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Aoki A, Mizutani K, Taniguchi Y, Lin T, Ohsugi Y, Mikami R, Katagiri S, Meinzer W, Iwata T. Current status of Er:YAG laser in periodontal surgery. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:1-14. [PMID: 38148873 PMCID: PMC10750110 DOI: 10.1016/j.jdsr.2023.11.002] [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: 08/07/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 12/28/2023] Open
Abstract
Lasers have numerous advantageous tissue interactions such as ablation or vaporization, hemostasis, bacterial killing, as well as biological effects, which induce various beneficial therapeutic effects and biological responses in the tissues. Thus, lasers are considered an effective and suitable device for treating a variety of inflammatory and infectious conditions of periodontal disease. Among various laser systems, the Er:YAG laser, which can be effectively and safely used in both soft and hard tissues with minimal thermal side effects, has been attracting much attention in periodontal therapy. This laser can effectively and precisely debride the diseased root surface including calculus removal, ablate diseased connective tissues within the bone defects, and stimulate the irradiated surrounding periodontal tissues during surgery, resulting in favorable wound healing as well as regeneration of periodontal tissues. The safe and effective performance of Er:YAG laser-assisted periodontal surgery has been reported with comparable and occasionally superior clinical outcomes compared to conventional surgery. This article explains the characteristics of the Er:YAG laser and introduces its applications in periodontal surgery including conventional flap surgery, regenerative surgery, and flapless surgery, based on scientific evidence from currently available basic and clinical studies as well as cases reports.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
- Taniguchi Dental Clinic, Kita 7−17, 18-chome, Nango-dori, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Taichen Lin
- School of Dentistry, Chung Shan Medical University (CSMU), No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Dolińska E, Skurska A, Dymicka-Piekarska V, Milewski R, Pietruska M. Matrix Metalloproteinase 9 (MMP-9) and Interleukin-8 (IL-8) in Gingival Crevicular Fluid after Minimally Invasive Periodontal Surgery with or without Er:YAG and Nd:YAG Laser Application. Antibiotics (Basel) 2024; 13:704. [PMID: 39200004 PMCID: PMC11350890 DOI: 10.3390/antibiotics13080704] [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: 06/16/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND This study aimed to evaluate alterations in the concentrations of matrix metalloproteinase-9 (MMP-9) and interleukin-8 (IL-8) within gingival crevicular fluid (GCF) extracted from the intrabony periodontal defect site before and after minimally invasive regenerative surgery, with or without supplemental laser application. The surgical procedure was performed using the modified minimally invasive surgical technique (M-MIST). METHODS Thirty-eight patients, each presenting with a single vertical defect, were randomly assigned to either the test (M-MIST + Er:YAG + Nd:YAG) or the control group (M-MIST). IL-8 and MMP-9 levels (primary outcomes of the study) were assessed prior to therapy, after 2 and 4 weeks, and 6 months following the surgical procedure by means of dedicated ELISA kits. RESULTS Both procedures were clinically effective as evidenced by probing depth (PD) reduction and clinical attachment level (CAL) gain at the 6-month follow-up. No statistical differences were observed in the levels of MMP-9 and IL-8 between the groups at any time point assessed. The changes in the level of MMP-9 and IL-8 over time were not statistically significant in any group. IL-8 was positively correlated with MMP-9 in the control group throughout the study and in the test group 2 weeks and 6 months post-op. CONCLUSIONS Within the limitations of this study, the additional application of Er:YAG + Nd:YAG lasers alongside the M-MIST procedure did not enhance the clinical and biochemical treatment outcomes compared to M-MIST alone.
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Affiliation(s)
- Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
| | - Anna Skurska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
- Department of Integrated Dentistry, Medical University of Bialystok, ul. M. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Violetta Dymicka-Piekarska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15, 15-269 Bialystok, Poland;
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
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Saleh MHA, Dias DR, Ravida A, Wang HL. Root surface biomodification in periodontal therapy: Biological rationale and clinical applications. Periodontol 2000 2024. [PMID: 38978341 DOI: 10.1111/prd.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/09/2024] [Accepted: 05/10/2024] [Indexed: 07/10/2024]
Abstract
Regenerative periodontal therapy aims to form new cementum, periodontal ligament, and alveolar bone, all sealed by gingival tissue. The root surface acts as the wound margin during this regeneration process. Root surface biomodification (root conditioning/root decontamination), therefore, seems instrumental in promoting surface decontamination and enhancing tissue attachment by removing the smear layer, exposing collagen fibrils, and facilitating blood clot formation and stabilization. This review attempted to provide an all-encompassing, evidence-based assessment of the role of root surface biomodification in regenerative periodontal therapy, particularly in intrabony defects, furcation defects, and root coverage procedures. The reviewed evidence suggested that root conditioning agents, whether used independently or in conjunction with bone graft materials, biological agents, membranes, or connective tissue grafts, do not offer any clinical advantage regarding clinical attachment gain. Thus, integrating chemical methods with the mechanical root instrumentation process does not necessarily contribute to superior clinical outcomes.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Andrea Ravida
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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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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Aoki A, Mizutani K, Mikami R, Ohsugi Y, Kobayashi H, Akizuki T, Taniguchi Y, Takeuchi Y, Katagiri S, Sasaki Y, Komaki M, Meinzer W, Izumi Y, Iwata T. Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol 2023; 94:1187-1199. [PMID: 37015852 DOI: 10.1002/jper.22-0552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. METHODS Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12 months. RESULTS Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs. 1.89 mm on average; p = 0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs. 1.06 mm; p = 0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p = 0.031), compared with SRP alone. CONCLUSION The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Taniguchi Dental Clinic, Sapporo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiyuki Sasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University (KDU), Yokosuka, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Investigation of bactericidal effect of a mid-infrared free electron laser on Escherichia coli. Sci Rep 2022; 12:18111. [PMID: 36302931 PMCID: PMC9612618 DOI: 10.1038/s41598-022-22949-9] [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: 06/02/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
The rapid increase in the number of bacteria that are resistant to many commonly used antimicrobial agents and their global spread have become a major problem worldwide. In particular, for periodontal disease, which is a localized infection, there is a growing need for treatment methods that do not primarily involve antimicrobial agents, and antimicrobial photodynamic therapy (aPDT) is attracting attention. In this study, the bactericidal effects of a mid-infrared free electron laser (MIR-FEL) on E. coli were investigated as a basic study to examine the applicability of MIR-FELs, which can selectively excite molecular vibrations due to their wavelength tunability, to aPDT. The optimal irradiation wavelengths to be examined in this study were determined from the infrared spectrum of the bacteria, which was obtained using Fourier transform infrared spectroscopy. Five irradiation wavelengths (6.62, 6.88, 7.14, 8.09 and 9.26 µm) were selected from the FT-IR spectrum, and we found that the bactericidal effects at a wavelength of 6.62 µm were markedly stronger than those observed at the other wavelengths. At this wavelength corresponding to the Amide II band, the bacterial survival rate decreased significantly as the irradiation time increased. On the contrary, irradiation of a neodymium-doped yttrium aluminum garnet (Nd: YAG) laser at 1.06 µm exhibited no distinct bactericidal effect. No morphological changes were observed after MIR-FEL irradiation, suggesting that a bacterial organelle molecule may be the target of MIR-FEL irradiation, but the exact target was not identified. Furthermore, the temperature change induced in the culture medium by the laser irradiation was ± 1.5 °C at room temperature. These results suggest that the bactericidal effects of MIR-FEL are derived from photochemical reactions involving infrared photons, since E. coli is usually killed by heating it to 75 °C for 1 min or longer.
