Effect of low-power laser irradiation on cell growth and procollagen synthesis of cultured fibroblasts.
Pereira Aymann Nassif,Eduardo Carlos de Paula,Matson Edmir,Marques Márcia Martins
Lasers in surgery and medicine
BACKGROUND AND OBJECTIVES:In dentistry, low-power lasers have been used in the treatment of dentin hypersensitivity, gingivitis, periodontitis, and different forms of oral ulcers. This in vitro study focuses on the biostimulation of NIH-3T3 fibroblasts by a low-power Ga-As-pulsed laser. STUDY DESIGN/MATERIALS AND METHODS:We have studied cell growth and procollagen synthesis of cultured fibroblasts submitted to low-power laser irradiation with energy densities varying from 3 to 5 J/cm(2) over a period of 1-6 days. The light source was a 120 mW Ga-As diode laser (lambda = 904 nm). Growth curves and procollagen immunoprecipitation were obtained. RESULTS:Irradiation of 3 and 4 J/cm(2) increased the cell numbers about threefold to sixfold comparing to control cultures. However, this effect was restricted to a small range of energy densities since 5 J/cm(2) had no effect on cell growth. The energy density of 3 J/cm(2) remarkably increased cell growth, with no effect on procollagen synthesis, as demonstrated by the immunoprecipitation analysis. CONCLUSIONS:Our results showed that a particular laser irradiation stimulates fibroblast proliferation, without impairing procollagen synthesis.
The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation.
Qadri T,Miranda L,Tunér J,Gustafsson A
Journal of clinical periodontology
OBJECTIVES:The aim of this split-mouth, double-blind controlled clinical trial was to study the effects of irradiation with low-level lasers as an adjunctive treatment of inflamed gingival tissue. MATERIALS AND METHODS:Seventeen patients with moderate periodontitis were included. After clinical examination, all teeth were scaled and root planed (SRP). One week after SRP, we took samples of gingival crevicular fluid (GCF) and subgingival plaque. The laser therapy was started 1 week later and continued once a week for 6 weeks. One side of the upper jaw was treated with active laser and the other with a placebo. The test side was treated with two low-level lasers having wavelengths of 635 and 830 nm. The patients then underwent another clinical examination with sampling of GCF and plaque. The GCF samples were analysed for elastase activity, interleukin-1beta (IL-1beta) and metalloproteinase-8 (MMP-8). We examined the subgingival plaque for 12 bacteria using DNA probes. RESULTS:The clinical variables i.e. probing pocket depth, plaque and gingival indices were reduced more on the laser side than on the placebo one (p<0.01). The decrease in GCF volume was also greater on the laser side, 0, 12 microl, than on the placebo side, 0.05 microl (p=0.01). The total amount of MMP-8 increased on the placebo side but was slightly lower on the laser side (p=0.052). Elastase activity, IL-1beta concentration and the microbiological analyses showed no significant differences between the laser and placebo sides. CONCLUSION:Additional treatment with low-level lasers reduced periodontal gingival inflammation.
Laser-activated transforming growth factor-β1 induces human β-defensin 2: implications for laser therapies for periodontitis and peri-implantitis.
Tang E,Khan I,Andreana S,Arany P R
Journal of periodontal research
BACKGROUND:There is increasing popularity of high-power lasers for surgical debridement and antimicrobial therapy in the management of peri-implantitis and periodontal therapy. Removal of the noxious foci would naturally promote tissue healing directly. However, there are also anecdotal reports of better healing around routine high-power laser procedures. The precise mechanisms mediating these effects remain to be fully elucidated. This work examines these low-dose laser bystander effects on oral human epithelial and fibroblasts, particularly focusing on the role of human β-defensin 2 (HBD-2 or DEFB4A), a potent factor capable of antimicrobial effects and promoting wound healing. MATERIAL AND METHODS:Laser treatments were performed using a near-infrared laser (810 nm diode) at low doses. Normal human oral keratinocytes and fibroblast cells were used and HBD-2 mRNA and protein expression was assessed with real time polymerase chain reaction, western blotting and immunostaining. Role of transforming growth factor (TGF)-β1 signaling in this process was dissected using pathway-specific small molecule inhibitors. RESULTS:We observed laser treatments robustly induced HBD-2 expression in an oral fibroblast cell line compared to a keratinocyte cell line. Low-dose laser treatments results in activation of the TGF-β1 pathway that mediated HBD-2 expression. The two arms of TGF-β1 signaling, Smad and non-Smad are involved in laser-mediated HBD-2 expression. CONCLUSIONS:Laser-activated TGF-β1 signaling and induced expression of HBD-2, both of which are individually capable of promoting healing in tissues adjacent to high-power surgical laser applications. Moreover, the use of low-dose laser therapy itself can provide additional therapeutic benefits for effective clinical management of periodontal or peri-implant disease.
