment is suggested when DL is applied inside pocket in future clinical practice. Meanwhile, more than one session laser treatment presents better outcomes when DL is used outside pocket. PROSPERO: CRD42020156162.
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Affiliation(s)
- Shuchen Yu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Xiaodan Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China
| | - Yujiao Liu
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China. .,Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, China. .,Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
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Zhao P, Song X, Nie L, Wang Q, Zhang P, Ding Y, Wang Q. Efficacy of adjunctive photodynamic therapy and lasers in the non-surgical periodontal treatment: A Bayesian network meta-analysis. Photodiagnosis Photodyn Ther 2020; 32:101969. [DOI: 10.1016/j.pdpdt.2020.101969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
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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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Bansal V, Gupta R, Dahiya P, Kumar M, Samlok JK. A clinico-microbiologic study comparing the efficacy of locally delivered chlorhexidine chip and diode LASER as an adjunct to non-surgical periodontal therapy. J Oral Biol Craniofac Res 2019; 9:67-72. [PMID: 30294538 PMCID: PMC6170259 DOI: 10.1016/j.jobcr.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Considering the microbial etiology of the periodontal disease, the periodontal therapy aims to control or abolish the pathogenic microbes. The gold standard scaling and root planing procedure has been used since time immemorial but the drawbacks associated with it have led to the development of various adjunctive means. The current study was therefore, performed to comparatively assess the efficacy of local delivery of chlorhexidine and 808-nm diode LASER as an appurtenance to scaling and root planing in patients with chronic periodontitis. METHODS In a randomized split mouth evaluation, 30 patients having probing depth of ≥5 mm which bled on probing at least at 3 different sites were included. At baseline, the evaluation of plaque index, bleeding index, probing pocket depth and clinical attachment level was done and the microbial samples were collected for the assessment of spirochetes, motile rods and coccoid cells. The 3 selected sites of each subject were allocated to 3 different groups A, B, C viz; Scaling and root planing (SRP) + chlorhexidine chip, SRP + diode LASER and SRP respectively. The patients were recalled after 4 weeks to re-evaluate the clinical and microbiological parameters. RESULTS All the parameters significantly reduced from baseline to 4 weeks in all the 3 groups. Intergroup comparisons revealed remarkable difference between group A and C and group B and C, respectively; no notably significant difference was found between group A and B. CONCLUSION The additional use of LASER and chlorhexidine chip assures anti-inflammatory effect and anti-microbial effect that allows reduction in bacterial counts and promotes healing. The use of adjuncts have been found to be efficacious in controlling disease and promoting periodontal health and thereby reducing the need for surgical procedures to be undertaken.
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Affiliation(s)
| | - Rajan Gupta
- Department of Periodontics, Himachal Institutes of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
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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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Prasad N, Yadav V. Comparison of 50 μg Oral and Vaginal Misoprostol Tablets in Induction of Labor at Term. ACTA ACUST UNITED AC 2018. [DOI: 10.5005/jp-journals-10045-0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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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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Pamuk F, Lütfioğlu M, Aydoğdu A, Koyuncuoglu CZ, Cifcibasi E, Badur OS. The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoki. J Periodontal Res 2017; 52:872-882. [DOI: 10.1111/jre.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 01/24/2023]
Affiliation(s)
- F. Pamuk
- Department of Periodontology; Faculty of Dentistry; Yeditepe Univesity; Istanbul Turkey
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - M. Lütfioğlu
- Department of Periodontology; Faculty of Dentistry; Ondokuzmayis University; Samsun Turkey
