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Al-Hashedi AA, Dubreuil N, Schwinghamer T, Dorzhiyeva S, Anweigi L, Emami E, Tamimi F. Aragonite toothpaste for management of dental calculus: A double-blinded randomized controlled clinical trial. Clin Exp Dent Res 2022; 8:863-874. [PMID: 35419985 PMCID: PMC9382037 DOI: 10.1002/cre2.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives Aragonite from animal origin such as cuttlefish bone powder is an abrasive with hardness properties ideal for calculus removal. The purpose of this randomized controlled trial was to test the efficacy of a cuttlebone‐derived aragonite toothpaste in removing dental calculus. Materials and Methods Eighty‐one patients who fulfilled the inclusion criteria were blindly and randomly assigned into two study groups. The intervention treatment group (n = 40) received cuttlebone toothpaste (Dr. D‐Tart) and the control group (n = 41) received an off‐the‐shelf commercial toothpaste (Crest). Evaluations were performed before and after scaling and polishing procedures done at 3 months in order to evaluate the toothpaste's ability to remove calculus and to prevent calculus formation. Calculus, stains, plaque, and gingival indices scores, and patient satisfaction surveys were compared at baseline (first visit), 3, and 9 months, using generalized linear models and Wald's χ2 test. Results At the end of the 3‐month period, the intervention group showed a 30% reduction in total calculus compared to the baseline score (p = .0006) and 45% less total calculus compared to the control group (p = .0001). Six months after scaling, the mean calculus score for Crest users was 42% higher than that for Dr. D‐Tart users (p = .0692). There was a significant improvement in the gingival health of cuttlebone toothpaste users at the observed intervals, and both kinds of toothpaste achieved comparable results in terms of plaque and stains removal. Conclusions Aragonite toothpaste can remove calculus, prevent calculus formation, and improve gingival health. Patients are generally satisfied with the performance of the aragonite toothpaste. Clinical significance: Animal‐derived aragonite toothpaste (Dr. D‐Tart) shows promising efficacy in removing calculus, preventing calculus formation, and for the improvement of gingival health. Clinical trial ID: A08‐M35‐16B.
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Affiliation(s)
| | | | | | | | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Management of caries affected dentin (CAD) with resin modified glass ionomer cement (RMGIC) in the presence of different caries disinfectants and photosensitizers. Photodiagnosis Photodyn Ther 2020; 32:101978. [DOI: 10.1016/j.pdpdt.2020.101978] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/10/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022]
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Laky M, Laky B, Arslan M, Lettner S, Müller M, Haririan H, Husejnagic S, Rausch-Fan X, Wimmer G, Moritz A, Gregor R. Effectiveness of a 655-nm InGaAsP diode laser to detect subgingival calculus in patients with periodontal disease. J Periodontol 2020; 92:547-552. [PMID: 32786077 DOI: 10.1002/jper.19-0663] [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] [Received: 11/21/2019] [Revised: 05/24/2020] [Accepted: 07/13/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previous in vitro studies have proven laser fluorescence measurement using a 655-nm Indium Gallium Arsenide Phosphide (InGaAsP) based diode laser radiation to be a useful tool to detect subgingival calculus. The aim of this prospective study was to evaluate the 655-nm InGaAsP diode laser in detecting subgingival calculus in patients with periodontal disease compared with photographic assessment during periodontal surgery. METHODS Twelve patients (six women, six men) aged between 21 and 75 years with periodontitis scheduled for periodontal surgery were included in this prospective study. All laser fluorescence measurements were made before periodontal surgery. Intraoperatively a mucoperiostal flap was performed, subgingival calculus was visualized, and photographic images were taken. The presence of calculus was recorded for each evaluated site. RESULTS A total of 115 tooth surface sites of 32 teeth from the 12 patients were evaluated before (laser) and during surgery (image). Compared with image evaluation the laser assessment showed a sensitivity of 0.70 (CI0 .025 0.53 to CI0.975 0.83) and a specificity of 0.97 (CI0.025 0.85 to CI0.975 0.99). The overall probability to correctly detect subgingival calculus with the laser (accuracy) was 0.82 (CI0.025 0.74 to CI0.975 0.88). CONCLUSIONS The 655-nm diode laser was able to detect subgingival calculus. Hence, the 655 nm diode laser may be used as an additional tool for calculus detection in non-surgical periodontal therapy.