Photobiomodulation for the treatment of periodontal pockets in patients with type 2 diabetes: 1-year results of a randomized clinical trial.
Castro Dos Santos Nídia,Andere Naira M R B,Miguel Manuela Maria Viana,Dos Santos Lúcio Murilo,Santamaria Milton,Mathias Ingrid Fernandes,Jardini Maria Aparecida Neves,Santamaria Mauro Pedrine
Lasers in medical science
This study investigated the local effect of photobiomodulation (PBM) for the treatment of periodontal pockets in patients with periodontitis and type 2 diabetes. Thirty-eight periodontal pockets presenting probing depth (PD) and clinical attachment level (CAL) ≥ 5 mm were selected from 19 patients (two pockets/patient). The selected periodontal pockets were randomly assigned to receive mechanical debridement only (control group) or mechanical debridement with PBM (PBM group). Clinical measures, such as PD, CAL, bleeding on probing (BoP), and presence of supragingival biofilm (PI), were collected and compared at baseline, 3, 6, and 12 months. After 12 months, no statistically difference was observed for mean PD and mean CAL when control and PBM groups were compared. The frequency of pockets with PD 5-6 mm was significantly lower for the PBM group at 6 months when compared to the control group. Pockets with PD ≥ 7 mm changed significantly between baseline and 3, 6, and 12 months for the PBM group, while for the control group, statistical significance was only observed between baseline and 6 months. The PBM protocol used in this study did not provide significant changes for PD and CAL in periodontal pockets when compared to mechanical therapy only. However, PBM was more effective in reducing the percentage of moderate periodontal pockets at 6 months in patients with type 2 DM.
The effect of low-level laser irradiation on hyperglycemia-induced inflammation in human gingival fibroblasts.
Lee Kun-Tsung Denzel,Chiang Min-Hsuan,Chen Ping-Ho,Ho Mei-Ling,Lee Hong-Zin,Lee Huey-Er,Wang Yan-Hsiung
Lasers in medical science
Hyperglycemia-induced inflammation can greatly increase the risk of periodontal disease in people with diabetes. Low-level laser irradiation (LLLI) has been used for wound healing and anti-inflammation in many cases, and LLLI is known to inhibit the lipopolysaccharide (LPS)-stimulated inflammatory response. However, the therapeutic effect of LLLI in diabetes patients with periodontitis remains unknown. In this study, we cultured human gingival fibroblasts (HGFs) in high-glucose medium (35 mM) to mimic a hyperglycemic environment, and then measured the anti-inflammatory effect of LLLI by assessing the expression of pro-inflammatory genes including tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, and IL-8 by quantitative real-time polymerase chain reaction. The results demonstrated no significant inflammatory response in HGFs cultured in mannitol medium and in those treated only with LLLI. However, HGFs cultured only in high-glucose medium showed significantly higher expression of pro-inflammatory cytokine than in those treated together with LLLI. We then observed that LLLI reduced the expression of pro-inflammatory cytokines in HGFs cultured in high-glucose medium by modulating cAMP signaling. We also investigated whether antioxidant (vitamin C) treatment reduced the inflammatory effect of oxidative stress in HGFs cultured in high-glucose medium but found no additive effect upon co-treatment with LLLI, suggesting that LLLI may activate cAMP signaling, but not reactive oxygen species (ROS) signaling, to reduce the high glucose-induced inflammation. In conclusion, LLLI may have an anti-inflammatory effect on HGFs in a high glucose environment and may benefit the treatment of periodontal disease in diabetes patients.
Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus.
Obradović Radmila,Kesić Ljiljana,Mihailović Dragan,Jovanović Goran,Antić Slobodan,Brkić Zlata
Diabetes technology & therapeutics
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.
The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment.
