Dilsiz Alparslan, Sevinc Semanur
Department of Periodontology, Faculty of Dentistry, Atatürk University , Erzurum , Turkey.
Acta Odontol Scand. 2015 Feb;73(2):144-9. doi: 10.3109/00016357.2014.961955. Epub 2014 Sep 25.
Periodontal therapies aimed at altering the progression of periodontal diseases must include meticulous mechanical debridement during both the non-surgical and the surgical phases of periodontal treatment. The aim of this study was to evaluate and compare the immediate effect of trauma from instrumentation on clinical attachment level after non-surgical periodontal treatment with ultrasonic scalers and a Nd:YAG laser.
Twenty-four patients with untreated chronic periodontitis, presenting probing depths of 4-6 mm on anterior teeth, upper and lower, were entered into the study. The selected teeth were probed with a pressure-controlled probe, guided by stents. Each quadrant was randomly allocated in a split-mouth design either to treatment with Nd:YAG laser using an energy of 1W, 100mj, 1064nm (test group) or to periodontal treatment using ultrasonic scalers (control group). Clinical parameters, including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were acquired prior to and immediately after treatment.
Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). Immediately after treatment, the control group showed a greater PAL loss than the test group (p < 0.05). For the control group, there were statistically significant differences between PAL immediately before and after treatment (p < 0.05), but not test group (p > 0.05).
Within the limits of the present study, it may be concluded that non-surgical periodontal treatment with ultrasonic scalers causes a mean immediate attachment loss of 0.68 mm and that a Nd:YAG laser seems to reduce significantly the trauma the instrumentation produced.
旨在改变牙周疾病进展的牙周治疗，在牙周治疗的非手术和手术阶段均必须包括细致的机械清创。本研究的目的是评估和比较使用超声洁治器和钕：钇铝石榴石激光进行非手术牙周治疗后，器械操作创伤对临床附着水平的即时影响。
纳入24例未经治疗的慢性牙周炎患者，其上下前牙的探诊深度为4 - 6mm。选用的牙齿在支架引导下使用压力控制探针进行探诊。采用分口设计，将每个象限随机分配至使用1W能量、100mj、1064nm的钕：钇铝石榴石激光治疗组（试验组）或使用超声洁治器进行牙周治疗的对照组。在治疗前和治疗后即刻获取临床参数，包括菌斑指数（PI）、探诊出血（BOP）、探诊袋深度（PPD）和探诊附着水平（PAL）。
统计分析表明，所有参数在基线时两组之间无差异（p > 0.05）。治疗后即刻，对照组的PAL丧失大于试验组（p < 0.05）。对于对照组，治疗前后PAL有统计学显著差异（p < 0.05），但试验组无差异（p > 0.05）。
在本研究的范围内，可以得出结论，使用超声洁治器进行非手术牙周治疗会导致平均即刻附着丧失0.68mm，而钕：钇铝石榴石激光似乎能显著减少器械操作产生的创伤。
