1
|
Elmeligy SMA, Saleh W, Elewa GM, Abu El-Ezz HZ, Mahmoud NM, Elmeadawy S. The efficacy of diode laser and subgingival air polishing with erythritol in treatment of periodontitis (clinical and microbiological study). BMC Oral Health 2024; 24:763. [PMID: 38965550 PMCID: PMC11225135 DOI: 10.1186/s12903-024-04481-6] [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: 01/16/2024] [Accepted: 06/13/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND There is insufficient clinical and microbiological evidence to support the use of diode laser and air-polishing with erythritol as supplements to scaling and root planning(SRP). The aim of the current study is to evaluate the clinical and microbiologic efficacy of erythritol subgingival air polishing and diode laser in treatment of periodontitis. METHODS The study encompassed twenty-four individuals seeking periodontal therapy and diagnosed with stage I and stage II periodontitis. Eight patients simply underwent SRP. Eight more patients had SRP followed by erythritol subgingival air polishing, and eight patients had SRP followed by diode laser application. At baseline and six weeks, clinical periodontal parameters were measured, including Plaque Index (PI), Gingival Index (GI), periodontal Probing Depth (PPD), and Clinical Attachment Level (CAL). The bacterial count of Aggregatibacter actinomycetemcomitans(A.A), Porphyromonas gingivalis (P.G) was evaluated at different points of time. RESULTS The microbiological assessment revealed significant differences in the count of A.A. between the laser and erythritol groups immediately after treatment, indicating a potential impact on microbial levels. However, the microbial levels showed fluctuations over the subsequent weeks, without statistically significant differences. Plaque indices significantly decreased post-treatment in all groups, with no significant inter-group differences. Gingival indices decreased, and the laser group showed lower values than erythritol and control groups. PPD and CAL decreased significantly across all groups, with the laser group exhibiting the lowest values. CONCLUSION The supplementary use of diode laser and erythritol air polishing, alongside SRP, represents an expedited periodontal treatment modality. This approach leads to a reduction in bacteria and improvement in periodontal health. TRIAL REGISTRATION This clinical trial was registered on Clinical Trials.gov (Registration ID: NCT06209554) and released on 08/01/2024.
Collapse
Affiliation(s)
- Sara M A Elmeligy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Gasser M Elewa
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt
| | - Hani Z Abu El-Ezz
- Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Suez University, Suez, Egypt
| | - Noha Mostafa Mahmoud
- Medical Microbiology and Immunology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt
- Medical Microbiology and Immunology Department, Faculty of Medicine, Horus University, New Damietta, Egypt
| | - Samah Elmeadawy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| |
Collapse
|
2
|
V V, Sk B, Krishnakumar D, Kumar D, Lavu V. Assessment of clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in the management of periodontitis - a split mouth randomized clinical trial. Lasers Med Sci 2024; 39:82. [PMID: 38418665 DOI: 10.1007/s10103-024-04032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
Aim of this study is to assess the clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in management of periodontitis. Type of study is a Split mouth clinical trial in which a total of 13 patients were recruited based on specific inclusion and exclusion criteria. In each participant, random allocation of selected sites into test and control in contralateral quadrants was done. Clinical parameters such as probing depth and clinical attachment loss was measured in control and test sites using occlusal stents. Flap surgery was carried out 6 weeks after phase I therapy and the selected contralateral sites with a probing depth of > 5mm were subjected to surgical therapy. In a test quadrant, 445 nm diode laser with a power of 0.8 W, CW mode, 320 µm fiber, in non-contact mode was used as an adjunct to flap surgery. Primary outcome variable assessed was change in PPD between baseline, pre-operative, 1-, 3- and 6-months post-surgery. Secondary outcomes variables assessed were Clinical attachment loss at baseline, pre-operative, 1, 3 and 6 months, visual analog scale at days 3 and 7 and patient satisfaction index at day 7 post surgery. Surgery for the second site (Test/control) in the contralateral quadrants was performed 1 week after the first surgery. A higher reduction in probing depth and gain in CAL was observed in test site at 1, 3 and 6 months follow up amongst all the included participants. VAS score was lower at the test site as compared to the control sites. PSI scores were similar in both the sites. The adjunctive use of 445nm diode laser to surgical periodontal therapy contributed to improved short term clinical outcomes as assessed at the end of 6 months post- surgery. VAS score indicative of post -surgical discomfort were also lower for the laser treated sites. Hence adjunctive use of laser (445 nm wavelength) can be recommended for achieving more predictable clinical outcomes.