Aykol Gokce,Baser Ulku,Maden Ilay,Kazak Zafer,Onan Utku,Tanrikulu-Kucuk Sevda,Ademoglu Evin,Issever Halim,Yalcin Funda
Journal of periodontology
BACKGROUND:The aim of this study is to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal therapy of smoking and non-smoking patients with moderate to advanced chronic periodontitis. METHODS:All 36 systemically healthy patients who were included in the study initially received non-surgical periodontal therapy. The LLLT group (n = 18) received GaAlAs diode laser therapy as an adjunct to non-surgical periodontal therapy. A diode laser with a wavelength of 808 nm was used for the LLLT. Energy density of 4 J/cm(2) was applied to the gingival surface after periodontal treatment on the first, second, and seventh days. Each of the LLLT and control groups was divided into two groups as smoking and non-smoking patients to investigate the effect of smoking on treatment. Gingival crevicular fluid samples were collected from all patients and clinical parameters were recorded on baseline, the first, third, and sixth months after treatment. Matrix metalloproteinase-1, tissue inhibitor matrix metalloproteinase-1, transforming growth factor-β1, and basic-fibroblast growth factor levels in the collected gingival crevicular fluid were measured. RESULTS:The primary outcome variable in this study was change in gingival bleeding and inflammation. At all time points, the LLLT group showed significantly more improvement in sulcus bleeding index (SBI), clinical attachment level, and probing depth (PD) levels compared to the control group (P <0.001). There were clinically significant improvements in the laser-applied smokers' PD and SBI levels compared to smokers to whom a laser was not applied, between the baseline and all time points (P <0.001) (SBI score: control group 1.12, LLLT group 1.49; PD: control group 1.21 mm, LLLT group 1.46 mm, between baseline and 6 months). Transforming growth factor-β1 levels and the ratio of matrix metalloproteinase-1 to tissue inhibitor matrix metalloproteinase-1 decreased significantly in both groups at 1, 3, and 6 months after periodontal therapy (P <0.001). Basic-fibroblast growth factor levels significantly decreased in both groups in the first month after the treatment, then increased in the third and sixth months (P <0.005). No marker level change showed significant differences between the groups (P <0.05). CONCLUSION:LLLT as an adjunctive therapy to non-surgical periodontal treatment improves periodontal healing.
Etiological periodontal treatment with and without low-level laser therapy on IL-1β level in gingival crevicular fluid: an in vivo multicentric pilot study.
Mastrangelo F,Dedola A,Cattoni F,Ferrini F,Bova F,Tatullo M,Gherlone E,Lo Muzio L
Journal of biological regulators and homeostatic agents
Cytokine proteins may have important roles during different human physiological and pathological processes. In the oral cavity, the bone loss and periodontal tissue pathology was related to inflammatory process activation. The aim of the present study was to assess the effects of etiological periodontal therapy with and without the use of Low Level Laser Therapy (LLLT) on clinical periodontal parameters and interleukin (IL)-1β level in gingival crevicular fluid (GCF) from chronic periodontitis (CP) patients. Thirty non-smoker CP patients were selected from the Foggia University Dental Clinic and other 2 private dental clinics. All patients were divided into two homogeneous randomized groups: 15 patients were treated with only scaling and root planing (group 1) and 15 patients with scaling and root planing etiological treatment and LLLT (group 2). In all sites, at baseline before treatment, the periodontal pocket depth (PPD) and bleeding on probing (BOP) were measured. In the PPD sites, the GCF samples were collected from 30 deep (≥5 mm) and shallow (≤3 mm) sites and IL-1β were evaluated at baseline, after 10 days and 1 month. In all the samples at baseline, the IL-1β concentration in GCF and BOP rate were significantly higher at deep PPD sites than at the shallow ones. After 10 days in all samples no PPD improvement was observed in the BOP rate but the IL-1 β level was statistically significantly improved (p<0.005) in group 2 compared to group 1. At 10 days and 1 month, in all deep PPD sites, PPD and BOP improvements were observed. At same time, IL-1β levels were lower and statistically significantly (p<0.005) improved in group 2 compared to group 1. The results confirmed that the periodontal etiology treatment of deep PPD sites with or with-out associated LLLT promotes periodontal health. Etiological treatment associated with LLLT, improves BOP and inflammation in periodontal disease. Moreover, the IL-1β concentration changes in GCF suggest these cytokines as a predictable marker of gingival inflammation in chronic periodontitis patients.
