Gokhale Sneha R, Padhye Ashvini M, Byakod Girish, Jain Sanjay A, Padbidri Vikram, Shivaswamy Sumanth
Department of Periodontology and Implantology, M.A. Rangoonwala College of Dental Sciences and Research Centre, Maharashtra, India.
Photomed Laser Surg. 2012 Oct;30(10):598-603. doi: 10.1089/pho.2012.3252. Epub 2012 Aug 13.
Research has shown that mechanical methods of periodontal therapy alone may fail to eliminate the tissue-invasive pathogenic flora; therefore, considerable attention has been given to adjunctive antimicrobial measures. The purpose of this study is to evaluate the efficacy of diode laser as an adjunct to mechanical debridement in periodontal flap surgery, on the basis of clinical parameters and microbiological analysis.
A total of 30 patients with generalized chronic periodontitis with probing depth >5 mm after phase I therapy were included in the study. Diode laser was used as an adjunct to open flap debridement (test) as compared with conventional flap surgery (control) in a split-mouth study design. Clinical parameters (plaque and gingival index, probing depth and relative clinical attachment level) and subgingival plaque samples of test and control groups were analyzed at baseline and 3 months post-therapy. Visual analogue scale (VAS) was used to determine patient discomfort intraoperatively and after 1 week.
The difference between the clinical parameters in the test and control groups did not reach a statistical significance. However, there was a statistically significant reduction in colony forming units (CFU) of obligate anaerobes in the test group as compared with the control group. The diode laser was well tolerated by the patients, as determined by the VAS.
The bactericidal effect of the diode laser was clearly evident by greater reduction of CFU of obligate anaerobes in the test group than in the control group.
研究表明,仅采用机械方法进行牙周治疗可能无法清除侵入组织的致病菌群;因此,辅助抗菌措施受到了广泛关注。本研究旨在基于临床参数和微生物学分析,评估二极管激光作为牙周翻瓣手术中机械清创辅助手段的疗效。
本研究纳入了30例在第一阶段治疗后探诊深度>5 mm的广泛性慢性牙周炎患者。在一项半口研究设计中,将二极管激光作为开放翻瓣清创术的辅助手段(试验组),并与传统翻瓣手术(对照组)进行比较。在基线和治疗后3个月时,对试验组和对照组的临床参数(菌斑和牙龈指数、探诊深度和相对临床附着水平)以及龈下菌斑样本进行分析。采用视觉模拟量表(VAS)来确定患者术中及术后1周的不适感。
试验组和对照组的临床参数差异未达到统计学显著性。然而,与对照组相比,试验组中 obligate anaerobes 的菌落形成单位(CFU)有统计学显著性降低。根据VAS测定,患者对二极管激光耐受性良好。
试验组中 obligate anaerobes 的CFU降低幅度大于对照组,这清楚地表明了二极管激光的杀菌效果。