Collapse
Affiliation(s)
- Vineet V
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Balaji Sk
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Dhanadivya Krishnakumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Divya Kumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Vamsi Lavu
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India.
| |
Collapse
|
3
|
Seyed-Monir A, Seyed-Monir E, Mihandoust S. Evaluation of 940-nm diode laser effectiveness on pocket depth, clinical attachment level, and bleeding on probing in chronic periodontitis: A randomized clinical single-masked split-mouth study. Dent Res J (Isfahan) 2023; 20:113. [PMID: 38020258 PMCID: PMC10680077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 09/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Diode lasers can be used in the treatment of periodontal diseases as they have an anti-bactericidal effect, and regulate oral tissue inflammatory responses. This study aimed to evaluate the adjunctive effects of Diode 940 nm laser on mechanical periodontal debridement. Materials and Methods In this split-mouth single-blind randomized clinical trial, 12 patients were selected. Forty-four oral segments were enrolled in the scaling and root planing (SRP) group and SRP + Laser group with a 1:1 allocation ratio following a simple randomization procedure (coin flip). Clinical parameters (pocket depth, clinical attachment loss [CAL], and bleeding on probing [BOP]) were measured at baseline. After the SRP, a 940 nm Diode laser (1 Watt power and continuous wave mode) was used in the SRP + Laser group as an adjunctive treatment. The clinical parameters were remeasured 2 months posttreatment. Statistical analysis was carried out using an unpaired t-test with a 5% significant level by SPSS. Results Although all clinical parameters had more improvements in the SRP + Laser group, the differences were not significant between the two study groups (P > 0.05). Only in individual tooth evaluations, CAL changes in first and second premolars and BOP changes in second premolars show statistically significant improvement in the SRP + L group compared to the SRP group (P < 0.05). Conclusion Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment.
Collapse
Affiliation(s)
- Ali Seyed-Monir
- Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Ebrahim Seyed-Monir
- Department of Periodontology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Sanaz Mihandoust
- Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
4
|
Roy S, Singh DK, Manohar B. Comparative evaluation of postoperative pain and tissue response in patients undergoing conventional flap surgeries with or without 940 nm diode laser exposure - A randomized clinical study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:417. [PMID: 36824074 PMCID: PMC9942145 DOI: 10.4103/jehp.jehp_568_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/07/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Over the past few years, a growing body of evidence has allowed us to ascertain that the initiation of periodontitis stems from the existence of oral microbial biofilm and that this requires definitive treatment. Owing to its exceptional usability, affordability, and antibacterial activity, the "diode laser" (DL) has increasingly become a popular and important tool in a dentist's armamentarium. However, there is a scarcity of scientific evidence on the utility and advantages of using "diode laser" in periodontal flap surgery. The study aimed to determine the efficacy of 940 nm diode laser exposure in combination with conventional periodontal flap surgery for the treatment of chronic periodontitis to evaluate postoperative discomfort and clinical parameters. MATERIALS AND METHODS A total of 10 subjects (7 males and 3 females) with generalized chronic periodontitis were recruited and completed the study without any dropouts. For this split-mouth study, 40 sample sites with pocket probing depth (PPD) 5-7 mm post periodontal Phase I therapy were selected. The quadrants were randomly allocated to Groups A, B, C, and D using the fish bowl lottery method. Kirkland flap surgery with laser and modified Widman flap (MWF) with laser were performed in Group A and C, respectively, while Kirkland flap surgery and MWF surgery were performed in Group B and Group D. Clinical parameters including visual analog scale (VAS) score and gingival inflammation were determined at 3rd and 7th day postoperatively while PPD, clinical attachment level (CAL), and sulcus bleeding index (SBI) were recorded at baseline and 6 months following treatment. Wilcoxon signed-rank test and Kruskal-Wallis test were used for intra-group and inter-group comparison of parameters, respectively. RESULTS Statistically significant difference was attained with postoperative discomfort in laser-assisted groups on 1st and 3rd day postoperatively (P < 0.001). There was no significant difference in the proportion of subjects with gingival inflammation. A statistically significant reduction in mean PPD at 6 months postoperatively was seen among all study groups (P < 0.05) but the inter-group difference was not statistically significant. SBI score reduced significantly from baseline to 6 months follow-up among all four groups (P < 0.05). However, we did not find the inter-group difference to be statistically non-significant. CONCLUSION Diode laser as an adjunct to the surgical procedure can demonstrate appreciable benefits by increasing the CAL and minimizing the postoperative pain and the probing pocket, but such additional effects were not observed with gingival inflammation.
Collapse
Affiliation(s)
- Sonali Roy
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Dhirendra K. Singh
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Balaji Manohar
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
| |
Collapse
|
5
|
Liu S, Zhang X, Zhou Q. Efficacy of Periodontal Endodontics Combined with Diode Laser (DL) Therapy on Severe Periodontitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:5689900. [PMID: 36285164 PMCID: PMC9588349 DOI: 10.1155/2022/5689900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/17/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022]
Abstract
Background For a long time, the impact of severe periodontitis on the pulp has been the focus of periodontal clinical research. Whether the teeth with severe periodontitis should be treated with pulp has also become the focus of clinical research. Aims To explore the effect of periodontal endodontic therapy combined with DL therapy on severe periodontitis. Materials and Methods The clinical data of 100 patients with severe periodontitis from January 2020 to July 2022 were selected and included in the retrospective study. According to the different retrieval treatment methods, they were divided into the control group and the treatment group with 50 cases in each group. The control group received periodontal endodontic treatment, and the treatment group received DL treatment on the basis of the control group. The differences in periodontal probing depth (PD), toothache degree, bleeding index (BI), inflammatory factors, plaque index (PLI), and attachment loss (AL) between the two groups were compared and analyzed. Results After 3 months of treatment, the bleeding index (BI), plaque index (PLI), and periodontal probing depth (PD) of the treatment group were significantly lower than those of the control group, and the difference was statistically significant (P < 0.05). The attachment loss (AL) of the group was not significantly different from that of the control group (P > 0.05). Before treatment, there was no significant difference in the levels of inflammatory factors between the two groups (P > 0.05). After 3 months of treatment, the levels of IL-6 and CRP in the treatment group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in the levels of inflammatory factors between the two groups (P > 0.05). After 3 days of treatment, the VAS score of the treatment group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05).After treatment, there were no complications during follow-up in the two groups. Conclusion The application of DL treatment has a significant effect, which can promote the healing of periodontal tissue, reduce the depth of periodontal pockets, and reduce the degree of toothache, thereby providing a reference for clinical treatment.
