Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807378, Taiwan.
School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan.
Lasers Med Sci. 2022 Dec;37(9):3517-3525. doi: 10.1007/s10103-022-03627-8. Epub 2022 Aug 11.
The aims of this study were to identify the microbiological changes in the periodontal pockets following an Er:YAG laser (ERL) irradiation and mechanical debridement to compare the effectiveness of ERL irradiation to mechanical debridement for peri-implantitis treatment through randomized controlled trials. Twenty-three patients with peri-implantitis lesions were treated in either a test group, ERL set at energy level of 100 mJ/pulse, frequency of 10 Hz, pulse duration was 100 µs, and irradiated by three passages, or a control group, with mechanical debridement using an ultrasonic scaler. An examiner measured the following clinical parameters at different stages (a baseline and at 3- and 6-month post-treatment): probing depth (PD), bleeding on probing (BOP), marginal bone loss (MBL), and anaerobic bacteria counts. Linear regression, with generalized estimation equations, was used to compare the clinical parameters and anaerobic bacterial counts at different stages and between groups. The anaerobic bacterial counts significantly decreased within the control group during the follow-ups. At the 6-month follow-up, both groups showed a significant reduction in PD (test group: mean difference of 0.84 mm; control group: mean difference of 0.41 mm), and the test group showed a significantly higher PD reduction on the buccal site (1.31 mm) compared to that of the control group (0.25 mm). Both ERL and mechanical debridement treatments led to significant improvements in PD. When mechanical debridement therapy was used, significant anaerobic bacterial count reductions were observed. Future treatment of peri-implantitis should involve a combination of both of these therapies.
本研究的目的是确定牙周袋内的微生物学变化，在牙周炎激光（ERL）照射和机械清创后，比较 ERL 照射和机械清创对种植体周围炎治疗的有效性，通过随机对照试验。23 名患有种植体周围炎病变的患者被分为实验组（能量水平为 100mJ/脉冲，频率为 10Hz，脉冲持续时间为 100µs，照射三次）或对照组（用超声波洁牙机进行机械清创）。一位检查者在不同阶段（基线和治疗后 3 个月和 6 个月）测量以下临床参数：探诊深度（PD）、探诊出血（BOP）、边缘骨丧失（MBL）和厌氧菌计数。使用广义估计方程的线性回归比较不同阶段和组间的临床参数和厌氧菌计数。在对照组中，厌氧菌计数在随访期间显著下降。在 6 个月的随访中，两组的 PD 均显著降低（实验组：平均差值为 0.84mm；对照组：平均差值为 0.41mm），实验组的颊侧 PD 降低更为显著（1.31mm），对照组为 0.25mm。 ERL 和机械清创治疗均导致 PD 显著改善。当使用机械清创治疗时，观察到厌氧菌计数显著降低。未来的种植体周围炎治疗应结合这两种治疗方法。