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The Effect of an Er, Cr: YSGG Laser Combined with Implantoplasty Treatment on Implant Surface Roughness and Morphologic Analysis: A Pilot In Vitro Study. J Funct Biomater 2022; 13:jfb13030133. [PMID: 36135568 PMCID: PMC9504904 DOI: 10.3390/jfb13030133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Although laser irradiation and implantoplasty (IP) are both treatment options for peri-implantitis, no studies have yet combined these two treatment solutions. The aim of this study was to identify the effect of an Er, Cr: YSGG laser on the IP surface. In experiment 1, TiUnite anodized surface implants were treated with an Er, Cr: YSGG laser at 0.5 to 2 W on the panel energy setting and 20 Hz under water irrigation. In experiment 2, all implant surfaces were treated with the IP procedure first, then irradiated with the Er, Cr: YSGG laser. All samples were analyzed by stereomicroscopy, scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and surface topography. Stereomicroscopy and SEM revealed no obvious surface change at any energy setting once the surface was polished with the IP procedure, whereas damage was caused to the TiUnite original implant surface when the Er, Cr: YSGG laser panel energy was set at 1 W or higher. EDS showed no significant difference in element composition once the surface was polished with the IP procedure, while a compositional change was detected when the Er, Cr: YSGG laser panel energy was set to 0.5 W or higher to irradiate the original TiUnite surface. Surface roughness may be related to laser irradiation energy, but no significant changes occurred following IP. These results indicated that the Er, Cr: YSGG laser may have little effect on the post-IP surface compared with the virgin TiUnite surface.
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Estrin NE, Lesniewski A, McClain S, Hou W, Romanos GE. Thermal Penetration Depth of Pulsed Lasers in Gingival Tissues: An In Vitro Study. Photobiomodul Photomed Laser Surg 2022; 40:410-416. [DOI: 10.1089/photob.2021.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nathan E. Estrin
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Agata Lesniewski
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Steve McClain
- Department of Dermatology, School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Georgios E. Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
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Estrin NE, Moraschini V, Zhang Y, Romanos GE, Sculean A, Miron RJ. Combination of Nd:YAG and Er:YAG lasers in non-surgical periodontal therapy: a systematic review of randomized clinical studies. Lasers Med Sci 2022; 37:2737-2743. [PMID: 35364744 DOI: 10.1007/s10103-022-03548-6] [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: 01/02/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
Lasers are increasingly utilized in the non-surgical treatment of periodontal disease. The aim of the present systematic review with meta-analysis was to investigate the combination use of Nd:YAG and Er:YAG laser therapy in the treatment of severe periodontitis. A systematic review of the literature including searches in PubMed/Medline, Cochrane Library, Google Scholar, and Grey Literature databases, as well as manual searches, was performed until November 1, 2021. Only studies a combination of lasers during non-surgical treatment of pockets ≥ 6mm were included. The eligibility criteria for meta-analysis comprised randomized controlled trials (RCTs) comparing the use of combination laser therapy with/without adjunctive mechanical for the non-surgical management of periodontitis. From 57 initial articles, 6 full-text articles were assessed for eligibility. Two studies were excluded, one study was not a randomized clinical trial (case series), and one study was an in vitro study. Four RCTs were included in the meta-analysis. It was shown that combination of Nd:YAG and Er:YAG may be beneficial for non-surgical periodontal therapy with an additional average reduction in pocket depth and clinical attachment level reported at 1.01 and 0.77 mm respectively when compared to controls. The findings suggest that the combination of Nd:YAG and Er:YAG lasers may lead to additional clinical improvements compared to nonsurgical treatment alone. Future research is needed to substantiate these findings and optimize clinical guidelines including more specific laser protocols. Preliminary data suggest favorable outcomes following the combination of Nd:YAG and Er:YAG lasers for non-surgical periodontal therapy.
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Affiliation(s)
- Nathan E Estrin
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
| | - Yufeng Zhang
- Department of Oral Implantology, Wuhan University, Wuhan, China
| | - George E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Yang C, Wang X, Wang Y. Effect of diode laser combined with minocycline hydrochloride in nonsurgical periodontal therapy: a randomized clinical trial. BMC Oral Health 2022; 22:71. [PMID: 35287641 PMCID: PMC8922840 DOI: 10.1186/s12903-022-02106-4] [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: 10/04/2021] [Accepted: 03/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background This study aimed to assess the effect of diode laser combined with minocycline hydrochloride in conventional nonsurgical periodontal therapy. Methods Ninety-two patients and 1206 teeth were included in this study. The patients were diagnosed moderate or severe periodontal diseases with the presence of teeth in at least 3 quadrants in the oral cavity. Each patient’s quadrants were randomly divided into three treatment groups as following, Control group: scaling and root planning (SRP); Experimental group 1 (Exp 1): SRP + minocycline hydrochloride; Experimental group 2 (Exp 2): SRP + 809 nm diode laser + minocycline hydrochloride. The minocycline in Exp 1 and Exp 2 was applied once per week, for 4 weeks. Clinical examinations including periodontal probing depth (PD), clinical attachment level (CAL) and bleeding index (BI), and the secretion of inflammatory factor (tumor necrosis factor, TNF-α) was detected by ELISA before and 3, 6 months after the treatments. The differences among these groups were assessed by One-Way ANOVA and Kruskal–Wallis test. P-value < 0.05 was considered significant. Results All the periodontal indexes (PD, CAL and BI) were improved after each treatment and the secretion of TNF-α was reduced for all three groups. In patients with deep periodontal pockets, Exp 2 showed significant improvements in all indexes comparison with Con group and Exp group 1. Conclusions The synergistic effect of SRP and 809 nm diode laser combined with minocycline hydrochloride could play an efficient and reliable effect in the nonsurgical periodontal treatment approach. Trial registration The clinical trial was retrospectively registered in chictr.org.cn with registration ChiCTR2100051708 (01/10/2021).
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Affiliation(s)
- Congchong Yang
- Department of Cariology and Endodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xikai Wang
- Department of Occupational Disease, Xi'an Central Hospital, Xi'an, Shaanxi, China
| | - Yanli Wang
- Department of Stomatology, Xi'an Central Hospital, No. 161 Xiwu Road, Xincheng District, Xi'an, 710003, Shaanxi, China.
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Mizutani K, Mikami R, Tsukui A, Nagai S, Pavlic V, Komada W, Iwata T, Aoki A. Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery. J Prosthodont Res 2021; 66:346-352. [PMID: 34545008 DOI: 10.2186/jpr.jpr_d_21_00045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This article describes a novel, minimally invasive procedure called Er:YAG laser micro-keyhole surgery (EL-MIKS) that removes metal or amalgam tattoos in the gingiva adjacent to prosthetic teeth without gingival deformity and recession. We aimed to evaluate the clinical efficacy of EL-MIKS for removing metal tattoos and present its long-term treatment outcomes. METHODS The EL-MIKS procedure consists of several steps that are all performed under a microscope. First, a micro-keyhole (1-2 mm diameter) was prepared using an Er:YAG laser in the center of the metal pigmentation. The connective tissue was evaporated in the deep layer, where metal debris was deposited. Second, within the accessible range, the irradiation angle was changed in various directions to ablate the metal pieces and discolored connective tissue without enlarging the keyhole. Finally, after blood filled the space created by the tissue evaporation, the surface of the blood clot at the entrance of the micro-keyhole was thermally coagulated with defocus laser irradiation. Pigmentation that could not be successfully removed from a single micro-keyhole was treated by forming new micro-keyholes at a distance of 3 mm or more from each previously created hole. Depigmentation over an extended area was completed over a few sessions every 4 weeks without gingival recession after surgery. CONCLUSIONS EL-MIKS, a novel depigmentation technique, was able to successfully remove an extended area of metal tattoos in the gingiva using a simpler, easier, and less invasive procedure than conventional periodontal plastic surgery. Esthetic restoration was successfully achieved without postoperative alteration of the gingival contour.
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Affiliation(s)
- Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | | | | | - Verica Pavlic
- Department of Periodontology and Oral Medicine, Medical Faculty University of Banjaluka.,Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka
| | - Wataru Komada
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
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12
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Gurpegui Abud D, Shariff JA, Linden E, Kang PY. Erbium-doped: yttrium-aluminum-garnet (Er:YAG) versus scaling and root planing for the treatment of periodontal disease: A single-blinded split-mouth randomized clinical trial. J Periodontol 2021; 93:493-503. [PMID: 34286867 DOI: 10.1002/jper.21-0133] [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: 03/04/2021] [Revised: 07/10/2021] [Accepted: 07/10/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This randomized, controlled clinical trial aimed to compare the differences in periodontal clinical outcomes, duration of the procedure, and patient's experience between conventional scaling and root planing and erbium-doped: yttrium-aluminum-garnet (Er:YAG) in the treatment of generalized moderate to severe chronic periodontitis or generalized Stages II or III, and Grade B periodontitis based on the Centers for Disease Control (CDC), American Academy of Periodontology (AAP), and European Federation of Periodontology (EFP) definitions. METHODS Thirty subjects were initially recruited. In a split-mouth fashion, right and left sides were randomly allocated into two treatment arms: conventional scaling and root planing (C-SRP) versus laser-assisted scaling and root planing (L-SRP). A blinded examiner recorded clinical measurements at baseline and 3 months. Duration of the procedure was also recorded for each visit, and the patient's experience was assessed with a questionnaire at baseline, 1, and 3 months. RESULTS The final sample consisted of 26 subjects. Both treatments resulted in overall improvement, but no significant differences were found between modalities for clinical attachment gain or probing depth reduction. The duration of the procedure was approximately half for L-SRP, and postoperative sensitivity was greater in C-SRP. CONCLUSIONS The low-energy protocol with Er:YAG (50 mJ) used for the non-surgical treatment of moderate-severe chronic or Stage II-III, Grade B periodontitis performed in this study population was a treatment modality that yielded similar clinical improvements when compared to conventional scaling and root planing.