Collapse
Affiliation(s)
- Sijia Liu
- Wuhan Hospital of Traditional Chinese Medicine, Department of Stomatology, No. 303 Sixin Avenue, Hanyang, Wuhan 430000, Hubei, China
| | - Xu Zhang
- Wuchang Hospital Affiliated to Wuhan University of Science and Technology (Stomatology), No. 116 Yangyuan Street, Wuchang District, Wuhan 430063, Hubei, China
| | - Quanying Zhou
- Wuhan 9th Hospital, Department Stomatology, No. 20, Jilin Street, Qingshan District, Wuhan 430080, Hubei, China
| |
Collapse
|
6
|
Doğan ŞB, Akça G. Clinical Evaluation of Diode Laser-Assisted Surgical Periodontal Therapy: A Randomized Split-Mouth Clinical Trial and Bacteriological Study. Photobiomodul Photomed Laser Surg 2022; 40:646-655. [DOI: 10.1089/photob.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Şeyma Bozkurt Doğan
- Department of Periodontology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gülçin Akça
- Department of Medical Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| |
Collapse
|
7
|
Patila T, Y SS, Vivekanandan G, Shetty RM, Rahman B, Al Shehadat S, Shetty SR. Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure-a randomised controlled split-mouth clinical trial. Lasers Med Sci 2022; 37:3213-3220. [PMID: 35867285 DOI: 10.1007/s10103-022-03605-0] [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: 10/06/2021] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study's limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.
Collapse
Affiliation(s)
- Thaneshwar Patila
- Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, India
| | - Sunaina Shetty Y
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
| | - Gopinath Vivekanandan
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| | - Raghavendra M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.,Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE.,Adjunct Faculty, Dept. of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
| | - Betul Rahman
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Saaid Al Shehadat
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| |
Collapse
|
8
|
Sopi M, Koçani F, Bardhoshi M, Meqa K. The Effect of Periodontal Therapy on the Level of MMP-8 in Patients with Chronic Periodontitis. Eur J Dent 2022; 17:70-75. [PMID: 35172347 PMCID: PMC9949935 DOI: 10.1055/s-0041-1742132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The complete removal of bacterial plaque and their endotoxins in deeper areas of periodontal pockets is often difficult to achieve with conventional methods such as periodontal pocket curettage. An alternative to these methods that recently gained popularity in periodontology is the diode laser, with its antibacterial effect, angiogenesis promotion as advantages. MATERIALS AND METHODS This study included 100 patients diagnosed with chronic periodontitis, with periodontal pockets up to 6 mm, and who were divided into two groups: patients treated with basic therapy and diode laser application, and patients treated with basic therapy and with flap surgery. The clinical periodontal evaluation was done before the treatment and 6 months after the treatment. Evaluation of matrix metalloproteinase (MMP)-8 as an inflammatory indicator in gingival exudate was done with dipstick immunoassay test before the treatment and 6 months later. RESULTS This study showed a more pronounced improvement of periodontal clinical parameters, as well as a decrease in MMP-8 values in gingival exudate in the laser-treated group compared with the surgically treated group. CONCLUSION The results of this study are encouraging for the use of the diode laser as a noninvasive method in the treatment of periodontal pathologies.
Collapse
Affiliation(s)
- Mirlinda Sopi
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Ferit Koçani
- Department of Dental Pathology and Endodontics, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Merita Bardhoshi
- Department of Oro-Maxillofacial Surgery, University of Medicine, Tirana, Tirana, Albania
| | - Kastriot Meqa
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo,Address for correspondence Kastriot Meqa, DDS, MSc, PhD Department of Periodontology and Oral Medicine, Dentistry School, University of PristinaRrethi I Spitalit Street, NN, QKSUK, Pristina 10000Kosovo
| |
Collapse
|
9
|
Nagarakanti S, Kolamala N, Chava V. Effect of diode laser as an adjunct to open flap debridement in treatment of periodontitis – A randomized clinical trial. J Indian Soc Periodontol 2022; 26:451-457. [PMID: 36339386 PMCID: PMC9626786 DOI: 10.4103/jisp.jisp_213_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The goals of periodontal therapy are to prevent the disease, arrest the disease progression, and regeneration of lost periodontium. Diode laser gained popularity in periodontal practice with a wide range of potential benefits. Aim: This study aims to evaluate and compare the clinical effects of laser-assisted open flap debridement (OFD) versus conventional OFD for the periodontitis treatment. Materials and Methods: A split-mouth, randomized clinical trial was conducted on fifteen participants with periodontitis having probing pocket depths (PPD) ≥5 mm. A total of 30 sites, two sites in each patient, were randomly divided into two groups. Group A received conventional OFD, and Group B received laser-assisted OFD. The assessment of PPD, relative attachment level (RAL), modified sulcular bleeding index (mSBI) was done at baseline, 3 months, and 6 months. Wound healing index (WHI) was assessed at 3rd and 7th day postsurgery, patient response to pain using visual analog scale (VAS) was assessed immediately, 1 day, and 1 week after surgery. Results: The results revealed a significant reduction in PPD, mSBI, and gain in RAL within the groups from baseline to 3 months and 6 months. Intergroup comparison showed a significant difference in PPD, RAL, mSBI, WHI and VAS scores. Conclusions: The use of 980 nm diode laser provided additional benefits over conventional flap therapy.
