Lopes Beatriz M V, Marcantonio Rosemary Adriana C, Thompson Gloria M A, Neves Lucia H M, Theodoro Letícia H
Department of Periodontology, Araraquara Dental School, São Paulo State University, Araraquara, SP, Brazil.
J Periodontol. 2008 Jul;79(7):1158-67. doi: 10.1902/jop.2008.070600.
Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis.
Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P <0.05).
Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P <0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P <0.05); and BOP decreased for SRPL, L, and SRP groups (P <0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P <0.05). PD decreased in treated groups (P <0.001), and differences were found between SRPL and C groups (P <0.05). CAL gain was significant only for the SRP group (P <0.01). GR increased for SRPL and L groups (P <0.05). No difference in IL-1beta was detected among groups and periods.
Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.
最近，掺铒钇铝石榴石（Er:YAG）激光已被用于牙周治疗。本研究比较了进行或不进行传统龈上洁治和根面平整（SRP）的Er:YAG激光照射（100 mJ/脉冲，10 Hz，12.9 J/cm²）与仅进行SRP治疗慢性牙周炎所致牙周袋的效果。
研究了21名在非相邻部位有5至9毫米牙周袋的受试者。采用双侧对照设计，每个部位随机分配至一个治疗组：SRP联合激光治疗（SRPL）、单纯激光治疗（L）、单纯SRP治疗（SRP）或不治疗（C）。在基线以及术后12天和30天时评估菌斑指数（PI）、牙龈指数（GI）、探诊出血（BOP）以及龈沟液中白细胞介素（IL）-1β水平，而在基线和治疗后30天时评估探诊深度（PD）、牙龈退缩（GR）和临床附着水平（CAL）。进行了统计学分析（P<0.05）。
术后12天，SRPL组和SRP组的PI降低（P<0.05）；L组、SRP组和C组的GI升高，而SRPL组降低（P<0.05）；SRPL组、L组和SRP组的BOP降低（P<0.01）。术后30天，治疗组的BOP降低，且低于C组（P<0.05）。治疗组的PD降低（P<0.001），且SRPL组和C组之间存在差异（P<0.05）。仅SRP组的CAL增加显著（P<0.01）。SRPL组和L组的GR增加（P<0.05）。各治疗组和各时间段之间未检测到IL-1β水平有差异。
Er:YAG激光照射可作为治疗牙周袋的辅助手段，尽管单独进行SRP时观察到显著的CAL增加，而激光治疗未观察到。