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Affiliation(s)
- Daniela Gurpegui Abud
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York.,Periodontics, Touro College of Dental Medicine at New York Medical College, Hawthorne, New York
| | - Jaffer A Shariff
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York.,Periodontics, Touro College of Dental Medicine at New York Medical College, Hawthorne, New York
| | - Eric Linden
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York
| | - Philip Y Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York
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13
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Zhu J, Wei R, Lv X, Qu C. Efficacy of a combined Er:YAG laser and Nd:YAG laser in non-surgical treatment for severe periodontitis. Lasers Med Sci 2021; 37:1095-1100. [PMID: 34125321 PMCID: PMC8202041 DOI: 10.1007/s10103-021-03357-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/07/2021] [Indexed: 12/05/2022]
Abstract
Severe periodontitis is challenging to treat. The aim of this study was to evaluate the efficacy of a combined Er:YAG laser (ERL) and Nd:YAG laser (NDL) in non-surgical treatment for severe periodontitis. One week after supragingival scaling, 32 systemically healthy patients with stage III or IV periodontitis were randomly divided into a control group (16 subjects) and a test group (16 subjects). The control group was treated by scaling and root planning (SRP) with ultrasonic equipment and manual instruments, and the test group was treated by SRP as well as ERL and NDL. Before treatment, the following clinical parameters were recorded at baseline: debris index (DI), probing depth (PD), clinical attachment level (CAL), and percentage of bleeding on probing (BOP %). Two months after therapy, the clinical parameters were recorded again, and the results between the groups were compared. All clinical parameters were significantly improved in both groups after therapy. For moderately deep periodontal pockets (4 mm ≤ PD ≤ 6 mm), the gains in CAL were greater in the test group (1.17 ± 1.47 mm) than in the control group (0.46 ± 2.78 mm), while no significant difference was found for PD reductions after therapy between the two groups. For deep periodontal pockets (PD > 6 mm), the differences in all of the clinical parameters were similar between the test group and the control group. In this short-term study, ERL and NDL radiation exhibited potential advantages in improving the clinical attachment level compared to conventional SRP in the non-surgical treatment of severe periodontitis.
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Affiliation(s)
- Jie Zhu
- Department of Stomatology, Peking University International Hospital, Shengmingyuan road, Changping District, Beijing, 102206, China.
| | - Rong Wei
- Department of Stomatology, Peking University International Hospital, Shengmingyuan road, Changping District, Beijing, 102206, China
| | - Xiaodan Lv
- Department of Stomatology, Peking University International Hospital, Shengmingyuan road, Changping District, Beijing, 102206, China.,Department of Stomatology, Shijiazhuang Second Hospital, Shijiazhuang, China
| | - Chunna Qu
- Department of Stomatology, Peking University International Hospital, Shengmingyuan road, Changping District, Beijing, 102206, China
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14
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Polak D, Shani-Kdoshim S, Alias M, Shapira L, Stabholz A. In vitro efficacy of biofilm removal from titanium surfaces using Er:YAG laser: Comparison of treatment protocols and ablation parameters. J Periodontol 2021; 93:100-109. [PMID: 34031877 DOI: 10.1002/jper.19-0574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aims of the present study were to compare the antibacterial effect of Er:YAG laser with other acceptable decontamination methods and to single out the optimal laser device parameters for effective bacterial elimination. METHODS A multispecies biofilm which was composed of Streptococcus sanguis, Actinomyces naeslundii, Porphyromonas gingivalis, and Fusobacterium nucleatum was grown on sandblasted and acid-etched (SLA, homogeneous moderately microrough, and nanosmooth surface) titanium disks. The biofilm was removed from the coated disks by hand curets, ultrasonic device, nylon brush (dental polishing prophy cup), or Er:YAG. Additionally, different parameter combinations of the laser machine were examined to reach an optimal lasing power for bacterial elimination/reduction. Residual biofilm samples were stained with bacterial live/dead staining and quantified using a fluorescent microscope. RESULTS A multispecies biofilm was accumulated on the SLA titanium surfaces exhibiting cluster distribution next to bacteria-poor areas. Hand curets, nylon brushes, and the ultrasonic device showed limited capability to effectively remove the biofilm from the SLA surfaces as opposed to the Er:YAG which displayed a superior ability to remove the biofilm. All Er:YAG parameter combinations that were evaluated as well as the tested "tip to target" distances showed similar excellent anti-biofilm effects. Furthermore, we observed that the Er:YAG capability of biofilm removal is not only due to its light emission, but depends on its water irrigation as well. CONCLUSIONS Er:YAG laser has an excellent biofilm removal capability compared with hand curets, ultrasonic devices, or nylon brushes even when low energy parameters and low power settings are used. Additionally, an excellent antibacterial effect can be reached using a non-contact mode of 1 to 5 mm "tip to target" distance.
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Affiliation(s)
- David Polak
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Ein Kerem, Jerusalem, Israel
| | - Sharon Shani-Kdoshim
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Ein Kerem, Jerusalem, Israel
| | - Mary Alias
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Ein Kerem, Jerusalem, Israel
| | - Lior Shapira
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Ein Kerem, Jerusalem, Israel
| | - Ayala Stabholz
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Ein Kerem, Jerusalem, Israel
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15
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Laky M, Müller M, Laky B, Arslan M, Wehner C, Husejnagic S, Lettner S, Moritz A, Rausch-Fan X. Short-term results of the combined application of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and erbium-doped yttrium aluminum garnet (Er:YAG) laser in the treatment of periodontal disease: a randomized controlled trial. Clin Oral Investig 2021; 25:6119-6126. [PMID: 33813638 PMCID: PMC8531101 DOI: 10.1007/s00784-021-03911-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/23/2021] [Indexed: 01/24/2023]
Abstract
Objectives Nd:YAG and Er:YAG lasers have been previously used as an adjunct in periodontal therapy. The aim of this single-blinded randomized controlled clinical trial was to evaluate the efficacy of a combined application of Nd:YAG and Er:YAG laser irradiation in periodontal treatment. Materials and methods Twenty-two patients with at least one site of ≥ 6 mm periodontal probing depth (PPD) after mechanical debridement with curettes and sonic instruments at periodontal reevaluation were included in the study. Patients were randomly allocated at a 1:1 ratio to either a combined Nd:YAG/Er:YAG laser therapy (test group) or a “turned off” laser therapy (control group). The Nd:YAG laser was used for periodontal pocket deepithelialization and to stabilize the resulting blood clot. The Er:YAG laser was primarily used for root surface modification. PPD (mm), clinical attachment level (CAL, mm), and bleeding on probing (BOP, +/−) at the site of laser treatment were evaluated at baseline and 2 months after treatment. Results The mean improvements from baseline to 2-month follow-up for PPD were significantly better in the laser group (2.05 ± 0.82 mm) compared to the control group (0.64 ± 0.90 mm; p = 0.001). Likewise, the gain in CAL was significantly better in the laser group (1.50 ± 1.10 mm) than in the control group (0.55 ± 1.01mm; p = 0.046). Conclusions The combined application of Nd:YAG and Er:YAG laser irradiation as an adjunct to conventional non-surgical therapy showed a significant beneficial effect on periodontal treatment results. Clinical relevance Combined Nd:YAG and Er:YAG laser irradiation could be a useful procedure additionally to conventional non-surgical periodontal therapy to improve periodontal treatment results. Clinical trial registration ISRCTN registry #ISRCTN32132076
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Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Maximilian Müller
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Brenda Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Muazzez Arslan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Christian Wehner
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Selma Husejnagic
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna, Sensengasse 2a, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.,Division for Dental Student Training and Patient Care, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
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16
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Kang J, Yi M, Chen J, Peng M. Comparative assessment between bio-adhesive material and silk suture in regard to healing, clinical attachment level and width of keratinized gingiva in gingival recession defects cases. Sci Prog 2021; 104:368504211011868. [PMID: 33940998 PMCID: PMC10454994 DOI: 10.1177/00368504211011868] [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] [Indexed: 11/15/2022]
Abstract
The objective of this study was to compare the silk suture with a cyanoacrylate adhesive to stabilize the free gingival graft in conjunction with Er: YAG laser-assisted recipient site preparation to augment the keratinized tissue in gingival recession cases. This randomized trial comprised of 300 recession defects patients. All the included patients were diagnosed using Miller class I and II gingival recession defects classification. Group I sites were treated with a free gingival graft (FGG) harvested using an Er: YAG laser and further sutured with silk. Group II sites were stabilized with isoamyl 2 cyanoacrylate bio-adhesive material. Clinical parameters, such as gingival recession depth, clinical attachment level, gain in gingival tissue thickness, and width of keratinized gingiva were recorded at baseline, and at third month, sixth month, and 12th month postoperatively. The mean changes in gingival recession from months 3 to 6 and months and 6 to 12 were significant (p < 0.05) in both groups. However, the improvement in recession depth was better in group II than in group I. The mean change in clinical attachment level did not differ significantly between the groups at the different time intervals. However, values tended to be higher in group II than in group I. The width of the keratinized gingiva tended to be higher from baseline to 3 months, baseline to 6 months, baseline to 12 months, 3 to 6 months, and from 6 to 12 months in group II as compared with group I (p > 0.05). Cyanoacrylate could be used as a substitute to silk sutures to stabilize FGGs. Cyanoacrylate was easy to apply, consumed less operating time, and was considered equally efficacious for stabilizing FGGs.
