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Aoki A, Mizutani K, Taniguchi Y, Lin T, Ohsugi Y, Mikami R, Katagiri S, Meinzer W, Iwata T. Current status of Er:YAG laser in periodontal surgery. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:1-14. [PMID: 38148873 PMCID: PMC10750110 DOI: 10.1016/j.jdsr.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 12/28/2023] Open
Abstract
Lasers have numerous advantageous tissue interactions such as ablation or vaporization, hemostasis, bacterial killing, as well as biological effects, which induce various beneficial therapeutic effects and biological responses in the tissues. Thus, lasers are considered an effective and suitable device for treating a variety of inflammatory and infectious conditions of periodontal disease. Among various laser systems, the Er:YAG laser, which can be effectively and safely used in both soft and hard tissues with minimal thermal side effects, has been attracting much attention in periodontal therapy. This laser can effectively and precisely debride the diseased root surface including calculus removal, ablate diseased connective tissues within the bone defects, and stimulate the irradiated surrounding periodontal tissues during surgery, resulting in favorable wound healing as well as regeneration of periodontal tissues. The safe and effective performance of Er:YAG laser-assisted periodontal surgery has been reported with comparable and occasionally superior clinical outcomes compared to conventional surgery. This article explains the characteristics of the Er:YAG laser and introduces its applications in periodontal surgery including conventional flap surgery, regenerative surgery, and flapless surgery, based on scientific evidence from currently available basic and clinical studies as well as cases reports.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
- Taniguchi Dental Clinic, Kita 7−17, 18-chome, Nango-dori, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Taichen Lin
- School of Dentistry, Chung Shan Medical University (CSMU), No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Cheng Z, Li W, Wang J, Huang X, Jia X, Zhou X. Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis. J Periodontol 2024. [PMID: 39185693 DOI: 10.1002/jper.24-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/30/2024] [Accepted: 07/11/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment. METHODS In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months. RESULTS For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups. CONCLUSION The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets. PLAIN LANGUAGE SUMMARY To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low level laser therapy into standard periodontal treatment may enhance the treatment's benefits in reducing pocket depth, especially for severe conditions.
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Affiliation(s)
- Zhexian Cheng
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Li
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jitian Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuan Huang
- Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xingyuan Jia
- Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xuan Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Chan AS, Chan AJ, Chan A, Armati P. Successful Intentional Replantation of a Severely Compromised Tooth Using 3 Types of Phototherapy: A Case Report. Photobiomodul Photomed Laser Surg 2024; 42:488-492. [PMID: 38700573 DOI: 10.1089/photob.2023.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024] Open
Abstract
Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm2, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm2, 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.
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Affiliation(s)
- Alex Simon Chan
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Andrew Jonathan Chan
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ambrose Chan
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
| | - Patricia Armati
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
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Öztürk A, Tosun E, Meral SE, Baştan FE, Üstel F, Kan B, Avcu E. The effects of diode and Er:YAG laser applications on the surface topography of titanium grade 4 and titanium zirconium discs with sand-blasted and acid-etched (SLA) surfaces. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101680. [PMID: 37951501 DOI: 10.1016/j.jormas.2023.101680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Laser application for the treatment of peri‑implantitis provides a variety of advantages; however, depending on the laser type and parameters, it may also have adverse effects on the implant surface qualities. This study's objective is to assess the effects of laser type and parameters on the surface properties of two different titanium-based implant materials: titanium Grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) discs with sand-blasted and acid-etched (SLA) surfaces under in vitro conditions. MATERIAL & METHOD Sand-blasted and acid-etched discs made of titanium grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) were treated using 808 nm AlGaAs (diode) and 2940 nm Er:YAG lasers with varying parameters (i.e., diode laser in continuous wave mode, Er:YAG in short pulse mode, and Er:YAG in variable square pulse mode with four different doses). Then, the surface morphology and topography of the treated discs were characterized using scanning electron microscopy and optical profilometry. RESULTS The 3D surface topographies of discs treated with a high power Er:YAG laser displayed irregular peaks and deep valleys, indicating surface deterioration. The average surface roughness values (Sa) of both discs varied with laser type and parameters (3.55-4.80 µm for Ti-Grade 4 versus 3.25-4.5 µm for Ti-Zr). With diode laser applications, the topography features of the discs were preserved despite a small number of irregular valleys and peaks. However, the surface morphologies of the discs were dramatically altered by erosion and local melting because of the Er:YAG laser treatment. CONCLUSION Diode laser application appears to be the most reliable method for treating peri‑implantitis, as diode laser-treated implants retained their overall surface quality despite a small number of irregular peaks and valleys.
