Abstract
The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.
Highlights
The foundation of any periodontal therapy begins with the removal of bacterial plaque and calculus to allow healing of the periodontium
The purpose of this study was to compare the outcome of scaling and root planing with and without CO2 laser for the treatment of chronic periodontitis, in a split mouth design; and to examine the effect of laser therapy on subgingival microbiota over a period of six months
From baseline to 3 months, a decrease of 0.80 ± 0.053 mm was observed for both groups with the test sites decreasing by 0.88 ± 0.076 mm compared to the control sites decrease of 0.71 ± 0.730 mm both were statistically significant (p < 0.05)
Summary
The foundation of any periodontal therapy begins with the removal of bacterial plaque (biofilm) and calculus to allow healing of the periodontium. The early colonizers are either independent of the defined complexes or members of the yellow (Streptococcus species) or purple complexes (Actinomyces species). The red complex (P. gingivalis, B. forsythus, and T. denticola) is associated with bleeding on probing, an important clinical parameter of destructive periodontal diseases [1]. Another approach to determining the potential virulence of subgingival plaque in biofilm was shown in a preliminary study by Germano et al using atomic force microscopy and analyzing the bacterial components at a nanoscale. Their work identified species of spirochetes, flagellated forms and filaments as representative of periodontal pathogens similar to those found in the green, orange and red complexes [2]
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