The effectiveness of low-level laser therapy as an adjunct to non-surgical periodontal treatment: a meta-analysis.
Ren C,McGrath C,Jin L,Zhang C,Yang Y
Journal of periodontal research
BACKGROUND AND OBJECTIVES:Although low-level laser therapy (LLLT) has been demonstrated to have a biomodulatory effect on periodontal tissue, no systematic review has exclusively addressed its effectiveness as an adjunct to non-surgical periodontal treatment. This study aimed to evaluate whether an additional benefit exists for the application of LLLT compared with scaling and root planing (SRP) alone. MATERIAL AND METHODS:An extensive search was conducted in the Cochrane Library (Issue 8, 2015), PubMed (1997) and EMBASE (1947) before August 2015 for randomized controlled trials (RCTs). The bias risk was assessed with the Cochrane tool for risk of bias evaluation. A meta-analysis was performed using REVMAN 5.3. RESULTS:After independent screening of 354 initial records, eight publications (seven RCTs) were included. However, six were rated as 'having a high risk of bias' as a result of major methodological weakness in 'allocation concealment' and 'blinding of key personnel'. Meta-analysis showed that LLLT-mediated SRP demonstrated significant short-term benefits over SRP monotherapy in the improvement of the probing pocket depth (p = 0.0009 at 1 mo; p = 0.03 at 2 mo) and the level of interleukin-1β in the gingival crevicular fluid (p = 0.01 at 1 mo). Nevertheless, LLLT failed to show significant additional intermediate-term (3 and 6 mo) effects in terms of clinical parameters and alveolar bone density. CONCLUSION:These findings indicated that LLLT showed only short-term additional benefits after conventional SRP. Its long-term effects remain unclear due to substantial methodological weaknesses and an insufficient number of current studies. Future RCTs with better designs and longer follow-up periods are required to assess the effectiveness of LLLT as an adjunctive treatment strategy in patients with periodontal disease.
Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial.
Alqahtani Fawaz,Alqhtani Nasser,Celur Sree Lalita,Divakar Darshan Devang,Al-Kheraif Abdulaziz A,Alkhtani Fahad
The Journal of oral implantology
We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.
Clinical, microbiological and cytomorphometric evaluation of low-level laser therapy as an adjunct to periodontal therapy in patients with chronic periodontitis.
Petrović M S,Kannosh I Y,Milašin J M,Mihailović D S,Obradović R R,Bubanj S R,Kesić L G
International journal of dental hygiene
OBJECTIVE:A clinical prospective study was designed to evaluate microbiological, cytomorphometric and clinical efficacy of low-level laser therapy (LLLT) as an adjunct to periodontal therapy in the treatment of chronic periodontitis. METHODS:Sixty subjects were included and randomly assigned into 2 groups: SRP (scaling root planning) group (n = 30) and LLLT + SRP group (n = 30). Clinical parameters were measured before intervention, after the fifth treatment, and after a month. All subjects received oral hygiene instructions and full-mouth conservative periodontal treatment (removal of dental plaque followed by SRP). Afterwards, in group II, Kavo LLLT (980 nm, 0.2 W, 6 J/cm ) was applied. Subgingival samples were collected at baseline and after the fifth treatment to quantify Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola by polymerase chain reaction (PCR). Gingival swabs were taken, and direct smears were prepared on slides for cytomorphometric analysis. RESULTS:Evaluation using clinical parameters showed better results in LLLT group. A statistically significant decrease in the prevalence of bacteria after treatment in LLLT group was observed for the following: T. forsythensis and T. denticola (P < .001), P. gingivalis (P < .01), A. actinomycetemcomitans and P. intermedia (P < .05). The values of nuclear area, perimeter and Ferret's diameter were significantly lower in both studied groups after treatment, but statistical significance was higher in LLLT group (P < .001) than in the SRP therapy group (P < .05). CONCLUSION:Low-level laser therapy as an adjunct to periodontal therapy demonstrates short-term additional bacteriological, cytological and clinical benefits.
Efficacy of adjunctive low-level laser therapy in the treatment of aggressive periodontitis: A systematic review.
