Al-Falaki Rana, Hughes Francis J, Wadia Reena
Al-FaPerio Clinic, 48A Queens Road, Buckhurst Hill, Essex IG9 5BY, UK.
Department of Periodontology, King's College London Dental Institute, Floor 21, Tower Wing Guys Hospital, London SE 1 9RT, UK.
Int Sch Res Notices. 2016 Jun 2;2016:7175919. doi: 10.1155/2016/7175919. eCollection 2016.
Introduction. Surgical management of infrabony defects is an invasive procedure, frequently requiring the use of adjunctive material such as grafts or biologics, which is time-consuming and associated with expense and morbidity to the patient. Lasers in periodontal regeneration have been reported in the literature, with each wavelength having potential benefits through different laser-tissue interactions. The purpose of this case series was to assess the efficacy of a new dual-wavelength protocol in the management of infrabony defects. Materials and Methods. 32 defects (one in each patient) were treated using ultrasonic debridement, followed by flapless application of Erbium, Chromium:Yttrium, Scandium, Gallium, Garnet (Er,Cr:YSGG) laser (wavelength 2780 nm), and final application of diode laser (wavelength 940 nm). Pocket depths (PD) were measured after 6 months and repeat radiographs taken after one year. Results. The mean baseline PD was 8.8 mm (range 6-15 mm) and 6 months later was 2.4 mm (range 2-4 mm), with mean PD reduction being 6.4 ± 1.7 mm (range 3-12 mm). There was a significant gain in relative linear bone height (apical extent of bone), with mean percentage bone fill of 39.7 ± 41.2% and 53% of sites showing at least 40% infill of bone. Conclusion. The results compare favourably with traditional surgery and require further validation through randomised clinical controlled trials.
引言。骨下袋缺损的外科治疗是一种侵入性手术，通常需要使用移植物或生物制剂等辅助材料，这既耗时又会给患者带来费用负担和发病风险。牙周再生领域的激光治疗已有文献报道，每种波长通过不同的激光与组织相互作用都具有潜在益处。本病例系列的目的是评估一种新的双波长方案在治疗骨下袋缺损中的疗效。材料与方法。对32处缺损（每位患者一处）先进行超声清创，然后采用非翻瓣方式应用铒铬钇钪镓石榴石激光（Er,Cr:YSGG，波长2780 nm），最后应用二极管激光（波长940 nm）。6个月后测量牙周袋深度（PD），并在1年后再次拍摄X光片。结果。平均基线牙周袋深度为8.8 mm（范围6 - 15 mm），6个月后为2.4 mm（范围2 - 4 mm），平均牙周袋深度减少6.4 ± 1.7 mm（范围3 - 12 mm）。相对线性骨高度（骨的根尖延伸）有显著增加，平均骨填充百分比为39.7 ± 41.2%，53%的位点骨填充至少达到40%。结论。结果与传统手术相比具有优势，需要通过随机临床对照试验进一步验证。
