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高强度二极管激光辅助非手术牙周治疗的临床和微生物学评价:一项为期 6 个月的临床试验。

Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial.

机构信息

Department of Stomatology, Discipline of Periodontics, School of Dentistry at the University of São Paulo (USP), Av Prof Lineu Prestes 2227, CEP 05508-900. Cidade Universitária, São Paulo, Brazil.

出版信息

Clin Oral Investig. 2013 Jan;17(1):87-95. doi: 10.1007/s00784-012-0703-7. Epub 2012 Mar 9.

Abstract

OBJECTIVES

This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction.

MATERIALS AND METHODS

A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808 ± 5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm(2). Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy.

RESULTS

There was a significant improvement of all the clinical parameters-clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)-for both groups (P < 0.001), with no statistical difference between them at the 6 weeks and the 6 months examinations. As for microbiological analysis, a significant reduction after 6 weeks (P > 0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study.

CONCLUSIONS

After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment.

CLINICAL RELEVANCE

The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.

摘要

目的

本随机分组、口腔内对照临床试验旨在通过临床参数和微生物减少评估牙周治疗中超声龈下刮治和根面平整联合高强度半导体激光的疗效。

材料和方法

选择 36 名性别混合的慢性牙周炎患者。从每位患者中选择一对相邻的、具有 5mm 以上牙周袋深度的单根牙。所有患者均接受非手术牙周治疗,此后,将实验牙分为实验组或对照组。所有牙齿均接受龈下刮治、根面平整和冠向抛光(SRP),实验组(SRP+DL)牙齿用 808nm±5nm 半导体激光照射,每个部位照射 20s,共两次,间隔 1 周。激光以连续模式、1.5W、功率密度 1193.7W/cm2 进行照射。在治疗前、治疗后 6 周和 6 个月时收集临床和微生物学数据。

结果

两组的所有临床参数(临床附着水平、探诊深度、菌斑指数和探诊出血)均有显著改善(P<0.001),且在治疗后 6 周和 6 个月的检查中,两组间无统计学差异。在微生物分析方面,两组在治疗后 6 周时 CFU 显著减少(P>0.05)。两组在治疗后 6 个月时黑色细菌显著减少,但实验组和对照组之间的差异无统计学意义。在研究的任何时间,组间与牙龈卟啉单胞菌、中间普氏菌和伴放线放线杆菌的存在均无相关性。

结论

经过 6 个月的评估,高强度半导体激光对常规牙周治疗没有显示出任何额外的益处。

临床意义

高强度半导体激光对非手术牙周治疗没有提供额外的益处。需要更多的研究来证明这种类型的激光在牙周临床实践中的实际需求。

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