Dortaj Dorara, Bassir Seyed Hossein, Hakimiha Neda, Hong Houlin, Aslroosta Hoori, Fekrazad Reza, Moslemi Neda
Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Operative Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
J Periodontol. 2022 May;93(5):662-672. doi: 10.1002/JPER.21-0242. Epub 2021 Sep 12.
This study aimed to explore the efficacy of Nd:YAG laser-assisted periodontal therapy for management of patients with stage II-IV periodontitis.
Patients who presented with residual periodontal pockets were enrolled. After non-surgical periodontal therapy (NSPT), test sites received Nd:YAG laser (first entrance to pocket: 3 W, 100 μs, 20 Hz; second entrance: 4 W, 600 μs, 20 Hz) and control sites received placebo (laser off). Periodontal probing depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 1, 2, 3, 4 and 6-month visits.
Twenty patients completed the 6-month period. Significant reductions in PPD, CAL, BOP, and PI values and a significant increase in GR at all follow-up visits compared to the baseline (all P < 0.001) were revealed in both groups. Test sites showed significantly greater improvement in PPD (P = 0.0002) and greater increase in GR (P < 0.0001) compared to the control sites at 6-month visit. There was no difference between two groups regarding CAL gain through the study period (P = 0.23).
NSPT+Nd:YAG laser with the current protocol results in greater PPD reduction compared to NSPT alone. However, this reduction is likely because of greater GR rather than attachment gain. Therefore, the adjunction of Nd:YAG laser (with the current setting) to the NSPT for the treatment of residual periodontal pockets did not ameliorate the clinical outcomes (ClinicalTrials.gov ID: NCT03365167).
本研究旨在探讨钕钇铝石榴石（Nd:YAG）激光辅助牙周治疗对II-IV期牙周炎患者的疗效。
纳入有残余牙周袋的患者。在进行非手术牙周治疗（NSPT）后，试验部位接受Nd:YAG激光治疗（首次进入牙周袋：3W，100μs，20Hz；第二次进入：4W，600μs，20Hz），对照部位接受安慰剂治疗（激光关闭）。在基线以及第1、2、3、4和6个月复诊时记录牙周探诊深度（PPD）、临床附着水平（CAL）、牙龈退缩（GR）、探诊出血（BOP）和菌斑指数（PI）。
20名患者完成了6个月的研究期。两组在所有随访时与基线相比，PPD、CAL、BOP和PI值均显著降低，GR显著增加（所有P<0.001）。在6个月复诊时，试验部位的PPD改善程度显著大于对照部位（P=0.0002），GR增加幅度也更大（P<0.0001）。在整个研究期间，两组在CAL增加方面无差异（P=0.23）。
与单独的NSPT相比，采用当前方案的NSPT+Nd:YAG激光可使PPD降低更多。然而，这种降低可能是由于GR增加更多而非附着增加。因此，在NSPT基础上加用Nd:YAG激光（采用当前设置）治疗残余牙周袋并未改善临床结局（ClinicalTrials.gov标识符：NCT03365167）。