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Affiliation(s)
- Anıl Öztürk
- DDS, Oral and Maxillofacial Surgery, İstanbul, Turkey
| | - Emre Tosun
- DDS, Hacettepe University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Salih Eren Meral
- DDS, Hacettepe University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey.
| | - Fatih Erdem Baştan
- Sakarya University, Engineering Faculty, Department of Metallurgy and Materials, Engineering, Thermal Spray Research and Development Laboratory, 54187, Sakarya, Turkey
| | - Fatih Üstel
- Sakarya University, Engineering Faculty, Department of Metallurgy and Materials Engineering, Thermal Spray Research and Development Laboratory, 54187, Sakarya, Turkey
| | - Bahadır Kan
- DDS, Okan University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, İstanbul, Turkey
| | - Egemen Avcu
- Kocaeli University, Ford Otosan İhsaniye Automotive Vocational School, Machine and Metal Technologies, Surface Treatment Laboratory, 41680, Kocaeli, Turkey.
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Park JS, Jung H, Ryu JJ, Koo KT, Lee J. Effect of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser-assisted periodontal therapy using radial firing tip during early healing period: a randomized controlled split-mouth clinical trial. BMC Oral Health 2024; 24:539. [PMID: 38720276 PMCID: PMC11080134 DOI: 10.1186/s12903-024-04270-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aimed to demonstrate the efficacy of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser-assisted nonsurgical periodontal therapy in periodontitis patients during 8 weeks of healing. METHODS A split-mouth, single-blinded, randomized controlled clinical trial was conducted on 12 patients diagnosed with stage III/IV periodontitis and had a minimum of two teeth with probing pocket depth (PPD) > 5 mm in at least two quadrants. Upon randomization, each quadrant was assigned for conventional scaling and root planing (SRP) procedure or laser-assisted therapy (SRP + laser) using radial firing tip (RFPT 5, Biolase). Clinical measurements and gingival crevicular fluid collection were performed for statistical analysis. RESULTS In the initial statistical analysis on the whole subject teeth, modified gingival index (MGI) reduction was greater in test group at 1(P = 0.0153), 4 (P = 0.0318), and 8 weeks (P = 0.0047) compared to the control in the same period. PPD reduction at 4 weeks in test group was -1.67 ± 0.59 showing significant difference compared to the control (-1.37 ± 0.63, P = 0.0253). When teeth with mean PPD ≥5 mm were sorted, MGI decrease was significantly greater in test group at 1 (P=0.003) and 8 week (P=0.0102) follow-ups. PPD reduction was also significantly greater in test group at 4 week period (-1.98 ± 0.55 vs -1.58 ± 0.56, test vs control, P=0.0224). CONCLUSIONS Er,Cr:YSGG-assisted periodontal therapy is beneficial in MGI and PPD reductions during early healing period.
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Affiliation(s)
- Jung Soo Park
- Department of Periodontology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Hannah Jung
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jun Ryu
- Department of Prosthodontics, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ki-Tae Koo
- School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA.
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Luo R, Wang Y, Li R, Ma Y, Chen H, Zhang J, Shen J. Laser therapy decreases oral leukoplakia recurrence and boosts patient comfort: a network meta-analysis and systematic review. BMC Oral Health 2024; 24:469. [PMID: 38632580 PMCID: PMC11025167 DOI: 10.1186/s12903-024-04179-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Oral leukoplakia (OLK) is a prevalent precancerous lesion with limited non-pharmacological treatment options. Surgery and various lasers are the mainstay of treatment; however, their relative efficacy and optimal choice remain unclear. This first network meta-analysis compared the effects of different lasers and surgical excision on post-treatment recurrence and comfort in OLK patients. METHODS We searched four databases for relevant randomized controlled trials (RCTs) up to April 2023. The primary outcome was post-treatment recurrence, and secondary outcomes included intraoperative hemorrhage and postoperative pain scores. The Cochrane Risk of Bias tool was used to assess the study quality. Meta-analysis and network meta-analysis were employed to determine efficacy and identify the optimal intervention. RESULTS A total of 11 RCTs including 917 patients and 1138 lesions were included. Er,Cr:YSGG laser treatment showed significantly lower recurrence rates compared to CO2 laser (OR: 0.04; 95% CI: 0.01-0.18), CO2 laser with margin extension (OR: 0.06; 95% CI: 0.01-0.60), Er:YAG laser (OR: 0.10; 95% CI: 0.03-0.37), electrocautery (OR: 0.03; 95% CI: 0.00-0.18), and standard care (OR: 0.08; 95% CI: 0.02-0.33). Er,Cr:YSGG laser also ranked the best for reducing recurrence, followed by standard care and CO2 laser combined with photodynamic therapy (PDT). Er:YAG and Er:Cr:YSGG lasers minimized bleeding and pain, respectively. None of the interventions caused severe adverse effects. CONCLUSION For non-homogeneous OLK, Er:YAG, Er:Cr:YSGG, and CO2 laser combined with PDT offer promising alternatives to surgical excision, potentially reducing recurrence and improving patient comfort. Further high-quality RCTs are necessary to confirm these findings and determine the optimal laser-PDT combination for OLK treatment.
