Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
J Periodontol. 2011 Mar;82(3):481-8. doi: 10.1902/jop.2010.100195. Epub 2010 Oct 8.
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.
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.
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).
LLLT as an adjunctive therapy to non-surgical periodontal treatment improves periodontal healing.
本研究旨在评估低水平激光疗法（LLLT）作为吸烟和非吸烟中重度慢性牙周炎患者非手术牙周治疗的辅助手段的疗效。
所有 36 名系统健康的患者最初均接受非手术牙周治疗。LLLT 组（n=18）在非手术牙周治疗后接受 GaAlAs 二极管激光治疗。使用波长为 808nm 的二极管激光，在牙周治疗后的第 1、2 和 7 天，将 4J/cm2 的能量密度应用于牙龈表面。将每个 LLLT 和对照组分为吸烟和非吸烟患者两组，以研究吸烟对治疗的影响。从所有患者中采集龈沟液样本，并在治疗后第 1、3 和 6 个月记录临床参数。测量收集的龈沟液中的基质金属蛋白酶-1、基质金属蛋白酶组织抑制剂-1、转化生长因子-β1 和碱性成纤维细胞生长因子水平。
本研究的主要观察变量为牙龈出血和炎症的变化。在所有时间点，与对照组相比，LLLT 组的龈沟出血指数（SBI）、临床附着水平和探诊深度（PD）水平均显著改善（P<0.001）。与未接受激光治疗的吸烟者相比，接受激光治疗的吸烟者的 PD 和 SBI 水平在基线和所有时间点均有显著改善（P<0.001）（SBI 评分：对照组 1.12，LLLT 组 1.49；PD：对照组 1.21mm，LLLT 组 1.46mm，基线与 6 个月）。在牙周治疗后 1、3 和 6 个月，两组转化生长因子-β1 水平和基质金属蛋白酶-1与基质金属蛋白酶组织抑制剂-1 的比值均显著降低（P<0.001）。两组碱性成纤维细胞生长因子水平在治疗后第 1 个月显著降低，然后在第 3 和第 6 个月升高（P<0.005）。两组间各标志物水平变化无显著差异（P<0.05）。
LLLT 作为非手术牙周治疗的辅助治疗可改善牙周愈合。
