ABSTRACT
OBJECTIVES: This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction. MATERIALS AND METHODS: A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808 ± 5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm(2). Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy. RESULTS: There was a significant improvement of all the clinical parameters-clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)-for both groups (P < 0.001), with no statistical difference between them at the 6 weeks and the 6 months examinations. As for microbiological analysis, a significant reduction after 6 weeks (P > 0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study. CONCLUSIONS: After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment. CLINICAL RELEVANCE: The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.
Subject(s)
Chronic Periodontitis/therapy , Dental Scaling/methods , Laser Therapy/methods , Lasers, Semiconductor/therapeutic use , Root Planing/methods , Adult , Aggregatibacter actinomycetemcomitans/isolation & purification , Bacterial Load/drug effects , Bacterial Load/radiation effects , Chronic Periodontitis/microbiology , Chronic Periodontitis/radiotherapy , Combined Modality Therapy , Dental Plaque/microbiology , Dental Plaque Index , Dental Prophylaxis/methods , Double-Blind Method , Female , Follow-Up Studies , Humans , Male , Middle Aged , Periodontal Attachment Loss/radiotherapy , Periodontal Attachment Loss/therapy , Periodontal Index , Periodontal Pocket/radiotherapy , Periodontal Pocket/therapy , Porphyromonas gingivalis/isolation & purification , Prevotella intermedia/isolation & purification , Time Factors , Treatment OutcomeABSTRACT
The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.
Subject(s)
Chronic Periodontitis/surgery , Chronic Periodontitis/therapy , Lasers, Semiconductor/therapeutic use , Bacterial Load , Chronic Periodontitis/microbiology , Chronic Periodontitis/pathology , Combined Modality Therapy , Dental Plaque Index , Dental Scaling , Double-Blind Method , Female , Humans , Male , Middle Aged , Periodontal Attachment Loss , Periodontal Index , Root PlaningABSTRACT
The Nd:YAG laser efficacy associated with conventional treatment for bacterial reduction has been investigated throughout literature. The purpose of this study was to evaluate the bacterial reduction after Nd:YAG laser irradiation associated with scaling and root planning in class II furcation defects in patients with chronic periodontitis. Thirty-four furcation lesions were selected from 17 subjects. The control group received conventional treatment, and the experimental group received the same treatment followed by Nd:YAG laser irradiation (100 mJ/pulse; 15 Hz; 1.5 W, 60 s, 141.5 J/cm(2)). Both treatments resulted in improvements of most clinical parameters. A significant reduction of colony forming unit (CFU) of total bacteria number was observed in both groups. The highest reduction was noted in the experimental group immediately after the treatment. The number of dark pigmented bacteria and the percentage of patients with Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans reduced immediately after the treatment and returned to values close to the initial ones 6 weeks after the baseline for both groups. The Nd:YAG laser associated with conventional treatment promoted significant bacterial reduction in class II furcation immediately after irradiation, although this reduction was not observed 6 weeks after the baseline.
