Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.
J Clin Periodontol. 2019 May;46(5):539-547. doi: 10.1111/jcpe.13107.
To evaluate the adjunctive efficacy of Er:YAG laser use with mechanical scaling and root planing (SRP) for non-surgical treatment of periodontitis.
In a randomized, single-blinded, controlled trial, 27 patients were recruited. Using a split-mouth design, two quadrants were randomly allocated into either a test group or a control group. The test quadrants received Er:YAG laser (ERL; 100 mJ/pulse; 15 Hz to hard tissue and 50 mJ/pulse; 30 Hz to soft tissue) plus SRP treatment, while the control quadrants received SRP only. We evaluated periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI) at baseline, 3 months, and 6 months.
The PD and CAL means in the ERL + SRP group were significantly lower than those in the SRP group at 3-month follow-up (PD: 2.98 ± 0.38 mm vs. 3.09 ± 0.35 mm; CAL: 4.51 ± 0.69 mm vs. 4.72 ± 0.67 mm) and 6-month follow-up (PD: 2.91 ± 0.31 mm vs. 3.02 ± 0.30 mm; CAL: 4.52 ± 0.65 mm vs. 4.72 ± 0.66 mm; p = 0.03 for both PD and CAL). There were no significant differences in BI and PLI between two groups.
The Er:YAG laser treatment combined with conventional SRP significantly improved PD and CAL compared to SRP therapy alone; however, these differences were very small and, as a result, the adjunctive effect of Er:YAG laser is likely to be minimal clinically important.
评估铒激光(Er:YAG)与机械龈下刮治和根面平整(SRP)联合应用于牙周炎非手术治疗的辅助疗效。
采用随机、单盲、对照临床试验,共招募 27 名患者。采用分牙区设计,将两个象限随机分配至实验组或对照组。实验组接受 Er:YAG 激光(ERL;100mJ/脉冲;15Hz 至硬组织,50mJ/脉冲;30Hz 至软组织)联合 SRP 治疗,对照组仅接受 SRP 治疗。我们在基线、3 个月和 6 个月时评估牙周指数,包括探诊深度(PD)、临床附着水平(CAL)、出血指数(BI)和菌斑指数(PLI)。
在 3 个月随访时,ERL+SRP 组的 PD 和 CAL 平均值明显低于 SRP 组(PD:2.98±0.38mm 比 3.09±0.35mm;CAL:4.51±0.69mm 比 4.72±0.67mm),在 6 个月随访时仍保持显著差异(PD:2.91±0.31mm 比 3.02±0.30mm;CAL:4.52±0.65mm 比 4.72±0.66mm;p 值均=0.03)。两组间 BI 和 PLI 无显著差异。
与单独 SRP 治疗相比,Er:YAG 激光治疗联合常规 SRP 可显著改善 PD 和 CAL,但差异非常小,因此 Er:YAG 激光的辅助效果可能在临床上意义不大。