Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.
Department of Medical Biochemistry, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey.
J Periodontal Res. 2017 Oct;52(5):853-862. doi: 10.1111/jre.12454. Epub 2017 Mar 23.
The aim of the present study was to compare the effectiveness of combined Er:YAG and Nd:YAG laser therapy to that of scaling and root planing with hand instruments in non-surgical treatment of chronic periodontitis.
Twenty-five systemically healthy patients with chronic periodontitis were selected for this study. The quadrants were randomly allocated in a split-mouth design to either combined Er:YAG (160 mJ/pulse, 10 Hz) and Nd:YAG laser (100 mJ/pulse, 20 Hz) therapy (test group) or scaling and root planing alone (control group). At baseline, 1 month and 3 months after treatment, plaque index, gingival index, probing depth, clinical attachment level and bleeding on probing (%), were recorded and gingival crevicular fluid and subgingival plaque samples were taken. The gingival crevicular fluid levels of interleukin-1β and tumor necrosis factor-α were analyzed by enzyme-linked immunosorbent assay. Quantitative analysis of red complex bacteria was performed using quantitative real-time polymerase chain reaction.
The clinical parameters had significantly improved for both groups after treatment. There were statistically significant differences in probing depth and clinical attachment level between the test and control groups only for deep pockets (≥7 mm) (P<.05). No significant differences between the two groups were observed for the biochemical and microbiological parameters at any time points (P>.05).
The present study suggests that a combined course of Er:YAG and Nd:YAG laser therapy may be beneficial particularly in inaccessible areas such as deep pockets on a short-term basis. Further, well-designed studies are required to assess the effectiveness of the combination of these lasers.
本研究旨在比较联合 Er:YAG 和 Nd:YAG 激光治疗与手工器械刮治和根面平整在慢性牙周炎非手术治疗中的疗效。
本研究选择了 25 例患有慢性牙周炎的系统健康患者。将象限随机分配为联合 Er:YAG（160 mJ/脉冲，10 Hz）和 Nd:YAG 激光（100 mJ/脉冲，20 Hz）治疗（试验组）或单独刮治和根面平整（对照组）。在基线、治疗后 1 个月和 3 个月时，记录菌斑指数、牙龈指数、探诊深度、临床附着水平和探诊出血（%），并采集龈沟液和龈下菌斑样本。通过酶联免疫吸附试验分析白细胞介素-1β和肿瘤坏死因子-α的龈沟液水平。使用实时定量聚合酶链反应对红色复合体细菌进行定量分析。
两组治疗后临床参数均显著改善。仅在深袋（≥7mm）时，试验组和对照组之间在探诊深度和临床附着水平方面存在统计学显著差异（P<.05）。在任何时间点，两组之间在生化和微生物学参数方面均无显著差异（P>.05）。
本研究表明，联合使用 Er:YAG 和 Nd:YAG 激光治疗可能在短期内特别有益于难以到达的区域，如深袋。需要进一步设计研究来评估这些激光联合使用的效果。