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Affiliation(s)
- Jing Kang
- Department of Orthodontics, Shanghai Huangpu District 2nd Dental Disease Prevention and Treatent Institute, Shanghai, China
| | - Min Yi
- Department of Periodontal, Shanghai Huangpu District 2nd Dental Disease Prevention and Treatment Institute, Shanghai, China
| | - Jie Chen
- Department of Radiology, Shanghai Huangpu District 2nd Dental Disease Prevention and Treatment Institute, Shanghai, China
| | - Minghui Peng
- Department of Orthodontics, Shanghai Huangpu District 2nd Dental Disease Prevention and Treatent Institute, Shanghai, China
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17
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Salvi GE, Stähli A, Schmidt JC, Ramseier CA, Sculean A, Walter C. Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:176-198. [PMID: 31859395 DOI: 10.1111/jcpe.13236] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/07/2019] [Accepted: 12/14/2019] [Indexed: 12/13/2022]
Abstract
AIM To compare the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical mechanical instrumentation alone in untreated periodontitis patients. MATERIALS AND METHODS Two focused questions were addressed using the Population, Intervention, Comparison and Outcome criteria as follows: in patients with untreated periodontitis, (a) does laser application provide adjunctive effects on probing pocket depth (PPD) changes compared with non-surgical instrumentation alone? and (b) does application of aPDT provide adjunctive effects on PPD changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Results of the meta-analysis are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. RESULTS Out of 1,202 records, 10 articles for adjunctive laser and 8 for adjunctive aPDT were included. With respect to PPD changes, 1 meta-analysis including 2 articles (total n = 42; split-mouth design) failed to identify a statistically significant difference (WMD = 0.35 mm; 95%CI: -0.04/0.73; p = .08) in favour of adjunctive aPDT (wavelength range 650-700 nm). In terms of adjunctive laser application, a high variability of clinical outcomes at 6 months was noted. Two articles included patient-reported outcomes and 10 reported on the presence/absence of harms/adverse effects. CONCLUSIONS Available evidence on adjunctive therapy with lasers and aPDT is limited by (a) the low number of controlled studies and (b) the heterogeneity of study designs. Patient-reported benefits remain to be demonstrated.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia C Schmidt
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
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18
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Lin Z, Strauss FJ, Lang NP, Sculean A, Salvi GE, Stähli A. Efficacy of laser monotherapy or non-surgical mechanical instrumentation in the management of untreated periodontitis patients. A systematic review and meta-analysis. Clin Oral Investig 2021; 25:375-391. [PMID: 33170372 PMCID: PMC7819921 DOI: 10.1007/s00784-020-03584-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 09/11/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate and compare the effects of laser monotherapy with non-surgical mechanical instrumentation alone in untreated periodontitis patients. MATERIALS AND METHODS A focused question was formulated based on the Population, Intervention, Comparison, Outcome, and Study design criteria (PICOS): in patients with untreated periodontitis, does laser mono-therapy provide adjunctive effects on pocket probing depth (PPD) changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. The results of the meta-analyses are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. RESULTS The search yielded 1268 records, out of which 8 articles could be included. With respect to PPD changes, a meta-analysis including 5 articles (n = 148) failed to identify statistically significant differences in favor of laser monotherapy for PPD change (WMD = 0.14 mm; 95% CI: - 0.04/0.32; z = 1.51; p = 0.132) nor for clinical attachment level (CAL) (WMD = 0.04 mm; 95% CI: - 0.35/0.42; z = 0.19; p = 0.850). Data on cost-effectiveness are lacking. One study reported patient-related outcome measures (PROMS). CONCLUSIONS In untreated periodontitis patients, laser monotherapy does not yield superior clinical benefits compared with non-surgical mechanical instrumentation alone. CLINICAL RELEVANCE In untreated periodontitis patients, mechanical instrumentation with hand and/or ultrasonic instruments remains the standard of care.
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Affiliation(s)
- Zhikai Lin
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Department of Periodontology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry Faculty of Dentistry , University of Chile , Santiago, Chile
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
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19
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Lin T, Yu CC, Liu CM, Hsieh PL, Liao YW, Yu CH, Chen CJ. Er:YAG laser promotes proliferation and wound healing capacity of human periodontal ligament fibroblasts through Galectin-7 induction. J Formos Med Assoc 2021; 120:388-394. [DOI: 10.1016/j.jfma.2020.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022] Open
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20
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Manjunath S, Singla D, Singh R. Clinical and microbiological evaluation of the synergistic effects of diode laser with nonsurgical periodontal therapy: A randomized clinical trial. J Indian Soc Periodontol 2020; 24:145-149. [PMID: 32189842 PMCID: PMC7069108 DOI: 10.4103/jisp.jisp_101_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/25/2019] [Accepted: 11/28/2019] [Indexed: 12/03/2022] Open
Abstract
Context: Nonsurgical and surgical therapies along with local and systemic antibiotic regimens have been advocated in the treatment of periodontitis. Due to increasing risk of developing antibiotic resistance and inability of nonsurgical periodontal therapy to completely eradicate the pathogenic microorganisms, lasers have been used as an adjunct to conventional therapy. Aim: The aim of the present study is to evaluate the effectiveness of the use of diode lasers as adjunct to scaling and root planing (SRP) compared to SRP alone on various clinical and microbiologic parameters in chronic periodontitis patients. Settings and Design: Patients were taken from the department of periodontology and implantology, who were having chronic periodontitis. Materials and Methods: A total of forty patients participated in the study and they were divided into Group I – the test group (SRP + diode laser) and Group II – the control group (SRP alone). The following clinical parameters were assessed: oral hygiene index simplified; clinical attachment level (CAL); probing pocket depth (PPD); bleeding on probing (BOP) at baseline, 4 weeks, and 12 weeks after the treatment; and colony-forming units (CFUs) 1 week postoperatively. Statistical Analysis Used: The statistical analysis was performed using paired t-test, unpaired t-test, Wilcoxon signed-rank test, and Mann–Whitney test. Results: There was reduction in BOP, PPD, and gain in CAL from baseline to 3 months and also a reduction in CFU 1 week postoperatively. Conclusion: There was a significant improvement in clinical parameters in test group (SRP + laser) as compared to the control group (SRP alone).