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Affiliation(s)
- Rui Luo
- National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China
| | - Yanan Wang
- Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, Hospital of Stomatological, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, China
| | - Ruixin Li
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, Hospital of Stomatological, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, China
| | - Yanan Ma
- School of Stomatology, Weifang Medical University, Weifang, 261053, China
| | - Haitao Chen
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, Hospital of Stomatological, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, China
| | - Jian Zhang
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 300070, China.
| | - Jun Shen
- National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
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Han Y, Zhu J, Zhang X, Hu S, Li C. Er:YAG Laser Therapy on Alveolar Osteitis After Mandibular Third Molar Surgery: A Randomized Controlled Clinical Study. Photobiomodul Photomed Laser Surg 2024; 42:238-245. [PMID: 38416636 DOI: 10.1089/photob.2023.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Background: Alveolar osteitis (AO) or "dry socket" affects the quality of life of patients, and there is a high clinical demand for its effective treatment. Objective: To evaluate the effect of Er:YAG laser therapy (ErLT) on AO after mandibular third molar surgery. Methods: Eighty-three patients were randomly divided into Er (n = 43) and control groups (n = 40). In the Er group, the Er:YAG laser (2940 nm; AT Fidelis Fotona, Ljubljana, Slovenia) was used to irradiate the AO site directly in micro short-pulsed mode (pulse duration 0.1 ms, pulse energy 100 mJ, frequency 40 Hz, water 4, and air 2) until all debris and necrotic material had been removed, exposing fresh bone and soft tissue surfaces with blood exudation. The control group received mechanical therapy until the treated lesions resembled those in the Er group. Pain assessment was performed at baseline and on days 1-7 post-intervention using the visual analog scale (VAS). Wound healing was assessed using the wound healing index (WHI). The operating times of the two therapies were also recorded. Results: Group Er had lower VAS scores than the control group on days 1-3 (p = 0.00). There was no significant difference between the two groups on days 4-7 (p = 0.15). The WHI scores were better in the Er group than those in the control group (t = 2.65, p = 0.01), especially in terms of redness (t = 2.70, p = 0.01). There was no significant difference in the operating time between the two groups (t = 0.76, p = 0.45). Conclusions: Compared with mechanical therapy, ErLT for AO provides rapid pain relief and improved wound healing.
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Affiliation(s)
- Yang Han
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Jie Zhu
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Xiqian Zhang
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Suning Hu
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Cong Li
- Department of Stomatology, Peking University International Hospital, Beijing, China
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Alpaslan NZ, Altindal D, Akbal D, Talmac AC, Keskin Tunc S, Ertugrul AS. Evaluation of the effect of Er,Cr:YSGG laser application on peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand and osteoprotegerin levels in the non-surgical treatment of peri-implantitis: A randomized clinical trial. J Periodontol 2024. [PMID: 38375939 DOI: 10.1002/jper.23-0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND This study aimed to investigate the effect of erbium, chromium doped:yttrium,scandium,gallium,garnet (Er,Cr:YSGG) laser application combined with non-surgical mechanical debridement (MD) on clinical parameters and peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) levels in the treatment of peri-implantitis. METHODS A total of 49 patients who underwent non-surgical treatment of peri-implantitis were randomly divided into two groups. The control group (n = 26) received MD alone, while the laser group (n = 23) received MD+Er,Cr:YSGG. The clinical parameters (bleeding on probing [BoP], gingival index [GI], plaque index [PI], probing depth [PD]), marginal bone loss (MBL), and biochemical parameters (RANKL and OPG) were measured at baseline (T0) and 6 months after treatment (T1). RESULTS There was a statistically significant decrease in all the clinical parameters in both groups at T1 compared to T0 (p < 0.05). The BoP, PD, MBL, and RANKL reductions were significantly higher in the laser group than in the control group (p = 0.046, p = 0.014, p = 0.047, p = 0.045, respectively). The OPG levels significantly increased at T1 in the laser group (p = 0.01). The OPG/RANKL ratio increased significantly in both groups at T1, which favored the laser group (p = 0.034). CONCLUSIONS Although both treatment methods were influential in treating peri-implantitis, the laser group (MD+Er,Cr:YSGG) yielded more favorable results by reducing clinical inflammation and improving biochemical parameters. Based on these findings, Er,Cr:YSGG laser may be a beneficial adjunctive treatment in this patient group.