Journal of investigative and clinical dentistry
The aim of the present study was to systematically review the efficacy of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) vs SRP alone in the treatment of aggressive periodontitis (AgP). The addressed PICO (Population, Interventions, Comparisons and Outcomes) question was: Is LLLT as an adjunct to SRP effective in the treatment of AgP? Electronic databases, including MEDLINE via PubMed, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials, and EMBASE, were searched until March 2018. Four clinical studies were included. Three studies showed significant improvement in periodontal outcomes among LLLT group compared to SRP alone, whereas only one study showed comparable periodontal outcomes between the adjunctive LLLT and SRP groups at follow up. The overall mean difference for clinical attachment level gain (weighted mean difference [WMD] = -1.69, 95% confidence interval [CI] = -3.46 to 0.07, P < 0.061) was not significant. However, significant difference for probing depth reduction (WMD = -0.95, 95% CI = -1.66 to 0.23, P = 0.009) was noticed between groups at follow up. Whether LLLT as an adjunct to SRP is more effective than SRP alone in the treatment of AgP remains debatable. Further randomized, clinical trials are required with long follow-up periods and standard laser parameters to reach a strong conclusion.
The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoking chronic periodontitis patients: A split-mouth, randomized control study.
Pamuk F,Lütfioğlu M,Aydoğdu A,Koyuncuoglu C Z,Cifcibasi E,Badur O S
Journal of periodontal research
BACKGROUND AND OBJECTIVE:This study aimed to investigate the effects of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) on smoking and non-smoking patients with chronic periodontitis. MATERIAL AND METHODS:The study was conducted using a split-mouth design with 30 patients with chronic periodontitis (15 smokers, 15 non-smokers) and 30 healthy individuals matched for age, sex and smoking status as controls. Groups were constituted as follows: Cp+SRP+Sham: non-smokers with chronic periodontitis treated with SRP; Cp+SRP+LLLT: non-smokers with chronic periodontitis treated with SRP+LLLT; SCp+SRP+Sham: smokers with chronic periodontitis treated with SRP; SCp+SRP+LLLT: smokers with chronic periodontitis treated with SRP+LLLT; C: control group comprised of periodontally healthy non-smokers; SC: control group comprised of periodontally healthy smokers. LLLT was first applied on the same day as SRP and again on days 2 and 7 after SRP treatment. Clinical parameters were recorded before non-surgical periodontal treatment (baseline) and on day 30. Gingival crevicular fluid samples were collected before periodontal treatment (baseline) and during follow-up visits on days 7, 14 and 30. Gingival crevicular fluid transforming growth factor (TGF)-β1, tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) levels were measured using enzyme-linked immunosorbent assay. RESULTS:All clinical parameters showed significant reductions between baseline and day 30 following SRP treatment in both the LLLT and sham groups (P<.001). No significant differences were observed between the LLLT and sham groups of either the smokers or non-smokers (P>.05). Gingival crevicular fluid PAI-1 levels decreased significantly in the SCp+SRP+sham and SCp+SRP+LLLT groups (P<.05), and gingival crevicular fluid tPA levels decreased significantly in the Cp+SRP+sham, Cp+SRP+LLLT and SCp+SRP+LLLT groups (P<.05). Gingival crevicular fluid TGF-β1 levels decreased significantly in all treatment groups (P<.05). Although no significant differences were found between the gingival crevicular fluid PAI-1, tPA and TGF-β1 levels of the LLLT versus sham groups (P>.05) at any of the time points measured, both LLLT groups showed significant reductions in tPA/PAI-1 ratios over time. CONCLUSION:Within the limits of this study, LLLT may be understood to play a role in the modulation of periodontal tissue tPA and PAI-1 gingival crevicular fluid levels, particularly in smoking patients with chronic periodontitis, and may thus be recommended as an adjunct to non-surgical periodontal treatment.
Combined photodynamic and low-level laser therapies as an adjunct to nonsurgical treatment of chronic periodontitis.