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Affiliation(s)
- Shiva Manjunath
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Deepak Singla
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rika Singh
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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21
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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 2020; 52:247-258. [PMID: 31236996 PMCID: PMC8880256 DOI: 10.1002/lsm.23122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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22
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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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Diebolder R, Schmid CU, Luthardt RG, Rudolph H, Kuhn K. Characterization of the transmission behavior of dental filling materials and cements for the diode lasers' and the Nd:YAG laser's wavelengths. Lasers Surg Med 2019; 51:653-663. [PMID: 30843244 DOI: 10.1002/lsm.23081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Diode lasers and the Nd:YAG laser are used in periodontal therapy and soft tissue surgery. Dental filling materials or cements might be inadvertently damaged. The underlying mechanism of the damage is based on the dental material's specific transmission and thus absorption behavior. MATERIALS AND METHODS Twenty-four material representatives for composites, glass ionomer cements and other material classes (e.g., compomer) were processed to 100 μm and 200 μm planar specimens and spectroscopically measured for their collimated transmission in the photo spectrometer Varian Cary 5000. The (1) mean intensity of transmitted light was determined for the laser wavelengths of interest (810 nm, 940 nm, 980 nm, 1,064 nm) and used to calculate the (2) absorption lengths. RESULTS The (1) mean intensity of transmitted light ranged between 9.51 % (Panavia F 2.0 for 810 nm) and 96.79% (Artegral Cem for 1,064 nm) for the composite specimens (100 μm) and was-with few exceptions-near zero for the representatives of glass ionomer cement and the other material classes. The (2) absorption lengths were between 0.06 mm (Panavia F 2.0 for all wavelengths of interest) and 1.33 mm (Coltène Duo Cement Plus for 1,064 nm) for the composites and below or equal 0.15 mm (PermaCem for 1,064 nm) for the few representatives of glass ionomer cements and the other material classes with mean intensities of transmitted light, which were not near zero and thus permitted to calculate absorption lengths. CONCLUSIONS The transmission behavior varied between the different material classes and even within, albeit less pronounced. Composites generally showed the highest intensities of transmitted light and are thus least susceptible to surface damage by laser light (810 nm, 940 nm, 980 nm, 1,064 nm). The results can be used to improve and develop laser applications involving purposeful interactions between laser light and dental materials. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Rolf Diebolder
- Institut für Lasertechnologien in der Medizin und Messtechnik, Ulm, 89081, Germany
| | - Carmen U Schmid
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Ulm, 89081, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Ulm, 89081, Germany
| | - Heike Rudolph
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Ulm, 89081, Germany
| | - Katharina Kuhn
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Ulm, 89081, Germany
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Clinical and Microbiological Effects of the Use of Erbium: Yttrium–Aluminum–Garnet Laser on Chronic Periodontitis in Addition to Nonsurgical Periodontal Treatment: A Randomized Clinical Trial—6 Months Follow-Up. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:182-190. [DOI: 10.1089/photob.2018.4510] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Miresmæili AF, Mollabashi V, Gholami L, Farhadian M, Rezaei-Soufi L, Javanshir B, Malekshoar M. Comparison of conventional and laser-aided fiberotomy in relapse tendency of rotated tooth: A randomized controlled clinical trial. Int Orthod 2019; 17:103-113. [PMID: 30765235 DOI: 10.1016/j.ortho.2019.01.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The aim of the present study was to compare the tendency of mandibular incisor rotation relapse after conventional circumferential supracrestal fiberotomy (CSF) with Er,Cr:YSGG laser-aided CSF. METHODS In this three-arm parallel study, the patients with one lower incisor rotation greater than 30 degrees before treatment were selected. The patients were randomly assigned to three groups in a 1:1:1 ratio. Rotational relapse tendency was measured on a digitized model one month after arch wire removal. Probing depth, clinical crown height and pain levels were also measured. RESULTS A total of 46 patients were recruited. Relapse tendency in conventional CSF and laser-aided CSF groups were 5.09±1.59° and 4.87±2.08°, respectively, and significantly lower than 11.28±2.93° in the control group (P<0.001). Relapse tendency was not different between the conventional CSF and laser CSF groups. Probing depth, clinical crown height, and experienced pain levels exhibited negligible differences. CONCLUSIONS Er,Cr:YSGG laser-aided CSF in one month was as effective in reducing rotational relapse tendency of mandibular incisor teeth as conventional CSF.
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Affiliation(s)
- Amir Farhang Miresmæili
- Department of Orthodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Mollabashi
- Department of Orthodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Gholami
- Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran; Department of Periodontics, Dentofacial Deformities Research Center, Dental Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Loghman Rezaei-Soufi
- Restorative Department, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Bahareh Javanshir
- Department of Orthodontics, Anzali International Campus, Guilan University of Medical Sciences, Rasht, Iran
| | - Milad Malekshoar
- Department of Orthodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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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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Tocarruncho O, Espitia Robayo XA, Ibáñez Pinilla E, Ríos-Osorio NR. Comparison between 940 nm Laser Diode and Topical 5 % Potassium Nitrate for Tooth Desensitization. Randomized Controlled Clinical trial. ACTA ACUST UNITED AC 2018. [DOI: 10.11144/javeriana.uo37-79.cldt] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To compare the effectiveness of two dental desensitization therapies, 940 nm laser diode and potassium nitrate, in patients with dental hypersensitivity (DH) symptoms. Methods: This randomized clinical trial included 30 patients who initially underwent basic periodontal therapy and presented gingival recessions Class I and II (Miller 1985) with symptoms of DH. Subjects were randomly assigned into two groups. The first group (n = 15) received laser 940 nm application for 90 seconds on the surface of the recession and were given a tube of glycerin to be applied daily in order to avoid generating bias. Patients in the second group (n = 15) were exposed to inactive laser simulating the actual application of the laser, and they were given a desensitizing gel containing 0.5 g of potassium nitrate to be applied twice daily during 14 days. Controls were carried out at 15 minutes, 8 days, 15 days, and 4 weeks. Data obtained were filled out in an Excel table. For comparison between groups the Mann Whitney U and t student tests were used (p=0.05). Results: All patients involve in the study experienced reduction in DH (p<0.01) and differences between the two interventions performed. Conclusions: Laser and nitrate therapies were effective to manage DH after basic periodontal therapy. However, a statistically significant higher sensitivity reduction was observed in laser therapy group.
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De Angelis N, Hanna R, Signore A, Amaroli A, Benedicenti S. Effectiveness of dual-wavelength (Diodes 980 Nm and 635 Nm) laser approach as a non-surgical modality in the management of periodontally diseased root surface: a pilot study. BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1544034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Nicola De Angelis
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Reem Hanna
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Andrea Amaroli
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
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Delgado-Ruiz R, Romanos G. Potential Causes of Titanium Particle and Ion Release in Implant Dentistry: A Systematic Review. Int J Mol Sci 2018; 19:E3585. [PMID: 30428596 PMCID: PMC6274707 DOI: 10.3390/ijms19113585] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/09/2018] [Accepted: 11/11/2018] [Indexed: 01/03/2023] Open
Abstract
Implant surface characteristics, as well as physical and mechanical properties, are responsible for the positive interaction between the dental implant, the bone and the surrounding soft tissues. Unfortunately, the dental implant surface does not remain unaltered and changes over time during the life of the implant. If changes occur at the implant surface, mucositis and peri-implantitis processes could be initiated; implant osseointegration might be disrupted and bone resorption phenomena (osteolysis) may lead to implant loss. This systematic review compiled the information related to the potential sources of titanium particle and ions in implant dentistry. Research questions were structured in the Population, Intervention, Comparison, Outcome (PICO) framework. PICO questionnaires were developed and an exhaustive search was performed for all the relevant studies published between 1980 and 2018 involving titanium particles and ions related to implant dentistry procedures. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for the selection and inclusion of the manuscripts in this review. Titanium particle and ions are released during the implant bed preparation, during the implant insertion and during the implant decontamination. In addition, the implant surfaces and restorations are exposed to the saliva, bacteria and chemicals that can potentially dissolve the titanium oxide layer and, therefore, corrosion cycles can be initiated. Mechanical factors, the micro-gap and fluorides can also influence the proportion of metal particles and ions released from implants and restorations.
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Affiliation(s)
- Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
| | - Georgios Romanos
- Department of Periodontics, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
- Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, 60323 Frankfurt, Germany.
