Influence of Photobiomodulation Therapy on Gingivitis Induced by Multi-Bracket Appliances: A Split-Mouth Randomized Controlled Trial.

OBJECTIVE: The objective of this split-mouth trial was to investigate the influence of photobiomodulation therapy (PBMT) on adjuvant treatment of gingivitis induced by multi-bracket appliances, after bracket debonding and professional tooth cleaning. MATERIALS AND METHODS: Thirteen patients (mean age 16.15 years; standard deviation ±2.12 years) who had completed active orthodontic treatment with fixed orthodontic appliances in an orthodontic clinic were included on a randomized basis. At time point T0, after bracket debonding and professional tooth cleaning, the papilla bleeding index (PBI) and bleeding on probing (BOP) were assessed in the upper jaw by the blinded investigator (M.S.), who was not aware at any time of which quadrant received PBMT. The study was based on a patient-blinded split-mouth design. In each patient, PBMT was administered by a practitioner (S.S.) in one upper quadrant (wavelength: 660 nm; Power: 100 mW; Power density: 100 mW/cm2; Energy density per application point = 2 J/cm2; Energy per application point = 2 J; Total dose = 52 J/cm2; Total energy = 52 J; Irradiation time: 26 × 20 sec), while the other upper quadrant received a simulated laser application with the laser system turned off. Randomized equal allocation of the sides was accomplished. The second PBI and BOP assessment followed 4-6 days after laser irradiation (T1) by M.S. RESULTS: No statistical differences were observed between the sides with regard to PBI and BOP values at T0 (p > 0.05). The PBI and BOP values decreased significantly between T0 and T1 on both sides (p < 0.05). At T1, the PBI and BOP values were significantly lower in the laser side in comparison with the control side (p < 0.05). CONCLUSIONS: On the basis of these results and study parameters, adjuvant PBMT is able to accelerate the healing process in patients with gingivitis induced by multi-bracket appliances.

Adjunctive dental therapy via tooth plaque reduction and gingivitis treatment by blue light-emitting diodes tooth brushing.

The efficacy of blue light-emitting toothbrushes (B-LETBs) (405 to 420 nm, power density 2 mW/cm(2)) for reduction of dental plaques and gingival inflammation has been evaluated. Microbiological study has shown the multifactor therapeutic action of the B-LETBs on oral pathological microflora: in addition to partial mechanical removal of bacteria, photodynamic action suppresses them up to 97.5%. In the pilot clinical studies, subjects with mild to moderate gingivitis have been randomly divided into two groups: a treatment group that used the B-LETBs and a control group that used standard toothbrushes. Indices of plaque, gingival bleeding, and inflammation have been evaluated. A significant improvement of all dental indices in comparison with the baseline (by 59%, 66%, and 82% for plaque, gingival bleeding, and inflammation, respectively) has been found. The treatment group has demonstrated up to 50% improvement relative to the control group. We have proposed the B-LETBs to serve for prevention of gingivitis or as an alternative to conventional antibiotic treatment of this disease due to their effectiveness and the absence of drug side effects and bacterial resistance.

Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus.

BACKGROUND: Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. SUBJECTS AND METHODS: Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). RESULTS: Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. CONCLUSIONS: It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis.

Cytomorphometric and clinical investigation of the gingiva before and after low-level laser therapy of gingivitis in children.

Gingival epithelial cells are the first physical barrier against periodontal pathogenic microorganisms. Bacterial products may penetrate the epithelium and directly disturb its integrity. We investigated the clinical and cytomorphological status of the gingiva in children with gingivitis before and after low-level laser therapy. The study enrolled 130 children divided into three groups: group 1 comprised 50 children with chronic catarrhal gingivitis who received basic treatment, group 2 comprised 50 children with chronic catarrhal gingivitis who received low-level laser treatment in addition to basic treatment, and group 3 comprised 30 children with healthy gingiva as controls. Oral hygiene and the status of the gingiva were assessed using the appropriate indexes before and after treatment. Inflammation of the gingiva was monitored by cytomorphometric evaluation. Cytomorphometric analysis revealed a statistically significant difference (p < 0.001) in the size of the nuclei of the stratified squamous epithelial cells of the gingiva before and after treatment in chronic catarrhal gingivitis. Evaluation using clinical parameters showed that treatment of gingivitis with basic treatment was successful. Cytomorphometric analysis showed that after basic treatment the nuclei of the stratified squamous epithelial cells of the gingiva were reduced in size, although not to the size found in healthy gingiva. However, after adjuvant low-level laser therapy, the size of the nuclei of the stratified squamous epithelial cells in the gingiva matched the size of the nuclei in the cells in healthy gingiva.