Lui J,Corbet E F,Jin L
Journal of periodontal research
BACKGROUND AND OBJECTIVE:In recent years, there has been a growing interest in the use of dental lasers for treatment of periodontal diseases. The purpose of this short-term clinical trial was to evaluate the effects of a combination of photodynamic therapy with low-level laser therapy as an adjunct to nonsurgical treatment of chronic periodontitis. MATERIAL AND METHODS:Twenty-four nonsmoking adults with untreated chronic periodontitis were randomly assigned in a split-mouth design to receive scaling and root debridement with or without one course of adjunctive photodynamic therapy and low-level laser therapy within 5 d. Plaque, bleeding on probing, probing depth and gingival recession were recorded at baseline, 1 and 3 mo after the treatment. Gingival crevicular fluid was collected for assay of interleukin-1β levels at baseline, 1 wk and 1 mo. RESULTS:The test teeth achieved greater reductions in the percentage of sites with bleeding on probing and in mean probing depth at 1 mo compared with the control teeth (p < 0.05). A significant decrease in gingival crevicular fluid volume was observed in both groups at 1 wk (p < 0.001), with a further decrease at 1 mo in the test sites (p < 0.05). The test sites showed a greater reduction of interleukin-1β levels in gingival crevicular fluid at 1 wk than the control sites (p < 0.05). No significant differences in periodontal parameters were found between the test and control teeth at 3 mo. CONCLUSIONS:The present study suggests that a combined course of photodynamic therapy with low-level laser therapy could be a beneficial adjunct to nonsurgical treatment of chronic periodontitis on a short-term basis. Further studies are required to assess the long-term effectiveness of the combination of photodynamic therapy with low-level laser therapy as an adjunct in nonsurgical treatment of periodontitis.
Effect of low-level laser on guided tissue regeneration performed with equine bone and membrane in the treatment of intrabony defects: a clinical study.
Doğan Gülnihal Emrem,Demir Turgut,Orbak Recep
Photomedicine and laser surgery
OBJECTIVE:The purpose of the present study was to evaluate the clinical results of guided tissue regeneration (GTR) after the application of equine bone and membrane alone or combined with low-level laser therapy (LLLT) for the treatment of periodontal defects. MATERIALS AND METHODS:This study was an intra-individual longitudinal study of 6 months' duration conducted using a split-mouth and randomized design. In 13 periodontitis patients with bilateral intrabony periodontal defects, while one defect site was treated with GTR plus LLLT (1064 nm, 100 mW, with energy density of 4 J/cm(2)), the contralateral defect site was treated with guided GTR alone. GTR was performed with a combination of equine bone and membrane. LLLT was used both intra- and postoperatively. Clinical probing depth (PPD), clinical attachment level (CAL), clinical gingival recession level (REC), plaque index (PI) score, and sulcus blooding index (SBI) score were recorded at the time of surgery, and at the 3rd and 6th months after operation. RESULTS:The treatment of periodontal intrabony defects with equine bone and membrane in the operation of GTR alone or GTR plus LLLT in combination led to statistically significant PPD reduction, CAL gain, and lower SBI score at the end of the study (p<0.05). In addition, between the two groups, GTR plus LLLT resulted in statistically significant lower REC (p=0.025), lower SBI (p=0.008) score, more reduction of PPD (p=0.009) and CAL gain (p=0.002) compared with GTR alone at 6th month control. CONCLUSIONS:This study showed that GTR is an effective treatment for periodontal regeneration, and that LLLT may improve the effects of GTR in the treatment of periodontal defects.
Clinical effects of photodynamic and low-level laser therapies as an adjunct to scaling and root planing of chronic periodontitis: A split-mouth randomized controlled clinical trial.
Malgikar Suryakanth,Reddy S Harinath,Sagar S Vidya,Satyanarayana D,Reddy G Vikram,Josephin J Juliet
Indian journal of dental research : official publication of Indian Society for Dental Research
BACKGROUND:There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) and low-level laser therapy (LLLT) as an adjunct to conventional scaling and root planing (SRP) alone. AIM:The aim of this clinical trial was to evaluate the clinical effects of adjunctive use of PDT, combination of PDT with LLLT as adjunct to conventional SRP alone in the treatment of chronic periodontitis. MATERIALS AND METHODS:In a single-centered randomized and controlled clinical trial, 24 patients (15 males and 9 females) with untreated chronic periodontitis were randomly assigned in a split-mouth design into three treatment groups which included Group I: SRP only, Group II: SRP and PDT (1% methylene blue [MB] solution), and Group III: SRP, PDT, and LLLT. Clinical parameters such as plaque index, gingival index, modified sulcular bleeding index, probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 1, 3, and 6 months after therapy. RESULTS:Within each group, significant improvements (P < 0.001) were found for all variables in 6-month follow-up compared with baseline. The improvement in clinical parameters was significantly greater in Group III compared to Group I and Group II. The mean PD (mm) reduction from baseline to 6 months in Group I was 2.50 ± 0.54, Group II was 2.57 ± 0.53, and Group III was 3.14 ± 0.50. The mean CAL (mm) gain from baseline to 6 months in Group I was 2.63 ± 0.47, Group II was 2.55 ± 0.44, and Group III was 3.07 ± 0.55. CONCLUSION:In patients with chronic periodontitis, a combination of a single application of PDT (using a 980 nm laser and MB) and LLLT provide additional benefit to SRP in terms of clinical parameters 6 months following the intervention.