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Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Brenda Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Muazzez Arslan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Michael Müller
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Hady Haririan
- Department of Periodontology, Medical Faculty, Sigmund Freud Private University Vienna, Vienna, Austria
| | - Selma Husejnagic
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Gernot Wimmer
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Medical University of Graz, Graz, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Rene Gregor
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Agoob Alfergany M, Nasher R, Gutknecht N. Calculus Removal and Root Surface Roughness When Using the Er:YAG or Er,Cr:YSGG Laser Compared with Conventional Instrumentation Method: A Literature Review. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 37:197-226. [PMID: 31050960 DOI: 10.1089/photob.2018.4465] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The purpose of this literature review was to evaluate the effectiveness of using Er:YAG (erbium-doped yttrium/aluminum/garnet) laser or Er,Cr:YSGG (erbium, chromium-doped yttrium/scandium/gallium/garnet) laser on calculus removal and their effect on the topography and roughness of root surface in comparison with the conventional instruments in the nonsurgical periodontal therapy. Background data: One of the most challenging problems in treatment of periodontal disease is the elimination of plaque and calculus, leaving a clean and smooth root surface to decrease plaque and calculus retention, and for good gingival reattachment. Materials and methods: PubMed and Google Scholar were searched for available literature. The electronic search was limited to articles published in the period between January 2007 and April 2017, in the English language. Results: A total of 47 publications fulfilled the inclusion criteria of this systematic review and screened according to the research questions. Calculus removal using the ultrasonic instrument showed remaining calculus compared with the hand instrument, whereas, on the contrary, erbium lasers revealed no remaining calculus or smaller amounts compared with the conventional instruments when used in appropriate settings. The results of this review showed that ultrasonic instrumentation produced effects on the root surface almost similar to that of hand instrumentation. Er:YAG laser and Er,Cr:YSGG laser clarify a little more surface roughness when compared with conventional instruments. Conclusions: The present systematic review indicates that a combination of scaling and root planing (SRP) using the erbium lasers as an adjunctive therapy at certain parameters can be appropriate to remove residual debris from the root surface and at the same time have little or no negative thermal effect on the root surface. The Er:YAG laser also seems to be the most suitable for nonsurgical periodontal therapy. Additional new good-designed studies are needed to evaluate the effectiveness of erbium lasers with SRP in nonsurgical periodontal therapy.
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Affiliation(s)
- Muftah Agoob Alfergany
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Riman Nasher
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Norbert Gutknecht
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
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Fried WA, Chan KH, Darling CL, Curtis DA, Fried D. Image-Guided Ablation of Dental Calculus From Root Surfaces Using a DPSS Er:YAG Laser. Lasers Surg Med 2019; 52:247-258. [PMID: 31236996 DOI: 10.1002/lsm.23122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Recent studies have demonstrated that near-infrared (IR) imaging can be used to acquire high-contrast images of root caries and calculus on the root surfaces of extracted teeth at wavelengths longer than 1450 nm. The purpose of this study was to determine if image-guided laser ablation can be used to selectively remove calculus from tooth surfaces with minimal damage to the underlying sound cementum and dentin. MATERIALS AND METHODS In this study, sequential near-IR images at 1500-1700 nm were used to guide a diode-pumped (DPSS) Er:YAG laser for the removal of calculus from the root surfaces of 10 extracted teeth. The selectivity of removal was assessed using digital microscopy, optical coherence tomography, and surface profilometry. RESULTS Calculus was removed rapidly with minimal damage to the underlying sound cementum and dentin. Image-guided ablation achieved high-selectivity, the mean volume of calculus removal was more than 27 times higher than the mean loss of cementum. CONCLUSIONS We have demonstrated that near-IR image-guided laser ablation can be used for the selective removal of calculus from root surfaces ex vivo. Additionally, we have demonstrated that a diode-pumped solid-state Er:YAG laser is well suited for selective removal. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- William A Fried
- University of California, San Francisco, San Francisco, California, 94143
| | - Kenneth H Chan
- University of California, San Francisco, San Francisco, California, 94143
| | - Cynthia L Darling
- University of California, San Francisco, San Francisco, California, 94143
| | - Donald A Curtis
- University of California, San Francisco, San Francisco, California, 94143
| | - Daniel Fried
- University of California, San Francisco, San Francisco, California, 94143