| | - A. Aydoğdu
- Department of Periodontology; Faculty of Dentistry; Istanbul Research and Application Center; Baskent University; Istanbul Turkey
| | - C. Z. Koyuncuoglu
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - E. Cifcibasi
- Department of Periodontology; Faculty of Dentistry; Istanbul University; Istanbul Turkey
| | - O. S. Badur
- Division of Virology and Immunology; Department of Microbiology; Faculty of Medicine; Istanbul University; Istanbul Turkey
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Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y. Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 2017; 68:217-69. [PMID: 25867988 DOI: 10.1111/prd.12080] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 12/18/2022]
Abstract
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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Cobb CM. Commentary: Is There Clinical Benefit From Using a Diode or Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Periodontitis? J Periodontol 2016; 87:1117-31. [PMID: 27181116 DOI: 10.1902/jop.2016.160134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Despite a quarter of a century of laser research, there is a persistent debate regarding the efficacy of dental lasers in the treatment of periodontitis or periodontal maintenance therapy. There are many claims and much hyperbole surrounding the use of lasers, either as a monotherapy or adjunctive to scaling and root planing, to treat periodontitis. There is little evidence that using a diode or neodymium:yttrium-aluminum-garnet laser adds clinical value over and above conventional non-surgical or surgical periodontal treatment. There is a significant need for better designed human clinical trials. Data from such trials should be analyzed according to initial probing depth and characteristics of the treated sites, such as non-molar, molar flat surfaces, and molar furcations, and evaluated for long-term post-treatment results.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, University of Missouri-Kansas City, Kansas City, MO
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Qadri T, Javed F, Johannsen G, Gustafsson A. Role of Diode Lasers (800–980 Nm) as Adjuncts to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Systematic Review. Photomed Laser Surg 2015; 33:568-75. [DOI: 10.1089/pho.2015.3914] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Talat Qadri
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Gunnar Johannsen
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Anders Gustafsson
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
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Birang R, Shahaboui M, Kiani S, Shadmehr E, Naghsh N. Effect of Nonsurgical Periodontal Treatment Combined With Diode Laser or Photodynamic Therapy on Chronic Periodontitis: A Randomized Controlled Split-Mouth Clinical Trial. J Lasers Med Sci 2015; 6:112-9. [PMID: 26464778 DOI: 10.15171/jlms.2015.04] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The optimum removal of bacteria and their toxins from periodontal pockets is not always obtained by conventional mechanical debridement. Adjunctive therapies may improve tissue healing through detoxification and bactericidal effects. The purpose of the present study was to evaluate the impact of adjunctive laser therapy (LT) and photodynamic therapy (PDT) on patients with chronic periodontitis. METHODS Twenty patients with at least three quadrants involved and each of them presenting pockets 4-8 mm deep were included in the study. Periodontal treatment comprising scaling and root planning (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (group A), SRP with LT (group B), and SRP with PDT (group C). The clinical indices were measured at baseline 6 weeks and 3 months after treatment. Microbiological samples were taken and evaluated at baseline and 3-month follow-up. RESULTS All groups showed statistically significant improvements in terms of clinical attachment level (CAL) gain, periodontal pocket depth (PPD) reduction, papilla bleeding index and microbial count compared to baseline (P < .05). The results showed more significant improvement in the 6-week evaluation in terms of CAL in groups B and C than in group A (P < .05). Group B also revealed a greater reduction in PPD than the other treatment modalities (P < .05). CONCLUSION The obtained data suggested that adjunctive LT and PDT have significant short-term benefits in the treatment of chronic periodontitis. Furthermore, LT showed minimal additional advantages compared to PDT.