Collapse
|
10
|
Ebrahimi H, Darvish F, Alaeddini M, Etemad-Moghadam S. Comparison between the Effect of 810 nm and 940 nm Diode Laser Irradiation on Histopathological Changes in Iatrogenic Oral Ulcers: an Animal Study. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:267-272. [PMID: 34904123 PMCID: PMC8665437 DOI: 10.30476/dentjods.2021.86623.1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/19/2020] [Accepted: 12/14/2020] [Indexed: 11/19/2022]
Abstract
STATEMENT OF THE PROBLEM Considering the relatively high prevalence of oral mucosal ulcers, their fast healing is of significance. PURPOSE This study aimed to histopathologically compare the effects of 810 nm and 940 nm diode laser on the healing of iatrogenic oral ulcers in rabbits. MATERIALS AND METHOD In this single-blind experimental study, mucosal ulcers measuring 3mm in diameter and 1mm in depth were bilaterally created in the buccal mucosa of 18 rabbits using a biopsy punch. The defects were irradiated with 810 nm diode laser on the right side and 940 nm diode laser on the left side. Biopsy samples of the same depth were obtained from the ulcers on days 3 and 7 followed by histopathological analysis. The intensity of inflammation was determined on hematoxylin-eosin-stained sections using a four-point scale. Data were analyzed employing the Wilcoxon signed rank test. RESULTS The degree of inflammation was not significantly different between the 810nm and 940nm diode laser groups on day 3; but on day 7, animals receiving 810 nm experienced a significantly lower degree of inflammation compared to those treated with 940 nm laser (p= 0.028). CONCLUSION When comparing 810- and 940-nm diode lasers, 810 nm irradiation significantly decreased the severity of inflammation in oral wounds created on the buccal mucosa of rabbits in a time-dependent manner.
Collapse
Affiliation(s)
- Hooman Ebrahimi
- Dept. of Oral Medicine, Dental Faculty, Islamic Azad University of Medical Sciences,Tehran, Iran
| | | | - Mojgan Alaeddini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahroo Etemad-Moghadam
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Pawelczyk-Madalińska M, Benedicenti S, Sălăgean T, Bordea IR, Hanna R. Impact of Adjunctive Diode Laser Application to Non-Surgical Periodontal Therapy on Clinical, Microbiological and Immunological Outcomes in Management of Chronic Periodontitis: A Systematic Review of Human Randomized Controlled Clinical Trials. J Inflamm Res 2021; 14:2515-2545. [PMID: 34163210 PMCID: PMC8214554 DOI: 10.2147/jir.s304946] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022] Open
Abstract
Background Due to the limitations of scaling and root planing (SRP) in chronic periodontitis (CP) management, research has been focused on utilising additional therapies to enhance conventional treatment methods. The present systematic review is aimed to appraise the accessible scientific evidence of in vivo human studies to establish the effectiveness of adjunctive diode (λ 808- λ 980nm) laser treatment to SRP in CP. Methodology This systematic review was conducted following the PRISMA statement guidelines. The review protocol is registered in PROSPERO (CRD 42021227695). The search strategies were based on structured electronic and manual (with appropriate keywords) and were conducted to collect the applicable published data on RCTs studies (in vivo human), spanning over ten years between August 2010 and August 2020. The articles were selected to address the following research focus question: “Does diode laser (λ 808- λ 980nm) therapy have superior effects as an adjunct to SPR, compared to SRP alone, in terms of clinical or microbiological or immunological profiles in the management of CP?” Results Fifteen articles met the eligibility criteria and are included in this review. A wide range of discrepancies and inconsistencies were shown in the outcomes of the laser and SPR treatment modality, compared to SRP alone. The data on standardised study protocol, optimal laser parameters and outcome measurements were inconclusive, and a high risk of bias in the majority of the studies observed, which are crucial in establishing a homogenous and reproducible protocol. Conclusion In light of the confined evidence-based data and critical evaluation of this systematic review, the efficacy of adjunctive diode laser treatment ranging between 808 and 980nm to SRP remains debatable. The observational quality of the present systematic review was emphasised after scrutinising the available data, and an attempt to propose a laser protocol for future RCTs consideration was a great challenge due to an absence of clear and standardised recommendations in delivering a reliable laser protocol which can be replicable by future investigators. RCTs with robust methodology are warranted.
