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Clem D, Heard R, McGuire M, Scheyer ET, Richardson C, Toback G, Gunsolley JC, Geurs N. A comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Twelve-month results of a multicenter, randomized, controlled study. J Periodontol 2024; 95:621-631. [PMID: 37846761 DOI: 10.1002/jper.23-0286] [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: 05/29/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND The purpose of this publication is to report on the 12-month clinical and radiographic results comparing the surgical use of the Er,Cr:YSGG laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. METHODS Fifty-three adult subjects (29 females and 24 males; 19-73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Fifty subjects completed the study. Recession (REC), probing depth (PD), clinical attachment level (CAL), treatment time, and standardized radiographs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4-6 weeks following SRP, and 6 and 12 months following surgical therapy. Radiographic results were compared to baseline at 6 and 12 months following surgical therapy. RESULTS The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.7 mm (p = 0.05), PD with a non-inferiority margin of 0.7 mm (p = 0.05), and REC with a non-inferiority margin of 0.4 mm (p = 0.05). Standardized radiographs suggest similar bone fill of 1.14 ± 1.73 mm for MIST and 1.12 ± 1.52 mm for ERL. CONCLUSIONS This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST at 12 months in terms of clinical outcomes and similar to MIST in terms of radiographic bone fill for the surgical treatment of intrabony defects.
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Affiliation(s)
- Donald Clem
- Private Practice, Fullerton, CA, USA
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
| | - Rick Heard
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Victoria, TX, USA
| | - Michael McGuire
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Houston, TX, USA
| | - E Todd Scheyer
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Houston, TX, USA
| | - Chris Richardson
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Richmond, VA, USA
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Gregory Toback
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, New London, CT, USA
- Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - John C Gunsolley
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Nico Geurs
- Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA
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Clem D, Heard R, McGuire M, Scheyer ET, Richardson C, Toback G, Gwaltney C, Gunsolley JC. Comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Six-month results of a multicenter, randomized, controlled study. J Periodontol 2020; 92:496-506. [PMID: 32613664 DOI: 10.1002/jper.20-0028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of this publication is to report on the six-month clinical results and patient-reported outcomes (PROs) comparing the surgical use of the erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. METHODS Fifty-three adults (29 females and 24 males; aged 19 to 73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Recession, probing depth (PD), clinical attachment level (CAL), treatment time, and PROs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4 to 6 weeks following SRP, and 6 months following surgical therapy. RESULTS The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.6 mm (p = 0.05), PD with a non-inferiority margin of 0.5 mm (p = 0.05). Recession with a non-inferiority margin of 0.4 mm (p = 0.05). Faster procedure times were found for ERL (16.39 ± 6.21 minutes) versus MIST (20.17 ± 5.62 minutes), p = 0.0002. In the first 2 to 3 days of post-therapeutic diary outcomes, subjects reported less bruising, facial swelling, and use of ice pack for the ERL group. CONCLUSIONS This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST in terms of clinical outcomes but is superior in PROs for the surgical treatment of intrabony defects.
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Affiliation(s)
- Donald Clem
- Private practice, Fullerton, CA.,A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX
| | - Rick Heard
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Victoria, TX
| | - Michael McGuire
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Houston, TX
| | - E Todd Scheyer
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, Houston, TX
| | - Chris Richardson
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA
| | - Gregory Toback
- A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.,Private practice, New London, CT.,Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT
| | | | - John C Gunsolley
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA
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ALEXANDRU BC, POPA M, DOGARU G, CONSTANTIN AM, GEORGIU C, ȘOVREA AS. Pulsed short waves in the remineralization of alveolar bone structures of the jaw in patients with diabetes mellitus – a series of cases. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This clinical study included three patients aged between 50 and 78 years who had chronic marginal periodontitis and type 2 diabetes mellitus, diseases that are frequently associated due to changes occurring in polymorphonuclear cells, as well as to alterations of microcirculation. No bone augmentation therapies were performed. Bone regeneration was strictly influenced by conventional periodontal therapy, supplemented with ten pulsed short wave sessions applied to the lower face shortly after closed periodontal curettage. The allocated time was ten minutes for the first two sessions, and 15 minutes for the following 8 sessions. Clinical and radiological evaluations were performed at the time of presentation, as well as after initiation of pulsed short wave therapy: in the first case, three weeks after initiation of therapy and three years after the end of complex oral rehabilitation; in the second case, eight weeks after the onset of pulsed short wave therapy and in the third case, five weeks after the onset of pulsed short wave therapy. The results were significant in all three cases, demonstrated radiologically by the same type of radiological examination at identical scales. Bone remineralization was obvious in the alveolar processes of the jaw. Although further studies in this direction are necessary, the results are both clinically and radiologically significant.