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Graetz C, Schorr S, Christofzik D, Dörfer CE, Sälzer S. How to train periodontal endoscopy? Results of a pilot study removing simulated hard deposits in vitro. Clin Oral Investig 2019; 24:607-617. [PMID: 31111282 DOI: 10.1007/s00784-019-02913-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is uncertainty regarding the benefits of periodontal endoscopy (PE) for subgingival instrumentation. Moreover, the influence of operators' experience and training with such a device on treatment results is unclear. Therefore, we compared in an in vitro study the use of PE for scaling and root planing (SRP) with the conventional non-surgical therapy, hypothesizing that using a PE allows to remove more simulated hard deposits than without (nPE), influenced by the operators' experience and training. MATERIAL AND METHODS A sonic device and Gracey curettes were utilized by 11 operators (six dentists, five dental hygienists) in periodontitis manikins heads. The time required for treatment and the proportion of removed simulated hard deposits by SRP were measured. RESULTS Using the PE led to a significant difference in removal of simulated hard deposits (%) (mean ± SD) irrespective of operators' experience (PE 90.78 ± 12.10% (range 58.80-100%); nPE 79.98 ± 22.15% (range 38.10-100%, p < 0.001)), sub-analyses for different tooth types demonstrated a significant difference in favor of PE for front teeth (p < 0.001) and in the upper jaw independent of the tooth type (p < 0.001). Comparison of treatment times for two quadrants with and without PE showed a significantly longer treatment time with PE (∆22.27 ± 17.98 mins, p <0.001). CONCLUSIONS Within the present pilot study, the use of PE led to more removal of simulated hard deposits but was concomitantly related to more time and financial effort. Using PE was most beneficial in the front area. CLINICAL RELEVANCE PE may provide additional benefits for the removal of hard deposits compared to traditional SRP. The beneficial effect of PE seems not to be influenced by operators experience nor by pocket probing depth.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany.
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
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Fried WA, Chan KH, Darling CL, Fried D. Selective removal of dental calculus with a diode-pumped Er:YAG laser. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2019; 10857:108570M. [PMID: 31000908 PMCID: PMC6467515 DOI: 10.1117/12.2512937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Selective removal of dental calculus with high precision is best accomplished using lasers operating at high pulse repetition rates focused to a small spot size to limit damage to sound tissues. Conventional flash-lamp pumped Er:YAG lasers are poorly suited for this purpose, but new diode-pumped solid state (DPSS) Er:YAG lasers have become available operating at high pulse repetition rates. The purpose of this study was to determine if image-guided laser ablation can be used to selectively remove calculus from tooth surfaces with minimal damage to the underlying sound cementum and dentin. A DPSS Er:YAG laser system was used to selectively remove calculus from ten extracted teeth using sequential SWIR images at 1500-1750-nm. The selectivity of removal was assessed using digital microscopy and optical coherence tomography. Calculus was removed with minimal damage to the underlying sound cementum and dentin.
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Affiliation(s)
- William A. Fried
- University of California, San Francisco, San Francisco, CA 94143-0758
| | - Kenneth H. Chan
- University of California, San Francisco, San Francisco, CA 94143-0758
| | | | - Daniel Fried
- University of California, San Francisco, San Francisco, CA 94143-0758
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Evaluation of calculus imaging on root surfaces by spectral-domain optical coherence tomography. Photodiagnosis Photodyn Ther 2019; 25:275-279. [PMID: 30648636 DOI: 10.1016/j.pdpdt.2019.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/30/2018] [Accepted: 01/11/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this in vitro study was to evaluate the ability of optical coherence tomography (OCT) to display calculus on root surfaces. MATERIAL AND METHODS Ten teeth with calculus on the root surface were embedded in resin, omitting the root surface. A region of interest (ROI) was marked by small drill holes coronally and apically of the calculus and imaged by spectral-domain optical coherence tomography ([SD OCT], Telesto SP5, centre wavelength 1310 nm) and light microscopy (LM). To evaluate the impact of different fluids on calculus visualisation, using OCT, root surfaces were covered by a layer of NaCl and blood and displayed by OCT. Subsequently, teeth were completely covered with resin and sectioned for histological evaluation. Within the ROI, lengths of root surface and calculus were measured by LM and OCT, and the ratio [%] was calculated. In addition, at three sites of each ROI, agreement of presence and length of calculus was evaluated. Both methods were compared using Pearson's correlation. RESULTS Regarding the presence of calculus, agreement between LM and OCT was strong (κi = 0.783, p = 0.033), and measurements regarding the length of the calculus were strongly correlated (ri >0.906; pi <0.001). However, the values differed for dry (p = 0.023) and NaCl-covered root surfaces (p = 0.035). CONCLUSION Calculus on the root surface can be displayed by SD-OCT, which therefore may be suited as imaging technology for subgingival calculus in periodontal pockets.
