Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis.

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of periodontology Pub Date : 2024-08-26 DOI:10.1002/JPER.24-0128
Zhexian Cheng, Wei Li, Jitian Wang, Xuan Huang, Xingyuan Jia, Xuan Zhou
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Abstract

Background: To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment.

Methods: In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months.

Results: For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups.

Conclusion: The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets.

Plain language summary: To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low level laser therapy into standard periodontal treatment may enhance the treatment's benefits in reducing pocket depth, especially for severe conditions.

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在牙周炎的非手术治疗中联合应用 Er:YAG 激光和低强度激光。
背景:比较Er:YAG激光(ERL)和低强度激光疗法(LLLT)联合治疗与单一激光应用以及洗牙和根面平整(SRP)用于非手术牙周治疗的疗效:在一项随机对照试验中,招募了 25 名非吸烟的二期或三期牙周炎患者。口内四个象限被随机分配到四种不同的治疗方法中:(1)ERL+SRP+LLLT联合应用;(2)ERL+SRP;(3)SRP+LLLT;(4)SRP。我们在基线、3 个月和 6 个月时评估了牙周指标,包括探诊深度 (PD)、临床附着水平 (CAL)、出血指数 (BI) 和牙菌斑指数 (PLI),以及龈沟液中的三种细胞因子(IL-1β、TNF-α、IL-10)和龈下牙菌斑中的红色复合病原体:对于最初的中度牙周袋(4 mm ≤ PD ≤ 6 mm),与对照组(SRP)相比,ERL+SRP+LLLT、ERL+SRP 和 SRP+LLLT 治疗的象限在 3 个月的随访中显示出更大的 PD 改善(1.25 ± 1.06、1.23 ± 1.12、1.00 ± 1.21 vs. 0.98 ± 1.21 mm)和 6 个月随访(1.35 ± 1.06、1.23 ± 1.17、1.35 ± 0.98 vs. 0.98 ± 1.23 mm)(p = 0.002)。在 3 个月随访(0.96 ± 1.42、0.61 ± 1.39 vs. 0.55 ± 1.57 mm)和 6 个月随访(0.84 ± 1.54、0.89 ± 1.49 vs. 0.48 ± 1.68 mm)时,接受 ERL+SRP+LLLT 和 SRP+LLLT 治疗的象限比对照象限显示出更多的 CAL 增益(p = 0.008)。对于最初的深袋(PD ≥ 7 mm),ERL+SRP+LLLT象限与对照象限相比,在随访时有更多的PD改善和CAL增加。四组之间在BI、PLI、炎症细胞因子和牙周病原体方面没有明显差异:白话摘要:比较联合使用 Er:YAG 激光(ERL)和低水平激光治疗(LLLT)与单一使用激光和传统牙周治疗(SRP)的治疗效果。共有 25 名不吸烟的牙周炎患者参与了这项研究,他们的口腔被分为四个部分,每个部分都接受了不同的治疗:分别接受 ERL+SRP+LLLT、ERL+SRP、SRP+LLLT 和 SRP 治疗。分别在基线、3 个月和 6 个月时对临床指标和实验室指标进行评估。6 个月后,对于初期中度牙周袋,联合激光组和单一激光组在减少牙周袋深度和增加附着水平方面的改善效果优于传统组。但对于初期的深牙周袋,只有联合激光组比传统组有更好的改善。各组在出血、牙菌斑、炎症或有害细菌水平方面没有明显差异。这些研究结果表明,将 Er:YAG 激光和低水平激光疗法整合到标准牙周治疗中可能会提高治疗效果,减少牙周袋深度,尤其是对于严重的情况。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
期刊最新文献
Periodontitis associated with brain function impairment in middle-aged and elderly individuals with normal cognition. Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients. Impact of nonsurgical periodontal treatment on arterial stiffness outcomes related to endothelial dysfunction: A systematic review and meta-analysis. Appraising the life-course impact of Epstein-Barr virus exposure and its genetic signature on periodontitis. Effectiveness of nonsurgical re‐instrumentation: Tooth‐related factors
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