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ABSTRACT: Background/Aim: The main objective of periodontal treatment is to control infection and thereby curb disease progression. Recent studies have demonstrated that adjunctive treatment procedures such as laser irradiation or photodynamic therapy (PDT) may provide some additional benefit in the treatment of chronic periodontitis. The aim of this randomized controlled trial was to clinically evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser and PDT on outcomes of treatment of chronic periodontitis. Materials and Methods: Twenty-four patients with untreated chronic periodontitis were treated using a split-mouth study design in which the teeth in each quadrant were randomly treated by scaling and root planing (SRP) alone (Group-A), PDT followed by SRP (Group-B), and KTP laser followed by SRP (Group-C). The periodontal pockets were exposed to a KTP laser with the following parameters: output power 0.8W, time on 50ms, time off 50ms, 30s per irradiation, 532nm and fluence 11,7 J/cm(2) with a flexible fiberoptic tip with a diameter of 200μm. The selected pockets were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters assessed included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PD), and probing attachment level (CAL), which were recorded at baseline and at 6 months following therapy. Results: Statistical analysis demonstrated no differences between groups at baseline for all parameters (P>0.05). All treatments yielded significant improvements in terms of BOP and PD decrease and CAL gain compared to baseline values (p<0.05). The Group-C showed a greater reduction in PD compared to the other groups (p<0.05). In addition, the Group-C showed a greater probing attachment gain compared to the other groups (p<0.05). Conclusions: In patients with chronic periodontitis, clinical outcomes from conventional periodontal treatment of deeper pockets can be improved by using adjunctive KTP laser.
Journal of Periodontology 05/2012; · 2.60 Impact Factor
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ABSTRACT: The objective of regenerative periodontal therapy is the reconstitution of lost periodontal structures, such as cementum, periodontal ligament, and alveolar bone. Enamel matrix proteins (EMP) are used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The aim of this split-mouth study evaluates and compares the healing of intrabony defects after treatment with an EMP with or without neodymium-doped:yttrium-aluminum-garnet (Nd:YAG) laser application for root surface conditioning.
Forty-two intrabony defects in 21 patients with chronic periodontitis were randomly assigned to an access flap surgery with application of Nd:YAG laser (1 W, 10 Hz, 100 mJ, 1064 nm) and EMP (test group), and on the contralateral defect to an access flap surgery with application of EDTA and EMP alone (control group). Clinical periodontal parameters were assessed at baseline and after 6 and 12 months.
Both treatments yielded significant improvements in terms of decrease in probing depth (PD) and gain in clinical attachment level (CAL) compared to baseline values. At 12 months after therapy, in the test group, the mean PD value was reduced from 7.3 ± 0.6 to 3.3 ± 0.4 mm and the mean CAL value changed from 9.5 ± 0.7 to 6.9 ± 0.7 mm (P <0.001). The sites treated with EMP (control) showed a reduction in mean PD value from 7.3 ± 0.7 to 3 ± 0.4 mm and a change in mean CAL value from 9.3 ± 0.8 to 6.4 ± 0.5 mm (P <0.001). The control group showed a greater reduction in PD and gain in CAL compared to the test group (P <0.05).
Within the limits of the present study, it may be concluded that both therapies led to improvements of the clinical parameters, and Nd:YAG laser root conditioning as used in this study compared to EDTA root conditioning did not improve the outcome of EMP use.
Journal of Periodontology 10/2010; 81(10):1411-8. · 2.60 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the effectiveness of three types of lasers, Er:YAG, Nd:YAG, and GaAlAs (Diode), as dentin desensitizers, as well as to determine both the immediate and late therapeutic effects on teeth with gingival recessions.
The study was conducted on 24 patients with 96 teeth with Miller's class I or class II gingival recessions with clinically elicitable dentin hypersensitivity (DH) divided into three test groups: (A) Er:YAG, 2,940 nm, 60 mJ/pulse, 2 Hz, 20 s; (B) Nd:YAG, 1,064 nm, 100 mJ/pulse, 15 Hz, 100 s, (C) diode; 808 nm, 100 mW, 20s; and one control group (d) control not irradiated. DH was assessed by means of air stimulus. A visual analogue scale (VAS) was used to measure DH. The selected teeth in three groups received laser therapy for three sessions. The measurements were performed before each treatment session and at 30 min after the laser application (immediate effect), and additional measurements were also performed at 15, 30, and 60 days after the conclusion of treatment (late effect) to assess the extent of desensitization obtained with the different laser devices.
Significant reduction of DH occurred at all times measured during the three treatment sessions in groups treated with Er:YAG, Nd:YAG, and diode lasers. Comparing the means of the responses in the three treatment sessions of the four groups, Group b showed a higher degree of desensitization in teeth with gingival recession compared with the other groups (p < 0.001). The immediate and late therapeutic effects of group b were more evident compared with the other groups.