Collapse
Affiliation(s)
- Magdalena Pawelczyk-Madalińska
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Periodontology, Pomeranian Medical University, Szczecin, 70-204, Poland.,FAN-DENT Centrum Stomatologii i Periodontologii, Gdańsk, 80-257, Poland
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
12
|
Agarwal A, Saxena A, Gummaluri SS, Chaudhary B, Subramanyam S Sai K, Kumar G. Clinical and microbiological evaluation of 940-nm diode laser as an adjunct to modified Widman flap for the management of chronic periodontitis: A 6-month randomized split-mouth clinical trial. J Dent Res Dent Clin Dent Prospects 2021; 15:133-139. [PMID: 34386186 PMCID: PMC8346706 DOI: 10.34172/joddd.2021.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/02/2021] [Indexed: 01/11/2023] Open
Abstract
Background. The present randomized clinical trial aimed to determine the additive clinical and microbiological benefits of diode laser (DL) with modified Widman flap (MWF) to manage chronic periodontitis. Methods. Seventy-two sites in 36 healthy non-smoking patients diagnosed with chronic periodontitis were randomly assigned to the test group (MWF + active DL) or control group (MWF + sham DL). Clinical (probing pocket depth [PPD], clinical attachment level [CAL]) and microbiological (colony-forming units [CFUs]) measurements were recorded at baseline and 6- and 6-month postoperative intervals. Results. Compared to baseline, 6-month results showed significant changes in clinical and microbiological parameters in both groups. However, the intergroup comparison revealed significantly lower PPD (1.90±0.48 mm vs. 2.35±0.41 mm), CAL (4.43±0.57 mm vs. 4.93±0.58 mm), and CFUs for Porphyromonas gingivalis (6.32±0.18 vs. 8.88 ±1.88), Prevotella intermedia (7.62±1.86 vs. 8.12±1.78), and Aggregatibacter actinomycetemcomitans (6.43±1.44 vs. 7.24±1.22) in the test group after six months. Conclusion. Within the limitations, the present study confirmed the useful role of DL with MWF to manage chronic periodontitis.
Collapse
Affiliation(s)
- Ashish Agarwal
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly Uttar Pradesh, India
| | - Anugrah Saxena
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly Uttar Pradesh, India
| | - Shiva Shankar Gummaluri
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly Uttar Pradesh, India
| | - Bharti Chaudhary
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly Uttar Pradesh, India
| | | | - Geetika Kumar
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly Uttar Pradesh, India
| |
Collapse
|
13
|
Khan F, Chopra R, Sharma N, Agrawal E, Achom M, Sharma P. Comparative evaluation of the efficacy of diode laser as an adjunct to modified Widman flap surgery for the treatment of chronic periodontitis: A randomized split-mouth clinical trial. J Indian Soc Periodontol 2021; 25:213-219. [PMID: 34158688 PMCID: PMC8177179 DOI: 10.4103/jisp.jisp_252_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/11/2020] [Accepted: 12/12/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disease that is mainly initiated by plaque biofilm which may require treatment using periodontal flap surgery. Recently, diode lasers have become popular in the field of periodontology owing to advantages such as antibacterial effect, promoting angiogenesis, and providing hemostasis. However, scientific data on application of diode laser in periodontal flap surgery and its benefits are limited. Hence, the aim of the study was to investigate the adjunctive effect of removal of remnant pocket epithelium by 980 nm diode laser and biostimulation in modified Widman flap (MWF) surgery for the treatment of chronic periodontitis. MATERIALS AND METHODS A total of 20 patients with generalized chronic periodontitis with pocket probing depth (PPD) ≥5mm post Phase I therapy were selected for this split-mouth study. MWF surgery was performed in Group 1, and in Group 2, MWF surgery with adjunctive diode laser de-epithelization and biostimulation was done. Clinical parameters including PPD, clinical attachment level, plaque index, and gingival index were recorded at baseline and 3 months following treatment, and postprocedural pain (Visual Analog Scale [VAS] score) was assessed 1-week posttreatment. In addition, colony-forming units/milliliter (CFU/ml) of anaerobic bacteria at baseline and 3 months were microbiologically examined. RESULTS MWF surgery along with diode laser led to a significant improvement in Group 2 compared to Group 1 in clinical parameters such as PPD, relative clinical attachment level, VAS score as well as microbial parameter CFU/ml after 3 months. CONCLUSION Diode laser as an adjunct to MWF in chronic periodontitis can provide enhanced clinical attachment gain with little postoperative discomfort.