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Yang VB, Curtis DA, Fried D. Cross-polarization reflectance imaging of root caries and dental calculus on extracted teeth at wavelengths from 400 to 2350 nm. JOURNAL OF BIOPHOTONICS 2018; 11:e201800113. [PMID: 29952066 DOI: 10.1002/jbio.201800113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
The identification of root caries and calculus on tooth roots is of increasing importance with our aging population. Exposed root surfaces are often impacted by erosion, abrasion, calculus and staining which can make the identification and management of caries challenging. Identification of dental calculus on root surfaces and verification of its removal is also important for patient education and to decrease susceptibility to caries and periodontal disease. The objective of this study was to determine how the contrast of root caries lesions and dental calculus varies with wavelength in the visible to near-infrared. The contrast of suspected root caries lesions and dental calculus on 30 extracted teeth was measured using cross-polarization reflectance measurements at wavelengths from 400 to 2350 nm. Significantly higher (P < 0.05) lesion contrast was measured at wavelengths greater than 1460 nm. Stains interfered significantly at wavelengths less than 850 nm yielding non-diagnostic contrast for root caries lesions. We postulate that the high absorption of water at longer wavelengths reduced the light scattering from the surrounding and underlying normal dentin, thus increasing the lesion contrast. This study indicates that wavelengths beyond 1400 nm are advantageous for imaging calculus and caries lesions on root surfaces due to the high contrast and lack of interference from stain.
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Affiliation(s)
- Vincent B Yang
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California
| | - Donald A Curtis
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California
| | - Daniel Fried
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California
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Sumra N, Kulshrestha R, Umale V, Chandurkar K. Lasers in non-surgical periodontal treatment – a review. J COSMET LASER THER 2018; 21:255-261. [DOI: 10.1080/14764172.2018.1525744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nida Sumra
- Consulting Periodontist, Private Practice, Mumbai, India
| | | | - Vinay Umale
- Senior Lecturer, Department of Orthodontics, Yogita Dental College, Khed Maharashtra, India
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Sanz-Sánchez I, Ortiz-Vigón A, Herrera D, Sanz M. Microbiological effects and recolonization patterns after adjunctive subgingival debridement with Er:YAG laser. Clin Oral Investig 2015; 20:1253-61. [PMID: 26419675 DOI: 10.1007/s00784-015-1617-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/21/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to assess the microbiological effects and recolonization patterns after non-surgical periodontal treatment protocol based on the adjunctive use of erbium-doped yttrium aluminium garnet (Er:YAG) laser. MATERIAL AND METHODS Patients diagnosed with chronic periodontitis were randomly assigned to two different treatment protocols: test, full-mouth subgingival ultrasonic instrumentation followed by Er-YAG laser application 1 week later to sites with initial probing pocket depth ≥4.5 mm; and control, full-mouth ultrasonic subgingival instrumentation within 1 week. Clinical (at sampled sites) and microbiological (culture-based) parameters were recorded at baseline and 3 and 12 months. Microbiological variables included total counts, frequency of detection, proportions and counts of target species. RESULTS Results from 19 test and 21 control patients were compared. Minor changes were observed for total colony-forming units, with no differences between groups. For the frequency of detection, a limited and similar impact in both groups was observed for the most prevalent (over 80 %) periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum). For proportions, reductions in P. gingivalis occurred at 3 months, both in the test and control groups (from 16.3 to 10 % and 16 to 14.8 %, respectively), although these differences were not statistically significant. At 12 months, the test group showed a statistically significant greater reduction in probing depth for the sampled sites. CONCLUSIONS The adjunctive use of Er:YAG laser when compared with conventional ultrasonic debridement did not provide a microbiological added benefit. CLINICAL RELEVANCE Even though some clinical benefits with the adjunctive laser application were identified when comparing both treatment protocols, there were no differences in microbiological outcomes or in the bacterial recolonization patterns.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Postgraduate Clinic in Periodontology, Faculty of Odontology, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N., 28040, Madrid, Spain.