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Ma L, Zhang X, Ma Z, Shi H, Zhang Y, Wu M, Cui W. Clinical Effectiveness of Er: YAG Lasers Adjunct to Scaling and Root Planing in Non-Surgical Treatment of Chronic Periodontitis: A Meta-Analysis of Randomized Controlled Trials. Med Sci Monit 2018; 24:7090-7099. [PMID: 30289123 PMCID: PMC6186153 DOI: 10.12659/msm.911863] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Er: YAG lasers (ERLs) show suitable characteristics for scaling and root planing, but previous studies have drawn conflicting conclusions. This meta-analysis aimed to systematically appraise the available evidence concerning the effectiveness of ERLs as an adjunct to scaling and root planing (SRP) for non-surgical periodontal treatment. MATERIAL AND METHODS Randomized controlled trials (RCTs) comparing ERLs+SRP with SRP alone for the treatment of chronic periodontitis were searched in 9 electronic biomedical databases up to January 2018. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for probing depth (PD) reduction, clinical attachment level (CAL) gain, and visual analog scale (VAS) score. Heterogeneity was evaluated with the I² statistic for interstudy comparisons and the χ²-based Q statistic for intra-study comparisons. Sensitivity analysis was conducted by switching to a random or fixed effect model based on the heterogeneity. Publication bias was measured by Begg's test. RESULTS Ten related RCTs met the inclusion criteria. There were statistically significant differences in the assessed clinical parameters at the three-month follow-up: PD reduction (WMD=0.32, 95%CI range from 0.14 to 0.51, p<0.001; p=0.003, I²=69.7%); CAL gain (WMD=0.31, 95%CI range from 0.22 to 0.40, p<0.001; p=0.209, I²=28.8%); and VAS scores (WMD=-1.38, 95%CI range from -2.45 to -0.31, p<0.001; p=0.182, I²=44%). There were no significant differences at the six- and twelve-month follow-ups. Sensitivity analysis revealed that the results were consistent. No evidence of publication bias was detected. CONCLUSIONS This systematic analysis demonstrated that ERLs+SRP provides additional short-term effectiveness and that patients experience less pain compared to SRP. There were no significant differences at the medium-term and long-term follow-ups. Long-term well-designed RCTs are required.
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Affiliation(s)
- Lei Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University; Hebei Province Center for Disease Prevention and Control, Shijiazhuang, Hebei, China (mainland)
| | - Zhe Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Hong Shi
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yanning Zhang
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Mingxuan Wu
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wei Cui
- Department of Stomatology, No. 2 Hospital of Baoding, Baoding, Hebei, China (mainland)
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Yamakawa S, Niwa T, Karakida T, Kobayashi K, Yamamoto R, Chiba R, Yamakoshi Y, Hosoya N. Effects of Er:YAG and Diode Laser Irradiation on Dental Pulp Cells and Tissues. Int J Mol Sci 2018; 19:ijms19082429. [PMID: 30126087 PMCID: PMC6121961 DOI: 10.3390/ijms19082429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022] Open
Abstract
Vital pulp therapy (VPT) is to preserve the nerve and maintain healthy dental pulp tissue. Laser irradiation (LI) is beneficial for VPT. Understanding how LI affects dental pulp cells and tissues is necessary to elucidate the mechanism of reparative dentin and dentin regeneration. Here, we show how Er:YAG-LI and diode-LI modulated cell proliferation, apoptosis, gene expression, protease activation, and mineralization induction in dental pulp cells and tissues using cell culture, immunohistochemical, genetic, and protein analysis techniques. Both LIs promoted proliferation in porcine dental pulp-derived cell lines (PPU-7), although the cell growth rate between the LIs was different. In addition to proliferation, both LIs also caused apoptosis; however, the apoptotic index for Er:YAG-LI was higher than that for diode-LI. The mRNA level of odontoblastic gene markers-two dentin sialophosphoprotein splicing variants and matrix metalloprotease (MMP)20 were enhanced by diode-LI, whereas MMP2 was increased by Er:YAG-LI. Both LIs enhanced alkaline phosphatase activity, suggesting that they may help induce PPU-7 differentiation into odontoblast-like cells. In terms of mineralization induction, the LIs were not significantly different, although their cell reactivity was likely different. Both LIs activated four MMPs in porcine dental pulp tissues. We helped elucidate how reparative dentin is formed during laser treatments.
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Affiliation(s)
- Shunjiro Yamakawa
- Department of Endodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Takahiko Niwa
- Department of Periodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Takeo Karakida
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Kazuyuki Kobayashi
- Department of Dental Hygiene, Tsurumi Junior College, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Ryuji Yamamoto
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Risako Chiba
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Yasuo Yamakoshi
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Noriyasu Hosoya
- Department of Endodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
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Talebi-Ardakani MR, Torshabi M, Karami E, Vajar N, Rezaei Esfahrood Z, Meimandi M, Mojahedi SM. Comparison of Er:YAG Laser and Hand Instrumentation on the Attachment of Cultured Human Gingival Fibroblasts to Periodontally Involved Root Surfaces. J Lasers Med Sci 2017; 8:S51-S55. [PMID: 29071036 DOI: 10.15171/jlms.2017.s10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The present study compared the effects of erbium-doped yttrium aluminium garnet (Er:YAG) laser and hand instrumentation on the attachment of human gingival fibroblast (HGF) cells to periodontally involved root surfaces. Methods: A total of 40 tooth specimens were collected and treated in four distinct groups: scaled and root planed with hand instruments, scaled with Er:YAG laser, treated with a combination of hand instruments and Er:YAG laser and non-treated control group. The attachment and proliferation rate of HGF were assessed using MTT assay and scanning electron microscope (SEM) examination was used for cell morphological evaluation. Results: The MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide) assay showed significant decrease in HGF cell viability in both hand instruments only and combination treated teeth specimens compared to control specimens (P<0.05), 24 hours after cell seeding. However, at time 48, the cell viability of attached cells in these 2 treated groups was almost similar to control. In contrast, at 24 and 48 hours after cell seeding, viability of attached cells was higher than control in Er:YAG laser treated only specimens (P<0.05). According to SEM study, the laser treated specimens showed more surface roughness. Conclusion: Er:YAG laser increased attachment and proliferation of HGF cells in comparison to the hand instruments method.
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Affiliation(s)
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Karami
- Department of Periodontics, School of Dentistry, Yazd University of Medical Sciences, Yazd, Iran
| | - Nazanin Vajar
- School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Rezaei Esfahrood
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meimandi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Arora S, Lamba AK, Faraz F, Tandon S, Ahad A. Evaluation of the Effects of Er,Cr:YSGG Laser, Ultrasonic Scaler and Curette on Root Surface Profile Using Surface Analyser and Scanning Electron Microscope: An In Vitro Study. J Lasers Med Sci 2017; 7:243-249. [PMID: 28491260 DOI: 10.15171/jlms.2016.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects. Methods: Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test. Results: Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes. Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.
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Affiliation(s)
- Shipra Arora
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Arundeep Kaur Lamba
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Farrukh Faraz
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shruti Tandon
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abdul Ahad
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
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Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y. Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 2017; 68:217-69. [PMID: 25867988 DOI: 10.1111/prd.12080] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 12/18/2022]
Abstract
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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Mizutani K, Aoki A, Coluzzi D, Yukna R, Wang CY, Pavlic V, Izumi Y. Lasers in minimally invasive periodontal and peri-implant therapy. Periodontol 2000 2016; 71:185-212. [DOI: 10.1111/prd.12123] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/28/2022]
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Lin T, Kawamura R, Aoki A, Ichinose S, Mizutani K, Taniguchi Y, Eguro T, Saito N, Izumi Y. Energy output reduction and surface alteration of quartz tips following Er:YAG laser contact irradiation on soft and hard tissues in vitro. Dent Mater J 2016; 35:51-62. [PMID: 26830823 DOI: 10.4012/dmj.2015-020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Though the Er:YAG laser (ErL) has been used in periodontal therapy, the irradiated tip damage has not been studied in detail. In this study, the change in the energy output, surface morphology, and temperature of quartz tips was evaluated following contact irradiation. Soft tissue, calculus on extracted human teeth, and porcine bone were irradiated by ErL for 60 min at 14.2 or 28.3 J/cm(2)/pulse and 20 Hz with or without water spray. The energy output ratio declined the most in the calculus group, followed by the bone and soft tissue groups with and/or without water spray. Carbon contamination was detected in all groups, and contamination by P, Ca, and/or other inorganic elements was observed in the calculus and bone groups. The rate of energy output reduction and the degree of surface alteration/contamination is variously influenced by the targeting tissue, temperature elevation of the tip and water spray.