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Affiliation(s)
- Reza Birang
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Shahaboui
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Kiani
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Shadmehr
- Department of Endodontics, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Naghsh
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Slot DE, Jorritsma KH, Cobb CM, Van der Weijden FA. The effect of the thermal diode laser (wavelength 808-980 nm) in non-surgical periodontal therapy: a systematic review and meta-analysis. J Clin Periodontol 2014; 41:681-92. [PMID: 24460795 DOI: 10.1111/jcpe.12233] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/28/2022]
Abstract
FOCUSED QUESTION What is the adjunctive effect of a diode laser (DL) following non-surgical periodontal debridement (SRP) during the initial phase of periodontal therapy on the clinical parameters of periodontal inflammation. MATERIAL AND METHODS The MEDLINE-PubMed, Cochrane-Central Register of Controlled Trials and EMBASE databases were searched up to September 2013. Probing pocket depth (PPD) and clinical attachment loss (CAL) were selected as outcome variables. Also plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were considered outcome measures. Data were extracted and a meta-analysis (MA) was performed where appropriate. RESULTS Independent screening of 416 unique papers resulted in nine eligible publications. The MA evaluating PPD, CAL and PS showed no significant effect. The only significance favouring adjunctive use of the DL was observed for the outcome parameters GI and BS. CONCLUSION The collective evidence regarding adjunctive use of the DL with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. That is for PPD and CAL. The body of evidence considering the adjunctive use of the DL is judged to be "moderate" for changes in PPD and CAL. With respect to BS, the results showed a small but significant effect favouring the DL, however, the clinical relevance of this difference remains a question. This systematic review questions the adjunctive use of DL with traditional mechanical modalities of periodontal therapy in patients with periodontitis.
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Affiliation(s)
- Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Theodoro LH, Caiado RC, Longo M, Novaes VCN, Zanini NA, Ervolino E, de Almeida JM, Garcia VG. Effectiveness of the diode laser in the treatment of ligature-induced periodontitis in rats: a histopathological, histometric, and immunohistochemical study. Lasers Med Sci 2014; 30:1209-18. [DOI: 10.1007/s10103-014-1575-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/30/2014] [Indexed: 12/14/2022]
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Roncati M, Gariffo A. Systematic Review of the Adjunctive Use of Diode and Nd:YAG Lasers for Nonsurgical Periodontal Instrumentation. Photomed Laser Surg 2014; 32:186-97. [DOI: 10.1089/pho.2013.3695] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Marisa Roncati
- Prosthetic Department, University of Bologna, Bologna, Italy
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Dua A, Mittal R, Singla MG, Sood A, Sodhi PS. Clinical Evaluation of Middle Power Output 810 nm GaAIAs Diode Laser for Treating Severe Dentin Hypersensitivity: A Randomized Clinical Trial. ACTA ACUST UNITED AC 2014. [DOI: 10.5005/jp-journals-10022-1050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Iyer VH, sathyanarayanan C. A comparative in vivo study between the conventional Method and Diode Lasers in treatment of Gingival Pigmentation. ACTA ACUST UNITED AC 2014. [DOI: 10.5005/jp-journals-10022-1049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Khan SZ, Kokubu E, Tsuruoka M, Murakami S, Matsuzaka K, Inoue T. Morphological Effect of Diode Laser Irradiation of Periapical Lesion in Rat. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10022-1035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Stock K, Stegmayer T, Graser R, Förster W, Hibst R. Comparison of different focusing fiber tips for improved oral diode laser surgery. Lasers Surg Med 2012; 44:815-23. [DOI: 10.1002/lsm.22091] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 11/09/2022]
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Das D, Reed S, Klokkevold PR, Wu BM. A high-throughput comparative characterization of laser-induced soft tissue damage using 3D digital microscopy. Lasers Med Sci 2012; 28:657-68. [PMID: 22669178 DOI: 10.1007/s10103-012-1126-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/17/2012] [Indexed: 11/28/2022]
Abstract
3D digital microscopy was used to develop a rapid alternative approach to quantify the effects of specific laser parameters on soft tissue ablation and charring in vitro without the use of conventional tissue processing techniques. Two diode lasers operating at 810 and 980 nm wavelengths were used to ablate three tissue types (bovine liver, turkey breast, and bovine muscle) at varying laser power (0.3, 1.0, and 2.0 W) and velocities (1-50 mm/s). Spectrophotometric analyses were performed on each tissue to determine tissue-specific absorption coefficients and were considered in creating wavelength-dependent energy attenuation models to evaluate minimum heat of tissue ablations. 3D surface contour profiles characterizing tissue damage revealed that ablation depth and tissue charring increased with laser power and decreased with lateral velocity independent of wavelength and tissue type. While bovine liver ablation and charring were statistically higher at 810 than 980 nm (p < 0.05), turkey breast and bovine muscle ablated and charred more at 980 than 810 nm (p < 0.05). Spectrophotometric analysis revealed that bovine liver tissue had a greater tissue-specific absorption coefficient at 810 than 980 nm, while turkey breast and bovine muscle had a larger absorption coefficient at 980 nm (p < 0.05). This rapid 3D microscopic analysis of robot-driven laser ablation yielded highly reproducible data that supported well-defined trends related to laser-tissue interactions and enabled high throughput characterization of many laser-tissue permutations. Since 3D microscopy quantifies entire lesions without altering the tissue specimens, conventional and immunohistologic techniques can be used, if desired, to further interrogate specific sections of the digitized lesions.