| | - Alberto Ortiz-Vigón
- Postgraduate Clinic in Periodontology, Faculty of Odontology, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N., 28040, Madrid, Spain
| | - David Herrera
- Postgraduate Clinic in Periodontology, Faculty of Odontology, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N., 28040, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Postgraduate Clinic in Periodontology, Faculty of Odontology, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N., 28040, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Sanz-Sánchez I, Ortiz-Vigón A, Matos R, Herrera D, Sanz M. Clinical Efficacy of Subgingival Debridement With Adjunctive Erbium:Yttrium-Aluminum-Garnet Laser Treatment in Patients With Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2015; 86:527-35. [DOI: 10.1902/jop.2014.140258] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Lavu V, Sundaram S, Sabarish R, Rao SR. Root Surface Bio-modification with Erbium Lasers- A Myth or a Reality?? Open Dent J 2015; 9:79-86. [PMID: 25713635 PMCID: PMC4333616 DOI: 10.2174/1874210601509010079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 12/03/2014] [Accepted: 12/10/2014] [Indexed: 12/19/2022] Open
Abstract
The objective of this literature review was to critically review the evidence available in the literature regarding the expediency of erbium family of lasers for root bio modification as a part of periodontal therapy. The literature search was performed on the Pubmed using MeSH words such as "lasers/therapeutic use, scaling, dental calculus, tooth root/anatomy and histology, ultrasonic therapy". The studies were screened and were grouped as follows: those evaluating a) efficacy for calculus removal with the Erbium family of laser b) root surface changes following Er YAG and Er Cr YSGG application c) comparative studies of the Er YAG, Er Cr YSGG lasers versus conventional methods of root surface modification d) Bio compatibility of root surface following Erbium laser treatment e) Studies on the combined efficacy of laser root modification with conventional methods towards root surface bio-modification f) Studies on effectiveness of root surface bio-modification prior to root coverage procedures. In conclusion, the erbium family has a proven anti-bacterial action, predictable calculus removal, minimal root substance removal, and appears to favor cell attachment. The Erbium family of lasers appears to be a useful adjunct for the management of periodontal disease.
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Affiliation(s)
- Vamsi Lavu
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Subramoniam Sundaram
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Ram Sabarish
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Suresh Ranga Rao
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
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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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Reliability of recordings of subgingival calculus detected using an ultrasonic device. Clin Oral Investig 2014; 19:709-16. [PMID: 25055747 DOI: 10.1007/s00784-014-1287-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/10/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the intra-examiner reliability of recordings of subgingival calculus detected using an ultrasonic device, and to investigate the influence of subject-, tooth- and site-level factors on the reliability of these subgingival calculus recordings. MATERIALS AND METHODS On two occasions, within a 1-week interval, 147 adult periodontitis patients received a full-mouth clinical periodontal examination by a single trained examiner. Duplicate subgingival calculus recordings, in six sites per tooth, were obtained using an ultrasonic device for calculus detection and removal. RESULTS Agreement was observed in 65 % of the 22,584 duplicate subgingival calculus recordings, ranging 45 % to 83 % according to subject. Using hierarchical modeling, disagreements in the subgingival calculus duplicate recordings were more likely in all other sites than the mid-buccal, and in sites harboring supragingival calculus. Disagreements were less likely in sites with PD ≥ 4 mm and with furcation involvement ≥ degree 2. Bleeding on probing or suppuration did not influence the reliability of subgingival calculus. At the subject-level, disagreements were less likely in patients presenting with the highest and lowest extent categories of the covariate subgingival calculus. CONCLUSIONS AND CLINICAL RELEVANCE The reliability of subgingival calculus recordings using the ultrasound technology is reasonable. The results of the present study suggest that the reliability of subgingival calculus recordings is not influenced by the presence of inflammation. Moreover, subgingival calculus can be more reliably detected using the ultrasound device at sites with higher need for periodontal therapy, i.e., sites presenting with deep pockets and premolars and molars with furcation involvement.