Collapse
Affiliation(s)
- Farheen Khan
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Rahul Chopra
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Nikhil Sharma
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Eiti Agrawal
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Maydina Achom
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Preeti Sharma
- Department of Periodontology and Implantology, ITS-Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| |
Collapse
|
14
|
Patient-reported outcomes of laser-assisted pain control following non-surgical and surgical periodontal therapy: A systematic review and meta-analysis. PLoS One 2020; 15:e0238659. [PMID: 32941479 PMCID: PMC7498060 DOI: 10.1371/journal.pone.0238659] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022] Open
Abstract
Adjunctive use of laser devices as high reactive-level laser/light therapy (HLLT) or photobiomodulation therapy (PBMT) for periodontal therapy is known to be more effective on suppressing pain than conventional therapy, however, there are no systematic reviews addressed its effectiveness. This systematic review and meta-analysis aim to investigate the following clinical question (CQ): does adjunctive use of lasers with conventional therapy suppress the pain associated with periodontal treatment? A systematic and extensive literature search was performed to summarize the currently available knowledge to answer the CQ using the PubMed, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs) conducted before June 2020. Bias risk was assessed using the Cochrane tool for the risk of bias evaluation. A meta-analysis was performed on quantitative evaluation of pain control based on patient-reported outcomes. After an independent screening of 165 initial records, ten RCTs were included. Six of them focused on surgical procedures and the others on non-surgical periodontal pocket therapy. The protocols of HLLT, PBMT, and combination with HLLT and PBMT were employed in five, four and one RCTs, respectively. Following the assessment of bias risk, it is revealed that all RCTs had methodological weaknesses regarding the blinding of key personnel, although other bias risk factors were not evident. Meta-analysis showed that HLLT using erbium lasers significantly reduced the patient-reported pain immediately after treatment (two RCTs, p < 0.0001), while PBMT using diode lasers significantly reduced pain 2-7 days after treatment (two RCTs, p < 0.0001 to p = 0.03). The presented systematic review and meta-analysis suggest that the alternative use of HLLT using erbium lasers to conventional instrumentation can significantly suppress postoperative pain and that intraoperative or postoperative PBMT using diode lasers combined with periodontal surgery can significantly reduce postoperative pain. However, the evidence is still insufficient and more well-designed RCTs are required.
Collapse
|
15
|
Akram Z, Shafqat SS, Niaz MO, Raza A, Naseem M. Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: A systematic review and meta-analysis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 36:3-13. [PMID: 31373725 DOI: 10.1111/phpp.12499] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/01/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. METHODS Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. RESULTS Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = -0.61, 95% CI = -1.22 to -0.016, P = .044) and PD reduction (WMD = -1.79, 95% CI = -3.44 to -0.14, P = .034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = -0.75 to 0.79, P = .95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = -0.09 to 0.55, P = .159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = -0.67 to 1.31, P = .52, Figure 3B) and GR depth (WMD = -0.34, 95% CI = -2.47 to 1.78, P = .74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. CONCLUSION With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.
Collapse
Affiliation(s)
- Zohaib Akram
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Muhammad Omar Niaz
- Department of Community Dentistry, Foundation University College of Dentistry, Islamabad, Pakistan
| | - Anam Raza
- Department of Health Care Management, University College, University of Denver, Denver, CO, USA
| | - Mustafa Naseem
- College of Dentistry Research Center, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
16
|
Choung HW, Lee SH, Ham AR, Lee NR, Kim B, Pang KM, Jahng JW, Lee JH. Effectiveness of Low-Level Laser Therapy with a 915 Nm Wavelength Diode Laser on the Healing of Intraoral Mucosal Wound: An Animal Study and a Double-Blind Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E405. [PMID: 31344985 PMCID: PMC6722629 DOI: 10.3390/medicina55080405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/02/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022]
Abstract
Background and objectives: Diode laser has been the most popular low-level laser therapy (LLLT) technique in dentistry due to its good tissue penetration, lower financial costs, small size for portable application, and convenience to use. A series of recent studies with 940 nm or 980 nm lasers demonstrated that LLLT showed positive effects after third molar extraction or periodontal flap surgery. However, the effects of LLLT on intraoral mucosal wound healing after surgical incision have not yet been determined in human clinical study. Materials and Methods: The present study was performed to determine the efficacy and safety of 915 nm wavelength low-level laser therapy (LLLT) in mucosal wound healing. A total of 108 Sprague-Dawley rats were used. They were divided into three groups: Abrasive wound group, immediate LLLT once group, and daily LLLT group. As a clinical study, a total of 16 patients with split-mouth design subjected to bilateral mandibular third molar extraction were allocated into the LLLT group and placebo group. The process of LLLT was performed on postoperative days 0, 1, and 7, and parameters related to wound healing were analyzed on days 1, 7, and 14. Results: Repeated laser irradiation promoted mucosal wound healing of the rats. In the clinical study, although there were no significant statistical differences between the LLLT and placebo groups in all inflammatory parameters, the early stage mucosal healing tendency of wound dehiscence was higher in the LLLT group than in the placebo group clinically on postoperative day 1. Conclusions: The present results showed that 915 nm LLLT could be applied safely as an auxiliary therapy for mucosal wound healing.
Collapse
Affiliation(s)
- Han-Wool Choung
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul 03080, Korea
| | - Sung-Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul 03080, Korea
- Dental Life Science Research Institute & Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea
- School of Dentistry and Dental Research Institute, Seoul National University, Seoul 03080, Korea
| | - Ahe Reum Ham
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul 03080, Korea
| | - Na Ra Lee
- Clinical Research Team, Dentium, 21, Seoul 06169, Korea
| | - Bongju Kim
- Dental Life Science Research Institute & Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea
| | - Kang-Mi Pang
- Department of Oral and Maxillofacial Surgery, Seoul National University Kwanak Dental Hospital, Seoul 08826, Korea
| | - Jeong Won Jahng
- School of Dentistry and Dental Research Institute, Seoul National University, Seoul 03080, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul 03080, Korea.