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Affiliation(s)
- Debobrato Das
- Department of Bioengineering, Henry Samueli School of Engineering, University of California at Los Angeles, 410 Westwood Plaza, Engineering V, Los Angeles, CA 90095, USA
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Euzebio Alves VT, de Andrade AKP, Toaliar JM, Conde MC, Zezell DM, Cai S, Pannuti CM, De Micheli G. Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial. Clin Oral Investig 2012; 17:87-95. [DOI: 10.1007/s00784-012-0703-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/21/2012] [Indexed: 01/16/2023]
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Rao G, Tripthi PS, Srinivasan K. Hemostatic Effect of the CO2 Laser Over Excision of an Intraoral Hemangioma. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10022-1023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Deepalakshmi D. Root Coverage with a Free Gingival Autograft using an Er, Cr: YSGG Laser. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10022-1014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Pradhan S, Yasmin E, Mehta A. Management of Posterior Ankyloglossia using the Er, Cr:YSGG Laser. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10022-1016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Iyer VH, Ramalingam P, Moorthy V. Use of Lasers in the Management of Mucocele: Two Case Reports. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10022-1027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Sgolastra F, Petrucci A, Gatto R, Marzo G, Monaco A. Photodynamic therapy in the treatment of chronic periodontitis: a systematic review and meta-analysis. Lasers Med Sci 2011; 28:1393-402. [PMID: 22002328 DOI: 10.1007/s10103-012-1181-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 07/30/2012] [Indexed: 12/14/2022]
Abstract
This meta-analysis was conducted to investigate the efficacy and safety of antimicrobial photodynamic therapy used alone or adjunctive to scaling root planing in patients with chronic periodontitis. The meta-analysis was conducted according to the QUOROM statement and recommendations of the Cochrane Collaboration. An extensive literature search was performed on seven databases, followed by a manual search. Weighted mean differences and 95% confidence intervals were calculated for clinical attachment level, probing depth and gingival recession. The I(2) test was used for inter-study heterogeneity; visual asymmetry inspection of the funnel plot, Egger's regression test and the trim-and-fill method were used to investigate publication bias. At 3 months, significant differences in clinical attachment level (p = 0.006) and probing depth reduction (p = 0.02) were observed for scaling root planing with antimicrobial photodynamic therapy, while no significant differences were retrieved for antimicrobial photodynamic therapy used alone; at 6 months no significant differences were observed for any investigated outcome. Neither heterogeneity nor publication bias was detected. The use of antimicrobial photodynamic therapy adjunctive to conventional treatment provides short-term benefits, but microbiological outcomes are contradictory. There is no evidence of effectiveness for the use of antimicrobial photodynamic therapy as alternative to scaling root planing. Long-term randomized controlled clinical trials reporting data on microbiological changes and costs are needed to support the long-term efficacy of adjunctive antimicrobial photodynamic therapy and the reliability of antimicrobial photodynamic therapy as alternative treatment to scaling root planing.
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Affiliation(s)
- Fabrizio Sgolastra
- Department of Health Sciences, University of L'Aquila, San Salvatore 1, Building Delta 6, 67100, L'Aquila, Italy.
