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二极管激光治疗作为龈下刮治和根面平整辅助手段治疗侵袭性牙周炎的效果:一项为期1年的随机对照临床试验

The Effects of Diode Laser Therapy as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A 1-Year Randomized Controlled Clinical Trial.

作者信息

Matarese Giovanni, Ramaglia Luca, Cicciù Marco, Cordasco Giancarlo, Isola Gaetano

机构信息

1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy .

2 Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II" , Naples, Italy .

出版信息

Photomed Laser Surg. 2017 Dec;35(12):702-709. doi: 10.1089/pho.2017.4288. Epub 2017 Sep 14.

DOI:10.1089/pho.2017.4288
PMID:28945145
Abstract

OBJECTIVE

The aim of this study was to investigate and compare the clinical, microbial, and inflammatory effects of a diode laser as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of generalized aggressive periodontitis (GAgP).

METHODS

Using a split-mouth design, 31 patients with GAgP were enrolled in the study. The maxillary right and left quadrants were randomly assigned to SRP+diode laser or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable chosen. In addition, subgingival biofilm samples and gingival crevicular fluid (GCF) inflammatory mediators were analyzed at each follow-up session.

RESULTS

Compared to baseline, both treatments demonstrated an improvement in periodontal parameters at 1 year. However, SRP+diode laser produced a significant improvement in probing depth (PD; 2.56 ± 0.44 vs. 3.36 ± 0.51 mm, p < 0.05) and CAL (3.47 ± 0.25 vs. 4.11 ± 0.26 mm, p < 0.05) values compared to SRP alone. Similarly, in the SRP+diode laser group, the bacteria of orange complex group were significantly reduced at 30 and 60 days compared to SRP alone. Moreover, SRP+diode laser determined a reduction in mean GCF level of interleukin (IL)-1β and IL-1β/IL-10 ratio at 15 and 30 days compared to SRP alone (p < 0.05).

CONCLUSIONS

At 1 year, SRP+diode laser yielded a significant reduction in some clinical parameters, while microbial and inflammatory mediator changes were not significantly reduced compared to SRP alone.

摘要

目的

本研究旨在调查并比较二极管激光辅助龈下刮治术和根面平整术(SRP)与单纯SRP治疗广泛侵袭性牙周炎(GAgP)的临床、微生物学及炎症方面的效果。

方法

采用自身对照设计,31例GAgP患者纳入本研究。患者的上颌左右象限随机分为SRP联合二极管激光组或单纯SRP组。在1年的时间里定期检查患者的临床、微生物学及炎症介质变化。临床附着水平(CAL)是选定的主要观察变量。此外,在每次随访时分析龈下生物膜样本和龈沟液(GCF)中的炎症介质。

结果

与基线相比,两种治疗方法在1年时牙周参数均有改善。然而,与单纯SRP相比,SRP联合二极管激光组的探诊深度(PD;2.56±0.44对3.36±0.51mm,p<0.05)和CAL(3.47±0.25对4.11±0.26mm,p<0.05)值有显著改善。同样,与单纯SRP相比,SRP联合二极管激光组在30天和60天时橙色复合体组细菌显著减少。此外,与单纯SRP相比,SRP联合二极管激光组在15天和30天时龈沟液中白细胞介素(IL)-1β平均水平及IL-1β/IL-10比值降低(p<0.05)。

结论

在1年时,SRP联合二极管激光在一些临床参数上有显著降低,而与单纯SRP相比,微生物及炎症介质变化没有显著减少。

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