Abstract
Laser technology in periodontal therapy could help in reducing total bacterial count. The aim of this study was to evaluate the effects of pocket debridement using an erbium-doped yttrium aluminium garnet laser (Er:YAG laser - ERL), scaling and root planing (SRP) with photodynamic therapy (PDT), or SRP alone. Teeth vitality and soft tissue carbonization were also assessed. This study included 1,169 single-rooted teeth from 84 patients divided into 3 groups (n = 28). The G1 group had ERL with 40 mJ of energy, a frequency of 40 Hz and a fluence of 63.66 J/cm2. The G2 group had SRP + PDT (635 nm diode laser, 12 J of energy and irradiation time of 30 s) and a Toluidine Blue photosensitizer (PS) (application time of 60 s). The G3 group was administered SRP alone. In the 42 subjects (G1: n = 11, G2: n = 14 and G3: n = 17) with high amounts of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td) and Tannerella forsythia (Tf), additional 1-week antibiotic treatments with clindamycin or amoxicillin + clavulanic acid - in doses of 600 mg/day or 1000 mg/day, respectively - were prescribed 3 months after the therapy. Microbiological and clinical analyses of the probing depth (PD), recession (RC), plaque index (PI), bleeding on probing (BOP), and attachment loss (AT) were performed at baseline and at the follow-up of 3 months, 3 months and 1 week, and 6 months. Plaque index decreased in G1 after 3 months, 3 months and 1 week, and 6 months (p < 0.05) and was lower in G1 vs G2 after 3 months (p < 0.05). The reduction in BOP in G1 after 3 months and 1 week was higher in comparison with G2 or G3 (p < 0.02). Probing depth decreased in all groups (p < 0.05). We found a reduction in the percentage of sites with some bacteria after 3 months - Prevotella intermedia (Pi) (G1 and G2), Capnocytophaga gingivalis (Cg) and Eubacterium nucleatum (En) (G3), and after 3 months and 1 week with En, Td, Tf (G1, G2 and G3), Pi (G1 and G2), Aa, Peptostreptococcus micros (Pm), and Cg (G3), and with Pi (G1 and G2), Tf (G2), Pg, En (G2 and G3), and Pm (G3) after 6 months (p < 0.05). We observed no signs of carbonization or teeth injury. Scaling and root planing + PDT and ERL may be an alternative therapy for chronic periodontitis.
Highlights
More and more bacterial strains have become resistant to antibiotics.[1]
We found a reduction in the percentage of sites with some bacteria after 3 months – Prevotella intermedia (Pi) (G1 and G2), Capnocytophaga gingivalis (Cg) and Eubacterium nucleatum (En) (G3), and after 3 months and 1 week with En, Treponema denticola (Td), Tannerella forsythia (Tf) (G1, G2 and G3), Pi (G1 and G2), Aa, Peptostreptococcus micros (Pm), and Cg (G3), and with Pi (G1 and G2), Tf (G2), Porphyromonas gingivalis (Pg), En (G2 and G3), and Pm (G3) after 6 months (p < 0.05)
Scaling and root planing + photodynamic therapy (PDT) and ERL may be an alternative therapy for chronic periodontitis
Summary
More and more bacterial strains have become resistant to antibiotics.[1] The excessive use of antibiotics and the development of several new ones by pharmaceutical companies are 2 reasons why some researchers describe the first decade of the 21st century as the antibiotic resistance crisis.[2,3,4] Anaerobic bacterial growth in the periodontal pocket leads to periodontal diseases, which are becoming more and more common in Poland; they increase the risk of tooth loss or other medical complications, such as acute myocardial infarction or stroke.[5,6,7]. Clinical and microbiological analyses using traditional culture methods and the polymerase chain reaction (PCR) test provide general data about the severity of periodontitis, which are useful in designing treatment strategies.[8] the basic PCR technique does not provide a quantitative assessment of the identified bacteria.[9] Due to its ability to generate both qualitative and quantitative results, the newer and more costly real-time polymerase chain reaction (rtPCR) analysis has provided scientific advancement.[9]. Laser technology in periodontal therapy could help in reducing total bacterial count
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