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Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial. Lasers Med Sci 2010; 26:43-8. [DOI: 10.1007/s10103-009-0753-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 12/22/2009] [Indexed: 10/19/2022]
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Abstract
For many intraoral soft-tissue surgical procedures the laser has become a desirable and dependable alternative to traditional scalpel surgery. However, the use of dental lasers in periodontal therapy is controversial. This article presents the current peer-reviewed evidence on the use of dental lasers for the treatment of chronic periodontitis.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, 424 West 67th Terrace, Kansas City, MO 64113, USA.
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35
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Gingival curettage study comparing a laser treatment to hand instruments. Lasers Med Sci 2009; 26:7-11. [DOI: 10.1007/s10103-009-0732-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 08/25/2009] [Indexed: 10/20/2022]
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Ishikawa I, Aoki A, Takasaki AA, Mizutani K, Sasaki KM, Izumi Y. Application of lasers in periodontics: true innovation or myth? Periodontol 2000 2009; 50:90-126. [PMID: 19388956 DOI: 10.1111/j.1600-0757.2008.00283.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Kamma JJ, Vasdekis VG, Romanos GE. The Effect of Diode Laser (980 nm) Treatment on Aggressive Periodontitis: Evaluation of Microbial and Clinical Parameters. Photomed Laser Surg 2009; 27:11-9. [DOI: 10.1089/pho.2007.2233] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joanna J. Kamma
- Private Dental Clinic of Periodontics, Piraeus, Athens University of Economics and Business, Athens, Greece
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Schwarz F, Aoki A, Becker J, Sculean A. Laser application in non-surgical periodontal therapy: a systematic review. J Clin Periodontol 2009; 35:29-44. [PMID: 18724840 DOI: 10.1111/j.1600-051x.2008.01259.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The primary aim was to address the following focused question: What is the clinical effect of laser application compared with mechanical debridement in non-surgical periodontal therapy in patients with chronic periodontitis? A secondary aim was to survey the relevant literature in relation to safety of laser applications. MATERIAL AND METHODS Electronic databases of the PubMed and the Cochrane Library were searched and completed by manual searches up to December 2007. RESULTS Following screening, 12 publications (11 studies) were eligible for the review. A meta-analysis could not be performed due to the heterogeneity of the studies. The results from a narrative synthesis indicate that Er:YAG laser monotherapy resulted in similar clinical outcomes, both in the short and the long term (up to 24 months), compared with mechanical debridement. There is insufficient evidence to support the clinical application of either CO(2), Nd:YAG, Nd:YAP, or different diode laser wavelengths. CONCLUSIONS The Er:YAG laser seems to possess characteristics most suitable for the non-surgical treatment of chronic periodontitis. Research conducted so far has indicated that its safety and effects might be expected to be within the range reported for conventional mechanical debridement. However, the evidence from the evaluated studies is weak.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
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Assaf M, Yilmaz S, Kuru B, Ipci SD, Noyun U, Kadir T. Effect of the Diode Laser on Bacteremia Associated with Dental Ultrasonic Scaling: A Clinical and Microbiological Study. Photomed Laser Surg 2007; 25:250-6. [PMID: 17803380 DOI: 10.1089/pho.2006.2067] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate the potential use of diode lasers (DLs) to reduce bacteremia associated with ultrasonic scaling (US). Furthermore, the clinical efficacy of DLs as an adjunct to US in the treatment of gingivitis was investigated. BACKGROUND DATA Recently, lasers have found new applications in dental practice. The benefits of the use of DLs as an adjunct to US have not yet been determined. METHODS Twenty-two gingivitis patients were treated using a split-mouth study design in which each side was randomly treated by US alone or DL followed by US (DL + US). Blood samples were drawn just before and during US in each treatment step to detect induced bacteremia. Clinical parameters including plaque index, sulcus bleeding index, probing depth, and relative attachment level were recorded at baseline and 4 weeks postoperatively. RESULTS Bacteremia was detected in 15 patients (68%) after US alone, and in 8 patients following DL + US (36%). The reduction of the incidence of odontogenic bacteremia during US after the application of DL was statistically significant (p < 0.05). Clinical signs improved eventually, with no significant differences between the two treatment regimens (p > 0.05). CONCLUSIONS Application of DL energy can reduce bacteria in gingival crevices which may reduce bacteremia following US. The use of DL did not show additional clinical influence on gingival healing after treatment of gingivitis with US.