The Er:YAG, Nd:YAG, and diode lasers can be used to reduce DH. Nd:YAG laser irradiation is more effective in the treatment of DH than are Er:YAG and diode laser. Within the limitations of the present study, the Nd:YAG laser seems to be a suitable tool for successful reduction of DH, especially because the 3-month results of this treatment modality are promising.
Photomedicine and laser surgery 10/2010; 28 Suppl 2:S11-7. · 1.76 Impact Factor
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ABSTRACT: To test if leptin can be detected in the gingival crevicular fluid (GCF) around moving teeth, and to determine whether any changes occur during orthodontic tooth movement.
An upper canine requiring distal movement served as the test tooth; the contralateral canine was used as a control tooth. The control tooth was included in the orthodontic appliance, but was not subjected to the orthodontic force. GCF sampling from the distal sites of the test and control teeth was done at baseline, 1 hour, 24 hours, and 168 hours.
Leptin concentrations of the test teeth decreased in a time-dependent manner. When compared with the baseline measurement, the decrease was significant at 168 hours (P < .05).
The concentration of leptin in GCF is decreased by orthodontic tooth movement; the results of the present study also suggest that leptin may have been one of the mediators responsible for orthodontic tooth movement.
The Angle Orthodontist 05/2010; 80(3):504-8. · 1.21 Impact Factor
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ABSTRACT: Many patients seek to pursue orthodontic treatment for esthetic improvement. These patients present with mal-alignment of the anterior teeth. There was strong correlation between the severity and extent of gingival recessions and past orthodontic treatment, it was suggested that orthodontic tooth movement may lead to gingival recession. The principal objective in the treatment of gingival recession is to cover the exposed root surfaces to improve es-thetics and to reduce hypersensitivity. Different soft tissue grafting procedures have been proposed in the treatment of gingival recessions. Free gingival grafts (FGG) are a reliable method for treatment of gingival recessions: An autograft is taken from the palate as replacement for the lost keratinized gingiva. The purpose of this case report was to illustrate the relationship between orthodontic therapy and gingival recession, and to describe the successful treatment of this case. A 24-year-old girl with gingival recession and hypersensitivity in the anterior mandibulary region was admitted to periodontology clinic. Treatment consisted of oral hygiene instruction, mechanical debride-ment and surgical periodontal treatment. Root coverage is performed with a FGG in a one step method. The patient and clinicians were satisfied with the result. FGG can a viable alternative in the treatment of gingival recession. Surgical periodontal treatments result in esthetic improvement, elimination of sensitivity, and less risk of develo-ping root caries.
J Clin Exp Dent. Gingival Recession and Orthodontic Treatment. 01/2010; 2:30-3.
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ABSTRACT: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such procedures, however. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Nd:YAG laser application for root surface biomodification.
Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery.
Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05).
The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG.
Photomedicine and laser surgery 10/2009; 28(3):337-43. · 1.76 Impact Factor
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ABSTRACT: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such agents. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Er:YAG laser application for root surface biomodification.
Twenty-four teeth in 12 patients with Miller class I and II recession were treated with SCTG with (test group) or without (control group) the application of an Er:YAG laser (2 Hz, 60 mJ/pulse, 40 s, with air spray). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and 6 months postsurgery.
There were no significant differences between test and control groups (p > 0.05). Postoperatively, significant root coverage, gains in CAL, and highly significant increases in the RW were observed in both groups. For test and control groups, the average root coverage was 80% and 86%, respectively (p > 0.05), and complete root coverage was 75% and 67%, respectively.
The present study showed that root surface conditioning with an Er:YAG laser does not enhance the results achieved when SCTG was performed alone.
Photomedicine and laser surgery 09/2009; 28(4):511-7. · 1.76 Impact Factor
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ABSTRACT: Injuries to oral soft-tissues can occur due to accidental, iatrogenic, and factitious traumas. Traumatic lesions, whether chemical, physical, or thermal in nature, are among the most common in the mouth. A type of physical injury to the gingival tissues is self-inflicted. Sometimes the lesions are termed gingivitis artefacta. Self-inflicted gingival injuries in children and adolescents can occur as a result of accidental trauma, premeditated infliction, or chronic habits such as fingernail biting, digit sucking, or sucking on objects such as pens, pencils or pacifiers. The purpose of this case report was to illustrate the destructive nature of the habit and to describe the successful treatment of this case. A 14-year-old girl with moderate pain, gingival bleeding and recession in the anterior mandibulary region was admitted to periodontology clinic. Upon questioning, the patient readily admitted traumatizing her gingiva with her fingernail. Treatment consisted of oral hygiene instruction, mechanical debridement, psychological support and surgical periodontal treatment. Postoperatively, complete root coverage, gains in clinical attachment levels, and highly significant increases in the width of keratinized gingiva were observed. This case report shows that it is possible to treat gingival injury and maintain the periodontal health of a patient with destructive habit. Patient compliance, regular dental follow-ups, and psychological support may be useful in stabilizing the periodontal condition of these patients. Dentists must be aware that self-inflicted gingival injury, although thought to be uncommon, is quite widespread.
European journal of dentistry 05/2009; 3(2):150-4.
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