Key words: pulsed short waves, alveolar bone resorption, periodontal disease, diabetes,
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Affiliation(s)
| | - Monica POPA
- Department of Hygiene, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Gabriela DOGARU
- Department of Medical Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Anne-Marie CONSTANTIN
- Department of Histology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Carmen GEORGIU
- Department of Pathological Anatomy, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Alina Simona ȘOVREA
- Department of Histology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
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Ertugrul AS, Tekin Y, Talmac AC. Comparing the efficiency of Er,Cr:YSGG laser and diode laser on human β-defensin-1 and IL-1β levels during the treatment of generalized aggressive periodontitis and chronic periodontitis. J COSMET LASER THER 2017; 19:409-417. [DOI: 10.1080/14764172.2017.1334923] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
| | - Yasin Tekin
- Faculty of Dentistry, Department of Periodontology, Trakya University, Edirne, Turkey
| | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Yuzuncu Yil University, Van, Turkey
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Minimally Invasive Treatment of Infrabony Periodontal Defects Using Dual-Wavelength Laser Therapy. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2016; 2016:7175919. [PMID: 27366790 PMCID: PMC4912985 DOI: 10.1155/2016/7175919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 01/08/2023]
Abstract
Introduction. Surgical management of infrabony defects is an invasive procedure, frequently requiring the use of adjunctive material such as grafts or biologics, which is time-consuming and associated with expense and morbidity to the patient. Lasers in periodontal regeneration have been reported in the literature, with each wavelength having potential benefits through different laser-tissue interactions. The purpose of this case series was to assess the efficacy of a new dual-wavelength protocol in the management of infrabony defects. Materials and Methods. 32 defects (one in each patient) were treated using ultrasonic debridement, followed by flapless application of Erbium, Chromium:Yttrium, Scandium, Gallium, Garnet (Er,Cr:YSGG) laser (wavelength 2780 nm), and final application of diode laser (wavelength 940 nm). Pocket depths (PD) were measured after 6 months and repeat radiographs taken after one year. Results. The mean baseline PD was 8.8 mm (range 6–15 mm) and 6 months later was 2.4 mm (range 2–4 mm), with mean PD reduction being 6.4 ± 1.7 mm (range 3–12 mm). There was a significant gain in relative linear bone height (apical extent of bone), with mean percentage bone fill of 39.7 ± 41.2% and 53% of sites showing at least 40% infill of bone. Conclusion. The results compare favourably with traditional surgery and require further validation through randomised clinical controlled trials.
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Al-Falaki R, Cronshaw M, Parker S. The Adjunctive Use of the Erbium, Chromium: Yttrium Scandium Gallium Garnet Laser in Closed Flap Periodontal Therapy. A Retrospective Cohort Study. Open Dent J 2016; 10:298-307. [PMID: 27350796 PMCID: PMC4906144 DOI: 10.2174/1874210601610010298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 01/28/2023] Open
Abstract
Objectives: The current periodontal literature has been inconsistent in finding an added advantage to using lasers in periodontal therapy. The aim of this study was to compare treatment outcomes following root surface instrumentation alone (NL group), or with adjunctive use of Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser (L group). Material and Methods: Patients diagnosed with generalized chronic periodontitis, having a minimum of 1 year follow up were selected by a blinded party for inclusion in a retrospective analysis from patients treated prior to and after integration of laser in a single clinic setting. Probing depths (PD) of all sites ≥5 mm and full mouth bleeding scores were analyzed. Further analysis was carried out on the treatment outcomes of only the molar teeth and of pockets >6mm. Results: 53 patients were included (25 NL,28 L). There was no significant difference between baseline PDs (NL=6.19mm, L=6.27mm, range 5-11mm). The mean PD after one year was 2.83mm (NL) 2.45mm (L), with the mean PD reductions being 3.35mm (NL) and 3.82mm (L) (p<0.002). The mean PD reduction for the molars were 3.32mm (NL) and 3.86mm (L) (p< 0.007), and for ≥7mm group were 4.75mm (NL) compared to 5.14mm (L) (p< 0.009). There was significantly less bleeding on probing in the laser group after one year (p<0.001) Conclusion: Both treatment modalities were effective in treating chronic periodontitis, but the added use of laser may have advantages, particularly in molar tooth sites and deeper pockets. Further research with RCTs is needed to test this hypothesis further.
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Affiliation(s)
- Rana Al-Falaki
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | - Mark Cronshaw
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | - Steven Parker
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
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Slouka D, Polenik P, Hes O, Smid D, Slama K, Hosek P, Boudova L. Can we improve clinical results of tonsillectomy using lasers? J Appl Biomed 2016. [DOI: 10.1016/j.jab.2015.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Treatment outcome following use of the erbium, chromium:yttrium, scandium, gallium, garnet laser in the non-surgical management of peri-implantitis: a case series. Br Dent J 2014; 217:453-7. [DOI: 10.1038/sj.bdj.2014.910] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/08/2022]
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