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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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Krohn-Dale I, Bøe OE, Enersen M, Leknes KN. Er:YAG laser in the treatment of periodontal sites with recurring chronic inflammation: a 12-month randomized, controlled clinical trial. J Clin Periodontol 2012; 39:745-52. [PMID: 22694321 DOI: 10.1111/j.1600-051x.2012.01912.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2012] [Indexed: 11/26/2022]
Abstract
AIM The objective of this randomized, controlled clinical trial was to compare the clinical and microbiological effects of pocket debridement using erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser with conventional debridement in maintenance patients. MATERIAL & METHODS Fifteen patients, all smokers, having at least four teeth with residual probing depth (PD) ≥ 5 mm were recruited. Two pockets in two jaw quadrants were randomly assigned to subgingival debridement using an Er:YAG laser (test) or ultrasonic scaler/curette (control) at 3-month intervals. Relative attachment level (RAL), PD, bleeding on probing and dental plaque were recorded at baseline and at 6 and 12 months. Microbiological subgingival samples were taken at the same time points and analysed using a checkerboard DNA-DNA hybridization technique. RESULTS A significant decrease in PD took place in both treatments from baseline to 12 months (p < 0.01). In the control, the mean initial PD decreased from 5.4 to 4.0 mm at 12 months. For the test, a similar decrease occurred. No significant between-treatment differences were shown at any time point. The mean RAL showed no overall significant inter- or intra-treatment differences (p > 0.05). No significant between-treatment differences were observed in subgingival microbiological composition or total pathogens. CONCLUSION The results failed to support that an Er:YAG laser may be superior to conventional debridement in the treatment of smokers with recurring chronic inflammation. This appears to be the first time that repeated Er-YAG laser instrumentation has been compared with mechanical instrumentation of periodontal sites with recurring chronic inflammation over a clinically relevant time period.
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Affiliation(s)
- Ivar Krohn-Dale
- Department of Clinical Dentistry - Periodontotics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Soo L, Leichter JW, Windle J, Monteith B, Williams SM, Seymour GJ, Cullinan MP. A comparison of Er:YAG laser and mechanical debridement for the non-surgical treatment of chronic periodontitis: A randomized, prospective clinical study. J Clin Periodontol 2012; 39:537-45. [DOI: 10.1111/j.1600-051x.2012.01873.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2012] [Indexed: 01/01/2023]
Affiliation(s)
- Lingfeng Soo
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Jonathan W. Leichter
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Judith Windle
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Brian Monteith
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Sheila M. Williams
- Preventive and Social Medicine, Dunedin School of Medicine; University of Otago; Dunedin; New Zealand
| | - Gregory J. Seymour
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Mary P. Cullinan
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
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Badran Z, Demoersman J, Struillou X, Boutigny H, Weiss P, Soueidan A. Laser-induced fluorescence for subgingival calculus detection: scientific rational and clinical application in periodontology. Photomed Laser Surg 2011; 29:593-6. [PMID: 21495861 DOI: 10.1089/pho.2010.2951] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To review the data available on the laser-induced calculus fluorescence phenomenon and the calculus detection devices as well as to determine the clinical relevance of using commercialized calculus detection devices in periodontal treatment. METHODS In vitro or in vivo English publications found on Medline. RESULTS In vitro and in vivo studies showed that the devices on the market had a satisfactory detection capacity. Very few studies demonstrated that the erbium:yttrium-aluminium-garnet (Er:YAG) laser debridement, when performed with automatic calculus detection, could lead to improvements at the clinical level, and the outcome was similar to that obtained with conventional treatments. CONCLUSIONS Although preliminary data were encouraging, there was a lack of scientific data concerning the calculus detection devices. Therefore, future studies are crucial for determining the clinical relevance of such equipment.
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Affiliation(s)
- Zahi Badran
- Department of Periodontology, Faculty of Dental Surgery, Nantes, France
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Jepsen S, Deschner J, Braun A, Schwarz F, Eberhard J. Calculus removal and the prevention of its formation. Periodontol 2000 2010; 55:167-88. [DOI: 10.1111/j.1600-0757.2010.00382.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meissner G, Kocher T. Calculus-detection technologies and their clinical application. Periodontol 2000 2010; 55:189-204. [DOI: 10.1111/j.1600-0757.2010.00379.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schwarz F, Aoki A, Sculean A, Becker J. The impact of laser application on periodontal and peri-implant wound healing. Periodontol 2000 2010; 51:79-108. [PMID: 19878471 DOI: 10.1111/j.1600-0757.2009.00301.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Schoenly JE, Seka W, Rechmann P. Investigation into the optimum beam shape and fluence for selective ablation of dental calculus at λ
= 400 nm. Lasers Surg Med 2010; 42:51-61. [DOI: 10.1002/lsm.20884] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Polansky R, Haas M, Heschl A, Wimmer G. Clinical effectiveness of photodynamic therapy in the treatment of periodontitis. J Clin Periodontol 2009; 36:575-80. [DOI: 10.1111/j.1600-051x.2009.01412.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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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Braun A, Dehn C, Krause F, Jepsen S. Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 2008; 35:877-84. [DOI: 10.1111/j.1600-051x.2008.01303.x] [Citation(s) in RCA: 193] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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