- Dental Life Science Research Institute & Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea.
- School of Dentistry and Dental Research Institute, Seoul National University, Seoul 03080, Korea.
| |
Collapse
|
17
|
Karthikeyan J, Vijayalakshmi R, Mahendra J, Kanakamedala AK, Chellathurai BNK, Selvarajan S, Namachivayam A. Diode Laser as an Adjunct to Kirkland Flap Surgery-A Randomized Split-Mouth Clinical and Microbiological Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:99-109. [PMID: 31050933 DOI: 10.1089/photob.2018.4519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Mechanical methods of periodontal therapy alone may fail to eliminate the tissue-invasive pathogenic flora; therefore, considerable attention has been given to adjunctive antimicrobial measures. Objective: The aim of this study was to investigate and compare the clinical and microbiological effects of diode laser (DL) as an adjunct to Kirkland flap surgery versus Kirkland flap surgery alone for the treatment of generalized chronic periodontitis. Materials and methods: A total of 20 patients with generalized chronic periodontitis with probing pocket depth ≥5 mm after phase I therapy were included in this split-mouth study. Two contralateral quadrants of each patient were randomly assigned to either test or control group. Control group was treated with Kirkland flap surgery alone, whereas test group was treated with DL as an adjunct to Kirkland flap surgery. Periodontal parameters were recorded, and subgingival plaque samples were collected from both the control and test groups at baseline and third and sixth month. The plaque samples were then analyzed for red complex organisms using quantitative real-time polymerase chain reaction. Results: Compared with baseline, both treatments showed an improvement in periodontal parameters at the third and sixth month. However, test group produced a significant improvement in plaque index (1.039 ± 0.069 vs. 1.392 ± 0.17, p < 0.001), bleeding on probing (16.512 ± 5.982 vs. 37.051 ± 7.459, p < 0.001), probing pocket depth (1.727 ± 0.39 vs. 3.016 ± 0.47, p < 0.001), and clinical attachment level (2.054 ± 0.524 vs. 3.354 ± 0.728, p < 0.001) at third and sixth month compared with the control group. Moreover, in the test group, levels of red complex bacteria were significantly reduced at third and sixth month compared with the control group. Conclusions: DL as an adjunct to Kirkland flap surgery has resulted in a greater reduction in clinical and microbiological parameters compared with Kirkland flap surgery alone, thereby offering additional benefit in treating generalized chronic periodontitis patients.
Collapse
Affiliation(s)
- Janani Karthikeyan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Rajaram Vijayalakshmi
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Anil Kumar Kanakamedala
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | | | - Shalini Selvarajan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | | |
Collapse
|
18
|
Utilisation of antimicrobial photodynamic therapy as an adjunctive tool for open flap debridement in the management of chronic periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2019; 25:440-447. [PMID: 30684674 DOI: 10.1016/j.pdpdt.2019.01.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature. AIM This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis. MATERIALS AND METHOD Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 μm fibre, to provide a fluence (energy density) value of 0.0125 J/cm² per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively. RESULTS Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05). CONCLUSION Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis.
Collapse
|
19
|
El-Feky GS, Farouk Abdulmaguid R, Zayed GM, Kamel R. Mucosal co-delivery of ketorolac and lidocaine using polymeric wafers for dental application. Drug Deliv 2018; 25:35-42. [PMID: 29226726 PMCID: PMC6058486 DOI: 10.1080/10717544.2017.1413445] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The current study aimed to investigate the effectiveness of a developed sodium alginate and polyvinylpyrrolidone K-25 (PVP K-25) polymeric wafer for the co-delivery of ketorolac and lidocaine to soft tissues for healing and pain control following gingivectomy. Nine ketorolac/lidocaine lyophilized wafers were formulated and assessed for their hydration capacity, mucoadhesion ability and in vitro release profile to select the optimum system for further clinical investigation. Wafer F6 containing 2:1 sodium alginate to PVP K-25 and 10% glycerol showed optimum properties and was selected for the clinical study. Twenty patients were included in the study and the ketorolac/lidocaine wafer was assessed versus a market product. Visual pain analog was evaluated daily for the first week and wound healing index was evaluated for one week, two weeks and one month following the procedure. The developed ketorolac/lidocaine polymeric wafer proved to be an effective method of reducing pain and discomfort together with enhancing wound healing following gingivectomy.
