Aoki Akira, Mizutani Koji, Mikami Risako, Ohsugi Yujin, Kobayashi Hiroaki, Akizuki Tatsuya, Taniguchi Yoichi, Takeuchi Yasuo, Katagiri Sayaka, Sasaki Yoshiyuki, Komaki Motohiro, Meinzer Walter, Izumi Yuichi, Iwata Takanori
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
J Periodontol. 2023 Oct;94(10):1187-1199. doi: 10.1002/JPER.22-0552. Epub 2023 May 14.
This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial.
Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12 months.
Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs. 1.89 mm on average; p = 0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs. 1.06 mm; p = 0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p = 0.031), compared with SRP alone.
The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
在一项随机对照临床试验中,本研究评估了一种新型袋内治疗方法(铒激光辅助综合牙周袋内治疗[Er-LCPT])与单纯传统机械治疗相比,对残余牙周袋治疗的有效性。
18例患者在初始积极治疗后或支持治疗期间,有两个部位存在深度≥5mm的残余牙周袋,采用双侧分牙设计随机分为两组:对照组使用刮治器进行龈下刮治和根面平整(SRP),试验组使用刮治器和激光进行Er-LCPT。采用Er-LCPT时,在根面清创后,彻底清除龈内表面和骨表面/现存骨缺损内的炎性结缔组织。此外,用激光去除邻近的口腔上皮并凝固袋口的血凝块。在治疗前和治疗后的12个月内评估临床参数。
两组的临床参数均有显著改善。采用Er-LCPT时,袋内清创彻底且安全,无任何不良副作用和并发症,大多数病例观察到良好的愈合情况。在12个月时,与单纯SRP相比,Er-LCPT作为主要观察指标,在探诊深度减少方面显著更高(平均2.78mm对1.89mm;p = 0.012,Wilcoxon符号秩检验),临床附着获得(1.67mm对1.06mm;p = 0.004),且探诊出血值降低(0.89对0.56;p = 0.031)。
本研究结果表明,与单纯SRP相比,Er-LCPT对残余牙周袋的治疗更有效。