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Affiliation(s)
- Mohammad Assaf
- Faculty of Dentistry, Al-Quds University, Jerusalem., Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
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Castro GL, Gallas M, Núñez IR, Borrajo JLL, Alvarez JC, Varela LG. Scanning Electron Microscopic Analysis of Diode Laser-Treated Titanium Implant Surfaces. Photomed Laser Surg 2007; 25:124-8. [PMID: 17508849 DOI: 10.1089/pho.2006.1086] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this study was to analyze the possible morphological alterations of the surface implants after using 980-nm diode laser irradiation (InGalAsP) at various energies. BACKGROUND DATA Laser-based protocols have been proposed for decontaminating dental implant surfaces when treating peri-implantitis, although few studies have addressed this topic directly. METHODS Five smooth surface implants (TiOblast ST, Astra Tech AB, Mölndal, Sweden) were irradiated with 980-nm diode laser, and one implant that was not lased served as the control. The surface of each implant was treated for 60 sec on implant neck to apical threads. The experiment consisted of exposing the dental titanium implants to diode laser irradiation. Then the surfaces were analyzed by scanning electron microscopy (SEM). RESULTS SEM analysis demonstrated any damage or alteration of titanium surfaces. Regardless of the power setting, there was no visible difference between lased and non-lased titanium surfaces after irradiation with the 980-nm diode laser. CONCLUSION The results of this study suggest that the InGalAsP diode laser (980 nm) does not damage titanium surfaces, and seems to be safe and useful of treating peri-implantitis, irrespective of power output.
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Affiliation(s)
- Gonzalo López Castro
- School of Dentistry, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Seifi M, Shafeei HA, Daneshdoost S, Mir M. Effects of two types of low-level laser wave lengths (850 and 630 nm) on the orthodontic tooth movements in rabbits. Lasers Med Sci 2007; 22:261-4. [PMID: 17334676 DOI: 10.1007/s10103-007-0447-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2006] [Accepted: 12/21/2006] [Indexed: 11/29/2022]
Abstract
The effects of low-level lasers on bone cellular activity, bone structures, bone healing, fibroblasts activity and inflammation process have already been investigated. Considering orthodontic tooth movement, which is a complicated inflammatory process involving simultaneous bone apposition and resorption, the aim of this controlled study is to investigate the quantitative effects of a pulsed 850 nm laser (Optodan) and a continuous 630 nm laser (KLO3) on the orthodontic tooth movement in rabbits. This experimental study was conducted on 18 male albino rabbits divided into three equal groups of control, Optodan and KLO3. In all the groups, NiTi-closed coil springs were used on the first mandibular molars with 4-oz tension. The control group was not irradiated by laser, but the teeth in the laser groups were irradiated 9 days according to the periodontal therapeutic protocols. After 16 days, samples were sacrificed. The distance between the distal surface of the first molar and the mesial surface of the second molar was measured with 0.05-mm accuracy. The data were subjected to the statistical tests of Kolmogrov Smirnov and variance analysis. The mean orthodontic tooth movements of the first mandibular molars were 1.7 +/- 0.16 mm in control group, 0.69 +/- 0.16 mm in Optodan group and 0.86 +/- 0.13 mm in KLO3 group. There were statistically significant difference between the control and the two other laser-irradiated groups (P < 0.001). The findings of the present study imply that the amounts of orthodontic tooth movement, after low-level laser therapy, are diminished. It could not be concluded that any low-level laser will reduce the speed of teeth movement in orthodontic treatments, and further studies with less or more energies may show different results.