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Affiliation(s)
- Taichen Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Romanos G. Current concepts in the use of lasers in periodontal and implant dentistry. J Indian Soc Periodontol 2015; 19:490-4. [PMID: 26644712 PMCID: PMC4645532 DOI: 10.4103/0972-124x.153471] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Lasers have various periodontal applications including calculus removal (Er: YAG, Er, Cr: YSGG lasers); soft tissue excision, incision and ablation; decontamination of root and implant surfaces; biostimulation; bacteria reduction; and osseous surgery. This paper reviews some of the major opportunities for using lasers in periodontal and implant specialty practices. The literature relating to the use of lasers for removal of the pocket epithelium, root conditioning, bacterial reduction and decontamination of infected implant surfaces is discussed, and a summary of the advantages and disadvantages of using lasers for periodontal treatment is provided.
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Affiliation(s)
- Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA ; Department of Oral Surgery and Implant Dentistry, Dental School (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany
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Behdin S, Monje A, Lin GH, Edwards B, Othman A, Wang HL. Effectiveness of Laser Application for Periodontal Surgical Therapy: Systematic Review and Meta-Analysis. J Periodontol 2015; 86:1352-63. [DOI: 10.1902/jop.2015.150212] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Bouhout Y, Gonçalves RB. Laser assisted periodontics: A review of the literature. World J Stomatol 2015; 4:129-136. [DOI: 10.5321/wjs.v4.i4.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 06/29/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
Over the years, the use of the laser within health field and more particularly dentistry has been increasing and improving. The application of laser in the periodontal treatment takes part of a non-surgical and surgical approaches, is used for the decontamination of periodontal pockets due to its bactericidal effect, and the removal of granulation tissues, inflamed and diseased epithelium lining, bacterial deposits and subgingival calculus. However in spite of all the marketing surrounding, the use of laser highlighting its beneficial effect, the capacity of laser to replace the conventional treatment for chronic periodontitis is still debatable. In fact there is no evidence that any laser system adds substantial clinical value above conventional treatments of chronic periodontitis. Some studies showed a significant positive effect on clinical attachment level gain and probing depth reduction. In the other hand, several articles demonstrated no evidence of the superior effectiveness of laser therapy compared to root planing and scaling. Our aims is to review the literature on the capacity of erbium:Yttrium-aluminum-garnet and neodymium:Yttrium-aluminium-garnet laser to either replace or complete conventional mechanical/surgical periodontal treatments.
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Laxman KV, Ghosh S, Dhingra K, Patil R. Effect of Er: YAG or Nd:YAG Laser Exposure on Fluorosed and Non-Fluorosed Root Surfaces: An In Vitro Study. Laser Ther 2015; 24:93-101. [PMID: 26246689 DOI: 10.5978/islsm.15-or-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/02/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Fluorosis affects tooth mineralization. The therapeutic benefit provided by lasers on fluorosed and non fluorosed cementum requires studying and comparing. The aim of this study was to evaluate and compare the root surface changes following Er:YAG or Nd:YAG laser irradiation on periodontally healthy fluorosed versus non-fluorosed teeth by scanning electron microscopy (SEM). MATERIALS AND METHODS A total of 76 periodontally healthy fluorosed (FH) and non-fluorosed (NFH) teeth specimens were included in this study. In one group, the experimental root specimens were irradiated using Er:YAG or with Nd:YAG laser in the other. A SEM evaluation was performed to assess the laser induced ultra structural changes in the root surface followed by statistical analysis using Fisher's exact test. RESULTS It was observed that both FH and NFH groups were similarly affected by Nd:YAG or Er:YAG laser. However, the former caused more surface changes than the latter on melting of surface (p=0.12 for FH and p=0.08 for NFH), and Er:YAG laser caused more smear layer formation (p=0.51 for FH and p=0.16 for NFH). CONCLUSION RESULTS suggest that undesirable morphological changes were observed almost similarly in FH and NFH groups using Er:YAG or Nd:YAG laser. Hence further in-vitro studies at lower energy settings followed by clinical trials are required in this aspect.
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Affiliation(s)
| | - Saubhik Ghosh
- Dept. of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Kunaal Dhingra
- Department of Periodontics, Bangalore Institute of Dental Sciences, Bangalore, Karnataka, India
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Franzen R, Rashidisangsary B, Ozturan S, Vanweersch L, Gutknecht N. Intrapulpal temperature changes during root surface irradiation with dual-wavelength laser (2780 and 940 nm): in vitro study. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:018002. [PMID: 25602781 DOI: 10.1117/1.jbo.20.1.018002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/17/2014] [Indexed: 06/04/2023]
Abstract
This work reports that the ablation volume and rate of porcine skin changed significantly with the change of skin water content. Under the same laser irradiation conditions (532 nm Nd:YAG laser, pulse width = 11.5 ns, pulse energy = 1.54 J, beam radius = 0.54 mm), the ablation volume dropped by a factor of 4 as the skin water content decreased from 40 wt. % (native) to 19 wt. % with a change in the ablation rate below and above around 25 wt. %. Based on the ablation characteristics observed by in situ shadowgraph images and the calculated tissue temperatures, it is considered that an explosive rupture by rapid volumetric vaporization of water is responsible for the ablation of the high water content of skin, whereas thermal disintegration of directly irradiated surface layer is responsible for the low water content of skin.
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Affiliation(s)
- Rene Franzen
- RWTH Aachen University Hospital, Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Borna Rashidisangsary
- RWTH Aachen University Hospital, Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Seda Ozturan
- Biruni University, Faculty of Dentistry, Department of Periodontology, Topkapi 34010, Istanbul, Turkey
| | - Leon Vanweersch
- RWTH Aachen University Hospital, Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Norbert Gutknecht
- RWTH Aachen University Hospital, Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Pauwelsstrasse 30, 52074 Aachen, Germany
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Doshi S, Jain S, Hegde R. Effect of Low-Level Laser Therapy in Reducing Dentinal Hypersensitivity and Pain Following Periodontal Flap Surgery. Photomed Laser Surg 2014; 32:700-6. [DOI: 10.1089/pho.2014.3802] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Shreya Doshi
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
| | - Sanjay Jain
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
| | - Rashmi Hegde
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
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Belal MH, Watanabe H. Comparative Study on Morphologic Changes and Cell Attachment of Periodontitis-Affected Root Surfaces Following Conditioning with CO2and Er:YAG Laser Irradiations. Photomed Laser Surg 2014; 32:553-60. [DOI: 10.1089/pho.2014.3769] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Mahmoud Helmy Belal
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Oral & Dental Medicine, Fayoum University, Bahaariy Region, Al-Fayoum, Egypt
| | - Hisashi Watanabe
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
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Belal MH, Yassin A. A comparative evaluation of CO2 and erbium-doped yttrium aluminium garnet laser therapy in the management of dentin hypersensitivity and assessment of mineral content. J Periodontal Implant Sci 2014; 44:227-34. [PMID: 25368811 PMCID: PMC4216399 DOI: 10.5051/jpis.2014.44.5.227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 08/30/2014] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Dentin hypersensitivity is a potential threat to oral health. Laser irradiation may provide reliable and reproducible treatment but remains controversial. The present study aimed to evaluate the effects of CO2 or erbium-doped yttrium aluminium garnet (Er:YAG) laser therapy, and to assess mineral content. METHODS Eighteen human single-rooted teeth affected with advanced periodontitis were obtained. Buccal and lingual surfaces were planed to form 36 specimens. Ethylenediaminetetraacetic acid gel (24%) was applied to remove the smear layer and simulate hypersensitive teeth. The experimental groups were: group 1, control (no irradiation); group 2, CO2 laser (repetitive pulsed mode, 2 W, 2.7 J/cm(2)); and group 3, Er:YAG laser (slight contact mode, 40 mJ/pulse and 10 Hz). To evaluate dentinal tubule occlusion, six specimens per group (2-mm thickness) were prepared and observed using scanning electron microscopy (SEM) for calculation of the occlusion percentage. To evaluate the mineral content, six specimens per group (0.6-mm thickness) were used, and then the levels of Ca, K, Mg, Na, and P were measured by inductively coupled plasma-atomic emission spectrometry. In addition, the surface temperature of the specimens during laser irradiation was analyzed by a thermograph. RESULTS The SEM photomicrographs indicated melted areas around exposed dentinal tubules and a significantly greater percentage of tubular occlusion in the CO2 and Er:YAG laser groups than the control, and in the Er:YAG group than the CO2 laser group. In addition, no significant differences were noted among the experimental groups for the mineral elements analyzed. The CO2 laser group showed an evident thermal effect compared to the Er:YAG group. CONCLUSIONS CO2 and Er:YAG laser are effective in treating dentin hypersensitivity and reducing its symptoms. However, the Er:YAG laser has a more significant effect; thus, it may constitute a useful conditioning item. Furthermore, neither CO2 nor Er:YAG lasers affected the compositional structure of the mineral content.
