Approfondimenti Scientifici

Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing.
Kreisler M, Al Haj H, d'Hoedt B - Department of Oral Surgery, Johannes Gutenberg-University Mainz, Mainz, Germany.
matthiaskreisler@web.de

BACKGROUND AND OBJECTIVES: The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing.

MATERIALS AND METHODS: Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). RESULTS: Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate.

CONCLUSIONS: The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.

(c) 2005 Wiley-Liss, Inc.

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Clinical study of the gingiva healing after gingivectomy and low-level laser therapy.
Amorim JC, de Sousa GR, de Barros Silveira L, Prates RA, Pinotti M, Ribeiro MS - Department of Mechanical Engineering, Pampulha, Belo Horizonte, Brazil.
joseclaudioamorim@yahoo.com.br

OBJECTIVE: The purpose of this study was to investigate gingival healing after gingivectomy and adjunctive use of low-level laser therapy (LLLT).

BACKGROUND DATA: LLLT has been used in animal experiments to examine the influence of laser radiation on the wound healing process since the 1960s. However, clinical trials in dentistry are scarce, and most of them refer to treatment after extraction of the third molars, with only a few reports in the area of periodontics.

METHODS: Twenty patients with periodontal disease were selected, and treatment was planned for gingivectomy to bilateral maxillary and mandibular premolar teeth. After surgery, one side was submitted to LLLT using a 685-nm wavelength, output power of 50 mW, and energy density of 4 J/cm(2). The other side was used as the control and did not receive laser irradiation. Healing was evaluated, clinically and biometrically, immediately post-surgery and at days 3, 7, 14, 21, 28, and 35. Results were submitted to statistical analysis.

RESULTS: Biometrical evaluation indicated a significant improvement in healing for the laser group at 21 and 28 days. Clinical evaluation showed better repair for the laser group, mainly after the third day.

CONCLUSION: LLLT was an effective adjunctive treatment that appeared to promote healing following gingivectomy.