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Affiliation(s)
- Massoud Seifi
- Faculty of Dentistry, Orthodontics Department, Shaheed Beheshti University of Medical Science, Evin, Tehran, Iran.
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Castro GL, Gallas M, Núñez IR, Borrajo JLL, Varela LG. Histological evaluation of the use of diode laser as an adjunct to traditional periodontal treatment. Photomed Laser Surg 2006; 24:64-8. [PMID: 16503791 DOI: 10.1089/pho.2006.24.64] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe in vivo effects of scaling and root planing associated with 980-nm diode laser irradiation on periodontally diseased root surfaces. BACKGROUND DATA Rapid advances in the development of laser technologies used in dental offices demand careful evaluation of the respective histopathologic effects of each new system. There have been no reports of scaling and root planing associated with 980-nm diode laser effects on root surfaces after in vivo application. METHODS Single rooted teeth and multiple rooted teeth considered for extraction due to severe periodontal disease were included in the study. For light microscopic investigation, a resin-embedding technique was used to cut the undecalcified teeth into 30-microm-thick cross-sections and stained. The following parameters were recorded by a blind examiner: remaining debris, root surface morphology, and thermal side effects. RESULTS Root surfaces instrumented with hand instruments and diode laser in vivo did not show detectable surface alterations. There were no signs of thermal side effects in any of the teeth treated. CONCLUSION The present in vivo study showed that associated therapy was suitable for non-surgical periodontal treatment. The results suggest that the diode laser may be routinely used as an adjunct to scaling and root planing without damage to the cementum tissue.
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Affiliation(s)
- Gonzalo López Castro
- Periodontology, School of Dentistry, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Rua Entrerríos S/N, Santiago de Compostela, CP 15782, Spain
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Abstract
BACKGROUND Despite the large number of publications, there is still controversy among clinicians regarding the application of dental lasers to the treatment of chronic periodontitis. The purpose of this review is to analyze the peer-reviewed research literature to determine the state of the science concerning the application of lasers to common oral soft tissue problems, root surface detoxification, and the treatment of chronic periodontitis. METHODS A comprehensive computer-based search combined the following databases into one search: Medline, Current Contents, and the Cumulated Index of Nursing and Allied Health. This search also used key words. In addition, hand searches were done for several journals not cataloged in the databases, and the reference lists from published articles were checked. All articles were considered individually to eliminate non-peer-reviewed articles, those dealing with commercial laser technology, and those considered by the author to be purely opinion articles, leaving 278 possible articles. RESULTS There is a considerable conflict in results for both laboratory studies and clinical trials, even when using the same laser wavelength. A meaningful comparison between various clinical studies or between laser and conventional therapy is difficult at best and likely impossible at the present. Reasons for this dilemma are several, such as different laser wavelengths; wide variations in laser parameters; insufficient reporting of parameters that, in turn, does not allow calculation of energy density; differences in experimental design, lack of proper controls, and differences in severity of disease and treatment protocols; and measurement of different clinical endpoints. CONCLUSIONS Based on this review of the literature, there is a great need to develop an evidence-based approach to the use of lasers for the treatment of chronic periodontitis. Simply put, there is insufficient evidence to suggest that any specific wavelength of laser is superior to the traditional modalities of therapy. Current evidence does suggest that use of the Nd:YAG or Er:YAG wavelengths for treatment of chronic periodontitis may be equivalent to scaling and root planing (SRP) with respect to reduction in probing depth and subgingival bacterial populations. However, if gain in clinical attachment level is considered the gold standard for non-surgical periodontal therapy, then the evidence supporting laser-mediated periodontal treatment over traditional therapy is minimal at best. Lastly, there is limited evidence suggesting that lasers used in an adjunctive capacity to SRP may provide some additional benefit.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri, Kansas City, MO 64113, USA.
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Laser literature watch. Photomed Laser Surg 2005; 23:233-42. [PMID: 15910194 DOI: 10.1089/pho.2005.23.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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