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Affiliation(s)
- Mahmoud Helmy Belal
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Oral & Dental Medicine, Fayoum University, Al-Fayoum, Egypt
| | - Abdulaziz Yassin
- Department of Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
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Miremadi SR, Cosyn J, Schaubroeck D, Lang NP, De Moor RJG, De Bruyn H. Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling - a SEM study. Int J Dent Hyg 2014; 12:273-84. [PMID: 24871380 DOI: 10.1111/idh.12074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Despite promising results of Er:YAG laser in periodontal debridement, to date there is no consensus about the ideal settings for clinical use. This experimental clinical trial aimed to determine the effects of debridement using Er:YAG laser and to compare with ultrasonic treatment. MATERIALS AND METHODS Sixty-four teeth were divided into two in vivo and in vitro subgroups. Each tooth received ultrasonic treatment on one side and Er:YAG laser debridement at either 60, 100, 160 or 250 mJ pulse(-1) and at 10 Hz on the other side on a random basis. All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure. Treatment duration (d) was also recorded. RESULTS Laser debridement produced an irregular, rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface. The number of exposed dentinal tubules (n) followed an energy-dependent trend. The number of exposed tubules among the in vivo laser groups was n 60 mJ = n 100 mJ < n 160 mJ < n 250 mJ (P < 0.001). Also 160 and 250 mJ lasers led to significantly more dentinal exposure than ultrasound under in vivo condition. Within the in vitro laser groups, dentinal tubules exposure was n 60 mJ < n 100 mJ < n 160 mJ < n 250 mJ (P ≤ 0.0015). Furthermore, in vitro laser treatments at 100, 160 and 250 mJ led to significantly more dentinal denudation than ultrasound. Treatment duration (d) for the in vivo groups was d 60 mJ > d 100 mJ > d Ultrasound = d 160 mJ > d 250 mJ (P ≤ 0.046), while for the in vitro groups it was d 60 mJ > d 100 mJ = d Ultrasound = d 160 mJ >d 250 mJ (P ≤ 0.046). CONCLUSIONS Due to excessive treatment duration and surface damage, Er:YAG laser debridement at 60 and 250 mJ pulse(-1), respectively, is not appropriate for clinical use. Although laser debridement at 100 and 160 mJ pulse(-1) seems more suitable for clinical application, compared to ultrasound the former is more time-consuming and the latter is more aggressive. Using a feedback device or lower pulse energies are recommended when using laser in closed field.
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Affiliation(s)
- S R Miremadi
- Department of Periodontology, Faculty of Dentistry, Ghent University, Ghent, Belgium
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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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Sculean A, Schwarz F, Becker J. Anti-infective therapy with an Er:YAG laser: influence on peri-implant healing. Expert Rev Med Devices 2014; 2:267-76. [PMID: 16288590 DOI: 10.1586/17434440.2.3.267] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In addition to conventional treatment modalities (mechanical and chemical), the use of lasers has been increasingly proposed for the treatment of periodontal and peri-implant infections (i.e., cleaning and detoxification of implant surfaces). Preliminary results from basic studies have pointed to the high potential of the Erbium-doped: Yttrium, Aluminum and Garnet (Er:YAG) laser. Furthermore, preliminary clinical data indicate that treatment with this kind of laser may positively influence peri-implant healing. The aim of this research update is to evaluate, based on the currently available evidence, the use of an Er:YAG laser for the treatment of peri-implant infections and to indicate its potential as a new treatment modality.
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Affiliation(s)
- Anton Sculean
- Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.
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Detection, removal and prevention of calculus: Literature Review. Saudi Dent J 2013; 26:7-13. [PMID: 24526823 DOI: 10.1016/j.sdentj.2013.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 09/23/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022] Open
Abstract
Dental plaque is considered to be a major etiological factor in the development of periodontal disease. Accordingly, the elimination of supra- and sub-gingival plaque and calculus is the cornerstone of periodontal therapy. Dental calculus is mineralized plaque; because it is porous, it can absorb various toxic products that can damage the periodontal tissues. Hence, calculus should be accurately detected and thoroughly removed for adequate periodontal therapy. Many techniques have been used to identify and remove calculus deposits present on the root surface. The purpose of this review was to compile the various methods and their advantages for the detection and removal of calculus.
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Mishra MK, Prakash S. A comparative scanning electron microscopy study between hand instrument, ultrasonic scaling and erbium doped:Yttirum aluminum garnet laser on root surface: A morphological and thermal analysis. Contemp Clin Dent 2013; 4:198-205. [PMID: 24015009 PMCID: PMC3757882 DOI: 10.4103/0976-237x.114881] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Scaling and root planing is one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time consuming. In search of more efficient and less difficult instrumentation, investigators have proposed lasers as an alternative or as adjuncts to scaling and root planing. Hence, the purpose of the present study was to evaluate the effectiveness of erbium doped: Yttirum aluminum garnet (Er:YAG) laser scaling and root planing alone or as an adjunct to hand and ultrasonic instrumentation. SUBJECTS AND METHODS A total of 75 freshly extracted periodontally involved single rooted teeth were collected. Teeth were randomly divided into five treatment groups having 15 teeth each: Hand scaling only, ultrasonic scaling only, Er:YAG laser scaling only, hand scaling + Er:YAG laser scaling and ultrasonic scaling + Er:YAG laser scaling. Specimens were subjected to scanning electron microscopy and photographs were evaluated by three examiners who were blinded to the study. Parameters included were remaining calculus index, loss of tooth substance index, roughness loss of tooth substance index, presence or absence of smear layer, thermal damage and any other morphological damage. RESULTS Er:YAG laser treated specimens showed similar effectiveness in calculus removal to the other test groups whereas tooth substance loss and tooth surface roughness was more on comparison with other groups. Ultrasonic treated specimens showed better results as compared to other groups with different parameters. However, smear layer presence was seen more with hand and ultrasonic groups. Very few laser treated specimens showed thermal damage and morphological change. INTERPRETATION AND CONCLUSION In our study, ultrasonic scaling specimen have shown root surface clean and practically unaltered. On the other hand, hand instrument have produced a plane surface, but removed more tooth structure. The laser treated specimens showed rough surfaces without much residual deposit or any other sign of morphological change.
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Affiliation(s)
- Mitul Kumar Mishra
- Department of Periodontology and Implantology, SDK Dental College and Hospital, Hingna, Nagpur, Maharashtra, India
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Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in dentistry: An innovative tool in modern dental practice. Natl J Maxillofac Surg 2013; 3:124-32. [PMID: 23833485 PMCID: PMC3700144 DOI: 10.4103/0975-5950.111342] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The term LASER is an acronym for ‘Light Amplification by the Stimulated Emission of Radiation’. As its first application in dentistry by Miaman, in 1960, the laser has seen various hard and soft tissue applications. In the last two decades, there has been an explosion of research studies in laser application. In hard tissue application, the laser is used for caries prevention, bleaching, restorative removal and curing, cavity preparation, dentinal hypersensitivity, growth modulation and for diagnostic purposes, whereas soft tissue application includes wound healing, removal of hyperplastic tissue to uncovering of impacted or partially erupted tooth, photodynamic therapy for malignancies, photostimulation of herpetic lesion. Use of the laser proved to be an effective tool to increase efficiency, specificity, ease, and cost and comfort of the dental treatment.
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Affiliation(s)
- Sanjeev Kumar Verma
- Department of Orthodontics and Dental Anatomy, Aligarh Muslim University, Aligarh, India
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