A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus.
Obradović Radmila,Kesić Ljiljana,Mihailović Dragan,Antić Slobodan,Jovanović Goran,Petrović Aleksandar,Peševska Snežana
Lasers in medical science
Diabetes mellitus (DM) and chronic periodontitis are common chronic diseases in adults in the world population. DM has a strong influence on the oral cavity and represents a risk factor for gingivitis and periodontitis. Low-level laser therapy (LLLT) has proven effective in the reduction of inflammation and swelling. The aim of the present study was to evaluate the efficacy of LLLT in diabetic periodontitis through histological analysis. A total of 300 diabetics with chronic periodontal disease and teeth indicated for extraction were assigned into six equal groups. In the groups 1 and 4, indicated teeth were extracted before treatment, and in the rest of the groups upon completion of the entire treatment. All patients received oral hygiene instructions and full-mouth conservative periodontal treatment. In groups 3 and 6, LLLT was applied (670 nm, 5 mW, 2 J/cm(2), 16 min, 5 days). Histologic findings of gingival tissue treated with LLLT showed expressed healing, as is evident by the absence of inflammatory cells. Tissue edema could not be seen, and the number of blood vessels was reduced. In the gingival lamina, propria pronounced collagenization and homogenization were present. It can be concluded that LLLT has shown efficacy in the treatment of periodontitis in diabetics. Because of more pronounced alterations of periodontium in diabetics, the use of LLLT is of particular importance.
Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis.
Makhlouf Mona,Dahaba Mushira M,Tunér Jan,Eissa Sohair A,Harhash Tarek A-H
Photomedicine and laser surgery
OBJECTIVE:The aim of this split-mouth, double blinded, short-term, controlled clinical trial was to study the effect of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis. BACKGROUND DATA:LLLT is reported to improve the outcome of traditional SRP, but the evidence is still weak. MATERIALS AND METHODS:Sixteen patients with a probing pocket depth (PPD) of 4-6 mm involving at least three teeth in each quadrant were recruited for the study. Afterwards, SRP quadrants were randomly assigned for 10 sessions of LLLT. RESULTS:Results showed that when compared to sites treated with SRP alone, those treated with SRP+LLLT (10 sessions, 830 nm, 100 mW, 3 J per point, 3 J/cm(2)) exhibited greater reductions in PPD at 5 weeks and 3 months but not at 6 months. Further, SRP+LLLT-treated sites had a statistically significant increase in mean radiographic bone density when comparing 6- and 12-month data and overall from baseline to 12 months. There was a trend to reduce interleukin (IL)-1β but the difference between control and laser sites was not statistically significant. CONCLUSIONS:SRP combined with LLLT improved radiographic bone density and short-term PPD reduction in patients with chronic periodontitis, but did not significantly affect either the gingival crevicular fluid of IL-1β or the gingival or plaque index.
The effect of low-level laser therapy on non-surgical periodontal treatment: a randomized controlled, single-blind, split-mouth clinical trial.
Gündoğar Hasan,Şenyurt Süleyman Ziya,Erciyas Kamile,Yalım Mehmet,Üstün Kemal
Lasers in medical science
The purpose of this split-mouth, single-blind, controlled clinical study was to evaluate the impact of low-level laser therapy (LLLT) as an adjunct to non-surgical treatment of chronic periodontitis. Twenty-five systemically healthy and non-smoking adults with chronic periodontitis who had at least two bilateral premolar teeth with probing pocket depth (PPD) of 7 ≥ x ≥ 5 mm were included in the study. In the periodontal examination of these patients, PPD, gingival index (GI), plaque index (PI), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at the baseline, first, third, and sixth months after treatment. Gingival crevicular fluid (GCF) samples were taken at the baseline, first week, and first month after treatment. The collected GCF samples were analyzed using the MAGPIX™ system with a Bio-Plex Pro™ Human Cytokine 27-plex kit. After non-surgical periodontal treatment, LLLT with an energy density of 7.64 J/cm was performed four times: immediately after scaling and root planning (SRP) and on the first, third, and seventh day after treatment. In the first month, PPD levels were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. At the third and sixth months, CAL, PPD, and GI were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. Differences in GCF cytokines levels among the group were not statistically significant. Within the limitations of this study, it is indicated that LLLT as an adjunct to non-surgical periodontal treatment has a positive impact on clinical parameters.
