Ting Chun-Chan, Fukuda Mitsuo, Watanabe Tomohisa, Sanaoka Atsushi, Mitani Akio, Noguchi Toshihide
1 Department of Periodontology, School of Dentistry, Aichi-Gakuin University , Nagoya, Japan .
Photomed Laser Surg. 2014 Dec;32(12):649-57. doi: 10.1089/pho.2014.3793.
The purpose of this in vivo study was to examine morphologic alterations in the periodontal pocket epithelium with presence or absence of clinical inflammation following the use of the Neodymium: Yttrium-Aluminum-Garnet (Nd:YAG) laser irradiation.
Subgingival Nd:YAG laser irradiation has been proposed as an alternative technique for treatment of chronic periodontitis. Several published studies have reported the clinical outcomes of such treatment.
Twenty patients, diagnosed with moderate chronic periodontitis, were selected for the study. A total of 32 sites was identified and divided into a control (n=18) and laser-treated test groups (n=14). Probing depth (PD) and bleeding on probing (BOP) were recorded for all sites. Test sites were irradiated with an Nd:YAG laser using parameters of 2 W, 200 mJ pulse energy, and 10 pps delivered through a 320 μm diameter tip. Total laser treatment time ranged from 1 to 2 min. Following treatment, all specimens were harvested via biopsy and processed for scanning electron microscopy (SEM) and histologic examination.
Control group specimens, depending upon initial PD, exhibited either a relatively smooth and intact epithelium with little desquamation (PD≤3 mm), or increasing degrees of epithelial desquamation and leukocytic infiltration at a PD of ≥4 mm. In the laser-treated test group, the specimens with PD≤3 mm that were BOP negative (-) exhibited a thin layer of epithelium that was disrupted. In the specimens with initial PD of ≥4 mm, complete removal of the epithelium whose extent and degree were increasing, was observed in the inflamed portion, while epithelium remained in the uninflamed portion.
The SEM and histologic findings demonstrated the feasibility of ablating pocket epithelium with an Nd:YAG laser irradiation using parameters of 2 W of power (200 mJ, 10 pps). Furthermore, the presence or absence of clinical inflammation appeared to have an impact on the degree of laser-mediated epithelial ablation.
本体内研究的目的是检查使用钕：钇铝石榴石（Nd：YAG）激光照射后，存在或不存在临床炎症时牙周袋上皮的形态学改变。
龈下Nd：YAG激光照射已被提议作为治疗慢性牙周炎的一种替代技术。几项已发表的研究报告了这种治疗的临床结果。
选择20例诊断为中度慢性牙周炎的患者进行研究。共确定了32个部位，并分为对照组（n = 18）和激光治疗试验组（n = 14）。记录所有部位的探诊深度（PD）和探诊出血（BOP）。试验部位使用通过直径320μm的尖端传递的2W、200mJ脉冲能量和10pps的参数用Nd：YAG激光照射。总激光治疗时间为1至2分钟。治疗后，所有标本通过活检采集并进行扫描电子显微镜（SEM）和组织学检查。
对照组标本根据初始PD表现为要么上皮相对光滑完整且脱屑少（PD≤3mm），要么在PD≥4mm时上皮脱屑和白细胞浸润程度增加。在激光治疗试验组中，BOP阴性（-）且PD≤3mm的标本显示上皮层薄且有破坏。在初始PD≥4mm的标本中，在炎症部分观察到上皮完全被去除，其范围和程度不断增加，而在未发炎部分上皮仍然存在。
SEM和组织学结果表明，使用2W功率（200mJ，10pps）的参数用Nd：YAG激光照射消融袋上皮是可行的。此外，临床炎症的存在与否似乎对激光介导的上皮消融程度有影响。