The effects of low level laser irradiation on gingival inflammation.

OBJECTIVE: The goal of this study was to analyze the effects of low level laser irradiation treatment and conservative treatment on gingival inflammation. BACKGROUND: It is widely accepted today that the primary etiological factor for the onset of periodontitis is dental plaque, although the exact mechanism of damage remains unknown. Inflammation is a basic response of periodontal tissue to damage and serves as a fast first line of defense against damage and infections. The treatment of gingivitis and periodontitis has gone through various stages: from the simplest, classical treatment methods, through improved radical interventions, to a new era marked by laser technology. Low level laser irradiation has an anti-inflammatory effect, both general and local. MATERIALS AND METHODS: The research was done on patients who had chronic periodontal disease (mild periodontitis) with expressed clinical symptoms of gingival inflammation. All patients in the study underwent conservative treatment. After conservative therapy, the patients from the experimental group were subjected to 10 low level laser treatment sessions. Both groups underwent regular follow-up visits 1, 3, and 6 months after treatment, which involved only clinical examination using plaque index (PI), gingival index (GI), and bleeding on probing index (BOP index). RESULTS: A considerable decrease in all three indexes after the application of both therapies was noticed. The follow-up visits revealed the difference in index values. With laser therapy, the values of indexes decreased steadily, whereas with conservative therapy they increased up to a certain point, but did not reach the pre-therapy values. CONCLUSIONS: A general conclusion can be drawn that low level laser irradiation (semiconductor, 670 nm) can be used as a successful physical adjuvant method of treatment, which, together with traditional periodontal therapy, leads to better and longer-lasting therapeutic results.

[Low-level laser efficiency in the therapy of chronic gingivitis in children].

BACKGROUND/AIM: Gingivitis is a frequent phenomenon in children considered to be a risk factor for the occurrence and progression of paradontal tissue disease. So, it is necessary not only to identify inflammation, but also to react in due time and adequately in order to avoid further disease spread and the beginning of periodontitis. The aim of this study was to determine the efficiency of a low-level laser application in the therapy of chronic gingivitis in children. METHODS: The study a included hundred of children with permanent dentition suffering from chronic gingivitis. All the examinees were divided into two groups: group I--50 examinees with chronic gingivitis, who underwent the basic therapy; group II--50 examinees with chronic gingivitis, who underwent the basic therapy and also a therapy with a low-level laser. Evaluation of the condition of oral hygiene, the health of gingiva and periodontium were done using appropriate index before and after the therapy. RESULTS: For the plaque index (PI) following results were obtained: in the group I PI = 1.94, and in the group II PI = 1.82. After the therapy in both groups PI was 0. In the group I sulcus plaque index (SPI) was 2.02 before the therapy and 0.32 after the therapy. In the group II SPI was 1.90 before the therapy, and 0.08 after the therapy. In the group I Community Periodontal Index of Treatment Needs (CPITN) was 1.66 before the therapy, and 0.32 after the therapy, and in the group II CPITN was 1.60 before the therapy, and 0.08 after the therapy. CONCLUSION: Chronic gingivitis in children can be successfully cured by the basic treatment. The use of a low-level laser can significantly improve this effect.

Low dose irradiation as a treatment for gingivitis.

Improved dental hygiene has decreased the incidence of dental caries and focused attention on periodontal diseases. Gingivitis is the inflammation and/or ulceration of gingival tissue caused by anaerobic bacteria. Ionizing radiation produces a variety of oxygen species from the water in our tissues; each is highly toxic for anaerobic. The hypothesis is: low dose irradiation should be an effective treatment for gingivitis.

[Combined therapy of chronic catarrhal gingivitis using low intensity laser light]. / Kompleksnoe lechenie khronicheskogo kataral'nogo gingivita s primeneniem nizkointensivnogo lazernogo sveta.