Role of Low-Level Laser Therapy as an Adjunct to Initial Periodontal Treatment in Type 2 Diabetic Patients: A Split-Mouth, Randomized, Controlled Clinical Trial.
Demirturk-Gocgun Oya,Baser Ulku,Aykol-Sahin Gokce,Dinccag Nevin,Issever Halim,Yalcin Funda
Photomedicine and laser surgery
OBJECTIVE:In this split-mouth clinical trial, we evaluated the clinical benefits of low-level laser therapy (LLLT) as an adjunct to nonsurgical periodontal treatment in patients with type 2 diabetes mellitus (DM). BACKGROUND DATA:The impaired wound healing seen in diabetic patients may affect the results of periodontal treatment and may require an additional approach. MATERIALS AND METHODS:In total, 22 chronic periodontitis patients with type 2 DM were included. Applying a split-mouth design, two quadrants were treated with only scaling and root planing (SRP) as the control and those in the other two were treated with SRP + LLLT as the test sites in each patient. An 808 nm GaAlAs diode laser was performed in the test sites at the energy density of 4.46 J/cm on days 1, 2, and 7 after SRP. Plaque index (PI), probing depth (PD), bleeding on probing (BOP), and clinical attachment level were measured at baseline and again at 1 and 3 months after treatment. Deep periodontal pockets (PD ≥4 mm) were evaluated separately. RESULTS:Test sites showed significant improvement in PI and BOP in deep pockets at the 1-month follow-up period (p < 0.001 and <0.001, respectively), whereas no difference was found between the control and the test sites in other periodontal parameters. CONCLUSIONS:LLLT during periodontal treatment offered minimal short-term additional benefit in deep pocket healing in patients with type 2 DM.
Comparison between Antimicrobial Photodynamic Therapy and Low-level laser therapy on non-surgical periodontal treatment: A Clinical Study.
Engel Naves Freire Alice,Macedo Iunes Carrera Thaisa,de Oliveira Guilherme José Pimentel Lopes,Pigossi Suzane Cristina,Vital Ribeiro Júnior Noé
Photodiagnosis and photodynamic therapy
BACKGROUND:Alternative antibacterial therapeutic modalities, such as antimicrobial photodynamic therapy (aPDT) and low-level laser therapy (LLLT), have been proposed to improve the effectiveness of periodontal treatment. However, clinical studies evaluating the efficiency of these treatments have been inconclusive, partly due to contradictory results regarding their clinical and microbiological effects. The aim of this study was to evaluate the clinical effects of aPDT and LLLT after a one-stage full-mouth disinfection (OSFMD) protocol during periodontitis treatment. METHODS:A split-mouth clinical trial was conducted in 20 patients presenting at least two contralateral teeth with a probing pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) on both sides of the mouth. All patients were submitted to an OSFMD protocol. The selected sites randomly received either (1) aPDT (methylene blue as a photosensitizer activated by red and infrared diode laser) or (2) LLLT (red and infrared diode laser). Clinical parameters were assessed at baseline and at 4 and 12 weeks post-treatment. RESULTS:Both treatment protocols promoted significant reductions in PD, number of deep pockets and BOP and an increase in clinical attachment level (CAL) after 4 and 12 weeks, but there were no differences between the two groups. There was no change in the gingival level (GL) of either group for all periods of analysis. A decrease in the number of moderate pockets (4-5 mm) was found in the LLLT group (5.15 ± 4.20) when compared to the aPDT group (7.10 ± 5.24), but only after 4 weeks. CONCLUSIONS:In conclusion, both the aPDT and LLLT therapies promoted improvements in periodontal clinical parameters after the OSFMD protocol; however, in general, there were no distinct differences between the two treatment modalities evaluated in this study.