Collapse
Affiliation(s)
- Gina S El-Feky
- a Department of Pharmaceutical Technology , National Research Center , Cairo , Egypt.,b Department of Pharmaceutics, Faculty of Pharmacy , October University for Modern Sciences and Arts , Cairo , Egypt
| | - Rania Farouk Abdulmaguid
- c Department of Oral Medicine and Periodontology, Department Faculty of Dentistry , October University for Modern Sciences and Arts , Cairo , Egypt
| | - Gamal M Zayed
- d Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy , Al-Azhar University at Assiut , Assiut , Egypt
| | - Rabab Kamel
- a Department of Pharmaceutical Technology , National Research Center , Cairo , Egypt
| |
Collapse
|
20
|
Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery. Lasers Med Sci 2018; 33:1639-1645. [DOI: 10.1007/s10103-018-2492-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 03/21/2018] [Indexed: 12/15/2022]
|
21
|
Jonnalagadda BD, Gottumukkala SNVS, Dwarakanath CD, Koneru S. Effect of Diode Laser-assisted Flap Surgery on Postoperative Healing and Clinical Parameters: A Randomized Controlled Clinical Trial. Contemp Clin Dent 2018; 9:205-212. [PMID: 29875562 PMCID: PMC5968684 DOI: 10.4103/ccd.ccd_810_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background and Objectives: Lasers have been widely used because of several potential benefits such as antibacterial effect and stimulation of wound healing. In addition, lasers help in hemostasis and delaying epithelial migration which may facilitate the outcome of flap surgery. Hence, this study is aimed to investigate the adjunctive effect of diode laser irradiation on conventional access flap surgery in the treatment of periodontal disease. Materials and Methods: A total of 23 patients requiring periodontal flap surgery in two sextants with probing pocket depth ≥5 mm in at least three teeth post-phase I therapy were selected for a split-mouth study. Flap surgery with adjunctive diode laser irradiation was performed in the test quadrant while conventional access flap surgery was done in the control quadrant. Procedural pain and tissue response of the patients were evaluated at 3, 7, and 14 days postoperatively. Clinical parameters including probing depth, clinical attachment level, plaque index, and gingival index were recorded at baseline, 3 months, and 6 months following treatment. Results: There is no significant difference between the groups with respect to healing response of tissues; however, patients experienced more pain in test sites compared to control sites. Intragroup comparisons showed a statistically significant reduction of all clinical parameters from baseline to 6 months without any significant difference between the groups. Conclusion: Overall within the limitations of the study, diode lasers did not show any significant added benefits over conventional access flap surgery.
Collapse
Affiliation(s)
| | | | - C D Dwarakanath
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Suneetha Koneru
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| |
Collapse
|
22
|
Eroglu CN, Keskin Tunc S. Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery. Photomed Laser Surg 2016; 34:406-10. [PMID: 27420732 DOI: 10.1089/pho.2016.4101] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In low-level laser therapy (LLLT), applications are generally performed in repetitive sessions using wavelengths of around 800 nm, at which the depth of penetration of laser is greater. The present study aimed to investigate the effects of LLLT with a 940 nm diode laser, which was performed extraorally on all the primarily and secondarily affected areas immediately after surgery in a single session, on pain, swelling, and trismus that occurred after impacted tooth extraction. MATERIALS AND METHODS Thirty-five outpatients with similarly impacted lower third molars on both sides were selected. The teeth of patients were removed in two separate operations. Postoperatively, the patients received laser therapy with energy of 4 J/cm(2) on one side and no laser energy was applied to the other side (placebo side). Swelling, trismus, and subjective assessment of pain on a visual analog scale were evaluated and compared between the laser-treated and placebo sides. RESULTS There was no statistically significant difference in pain, swelling, or trismus between the sides (Mann-Whitney U test p > 0.05). However, according to the clinical outcomes, swelling and trismus were less in the laser-treated side than in the placebo side. CONCLUSIONS A single-session LLLT that would be applied with a diode laser immediately after impacted tooth extraction might help patients to be less affected by postoperative trismus and swelling.
Collapse
Affiliation(s)
- Cennet Neslihan Eroglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
| | - Serap Keskin Tunc
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
| |
Collapse
|
23
|
Kumar P, Rattan V, Rai S. Comparative evaluation of healing after gingivectomy with electrocautery and laser. J Oral Biol Craniofac Res 2015; 5:69-74. [PMID: 26258017 DOI: 10.1016/j.jobcr.2015.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE OF THE STUDY To evaluate whether laser has got any advantage over electrocautery in performing gingivectomy procedure. METHOD This was randomized split mouth prospective study where 17 patients having symmetrical gingival hyperplasia were treated with electrocautery and laser on each side. Intra- and postoperative parameters assessed were duration of surgery, bleeding, tissue sticking, postoperative pain and healing. The results were statistically analyzed and compared. RESULT There were 7 Females and 10 Males with a mean age of 28.2 ± 11.6 years. The mean time taken on the laser and electrocautery was 16 (±8.05) and 16.7 min (±9.86) respectively and the difference was not significant. On laser side, there was no bleeding in 3 (17.6%) and self limiting in 14 patients (82.4%) whereas electrocautery side, there was no bleeding in 2 (11.8%) and self limiting in 15 patients (88.2%). Both electrocautery and laser were comparable regarding ease of use during gingivectomy procedure. Charring was observed on both sides although there was more charring on the laser side. Fibrinous slough was present on both sides at 24 h. Difference in healing was not significant at various time intervals. There were no significant difference in postoperative pain experienced by the patients among the laser and cautery group at different time intervals. CONCLUSION Both techniques with proper adhesion to safeguards, can be used to remove gingival overgrowth with equal efficiency and wound healing capacity. There is no advantage of diode laser over electrocautery in performing gingivectomy.
Collapse
Affiliation(s)
- Praveen Kumar
- Ex Junior Resident, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | - Vidya Rattan
- Professor, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | - Sachin Rai
- Assistant Professor, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| |
Collapse
|