Periodontal diseases, one of which is chronic catarrhal gingivitis (CCG), represent a medicosocial problem. Standard therapy often fails to bring about stable results. Addition of low-energy laser exposure at wavelengths of 0.63 micron and 0.85-0.89 micron to therapeutic complexes helps attain stable results, which is confirmed by clinical, functional, immunological, and x-ray data and densitometry. Laser therapy exerts a multifactorial pathogenetic effect, eliminating inflammation in periodontal tissue, normalizing microcirculation in the periodontium, improving mineral saturation of osseous tissue of the alveolar processes of the jaws, and improving local immunity of the oral cavity. All this accelerates treatment and decreases the probability of relapses.

Plasma cell infiltration of the upper aerodigestive tract treated with radiation therapy.

A case of chronic, fluctuating plasma cell gingivostomatitis that progressed despite chemotherapy and surgery is reported. This is the first case reported of treatment with radiation therapy, and one of the few cases reported where the infiltrate has reached the larynx. After receiving low dose radiation therapy, via a conformal technique encompassing the respiratory mucosal lining from the base of tongue to carina, there has been symptomatic improvement.

Conventional versus laser-assisted therapy of periimplantitis: a five-year comparative study.

Between 1994 and 1999, 50 patients were treated with either profound parodontopathy (30) or periimplantitis (20). Half of each of the two groups of patients was treated conventionally, and the other half was treated with laser support. Before the operation, microbiological examinations were carried out, in addition to registering the clinical findings and taking x-rays. These procedures were repeated after the operation, and again after 6, 12, 24, 36, 48, and 60 months. The surgical part of therapy for each half of the patient groups included surface decontamination with diode laser light (1-watt output, maximum of 20 seconds) in addition to conventional procedures. The values of the laser-supported therapy were lower than those specified in the relevant literature. The relapse rate of the two diseases (13% for the periimplantitis and 23% for the parodontopathy group) after 5 years was lower than the comparative values of researched literature where decontamination was not included in the therapy. We think that integrating diode laser light decontamination in the approved treatment schemes for periimplantitis and parodontitis contributes considerably to the success of this therapy.

Effect of low level energy laser irradiation on gingival inflammation.

The effect of low level energy infra-red laser irradiation on gingival inflammation was studied. Gingivitis was induced in ten female dental students by refraining from all oral hygiene measures for 28 days. On days 21 and 24 the marginal gingiva, buccal to one of the lateral mandibular incisors, was exposed to 4 minutes of laser irradiation (total dose = 1J). Serving as a control site the gingiva of the contralateral incisors was exposed to ordinary light. There was no statistical difference between the laser exposed sites and the control sites related to either plaque formation or gingival bleeding. The gingivitis reaction was evaluated with the aid of a stereophotographic method by calculating changes in the number of gingival vessels. It was found that the number of vessels identified increased over time for both laser exposed and control sites. The difference between sites at day 28 was not statistically significant (t = 0.82, P > 0.05). These results suggest that low energy laser irradiation (LLLT) does not influence the inflammatory reaction of the gingiva.

The soft laser: therapeutic tool or popular placebo?

Because of the alleged effectiveness of soft laser therapy in the treatment of a wide range of medical and dental conditions, it is becoming increasingly popular with both patients and practitioners. It was the purpose of this study to assess soft laser treatment of hypersensitive dentin, gingivitis, pulp-capped teeth, herpes labialis, and nausea. Clinical trails demonstrated no advantage in augmenting or replacing conventional treatment of these conditions with soft laser therapy, despite its positive effect on patient attitude toward treatment.

[Intraoral UV irradiation in gingivitis and ulcerative stomatitis]. / Die intraorale UV-Bestrahlung bei Gingivitis und Stomatitis ulcerosa

The different specific and non-specific general effects of ultra-violet rays are discussed. Intro-oral ultra-violet irradiation is indicated in all ulcerous and ulcero-aphthous diseases of the gingiva and the remaining oral mucosa. The author's experience does not plead for other applications, e. g., in case of parodontopathia inflammata and parodontopathia dystrophica, which is sometimes recommedned. The technique of ultra-violet irradiation is described. It is emphasized that a stomatological nurse may give this treatment, which relieves the stomatologist