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Affiliation(s)
- Nazli Zeynep Alpaslan
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Dicle Altindal
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | | | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Serap Keskin Tunc
- Hamidiye Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Health Sciences, Istanbul, Turkey
| | - Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
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Zhang Y, Tang P, Yang Q, Li C, Li L, Han M. Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial. Clin Oral Investig 2024; 28:143. [PMID: 38349450 DOI: 10.1007/s00784-024-05510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE The study aims to determine the effects of Nd:YAG laser-assisted with subgingival scaling and root planing (SRP) treatment on glucose control and the dynamic changes of subgingival microbiome in periodontitis with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Twenty-two patients were split into Nd:YAG group (n = 11) and SRP group (n = 11). Patients in the Nd:YAG group received SRP and auxiliary Nd:YAG laser treatment; patients in the SRP group received SRP treatment only. Periodontal tissue inflammation and glycemic control were assessed and analyzed during the treatment period and the changes of subgingival microbiome were analyzed by full-length 16S rRNA sequencing. RESULTS After 3 months of treatment, PD and CAL values improved significantly in the Nd:YAG group compared to the SRP group. BOP in both groups improved significantly after treatment. FPG levels in the Nd:YAG group were significantly reduced after treatment. Porphyromonas and Porphyromonadaceae were enriched in the Nd:YAG group at baseline, and Fusobacteriota, Fusobacteriia, Fusobacteriales, Leptotrichiaceae, and Leptotrichia were enriched after treatment. CONCLUSION Nd:YAG laser-assisted SRP therapy has additional benefits in improving periodontal tissue inflammation and blood glucose control in periodontitis patients with T2DM compared with SRP therapy alone and there was a trend towards a decrease in disease-associated taxa and an increase in health-associated taxa following auxiliary Nd:YAG laser treatment. CLINICAL RELEVANCE The effects of Nd:YAG laser-assisted SRP treatment on inflammation, glucose control, and subgingival microbiome in periodontitis patients with T2DM were elucidated, and new ideas for the treatment of T2DM periodontitis were provided.
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Affiliation(s)
- Yifei Zhang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chen Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China.
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10
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Lin P, Niimi H, Hirota T, Ohsugi Y, Shimohira T, Toyoshima K, Katagiri S, Iwata T, Aoki A. Effects of low-level Er:YAG laser irradiation on proliferation and gene expression in primary gingival fibroblasts isolated from mouse maxilla. JOURNAL OF BIOPHOTONICS 2024; 17:e202300166. [PMID: 37975254 DOI: 10.1002/jbio.202300166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/06/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
We investigated the effects of low-level Er:YAG laser irradiation on proliferation and alternations in early gene expression of gingival fibroblasts. Mice primary gingival fibroblasts were irradiated with an Er:YAG laser (1.8, 3.9, and 5.8 J/cm2 ). Irradiation at 3.9 J/cm2 promoted cell proliferation without significant changes in lactate dehydrogenase or Hspa1a expression. Three hours after irradiation at 3.9 J/cm2 , the Fn1 expression level was significantly increased. RNA-seq identified 15 differentially expressed genes between irradiated and non-irradiated cells, some of which belonged to immediate early genes (IEGs). Kyoto Encyclopedia of Genes and Genomes pathway analysis indicated MAPK pathway enhancement, and gene set enrichment analysis showed enrichment in the TGF-β signaling gene set. Enhanced proliferation via laser irradiation disappeared upon inhibition of Dusp4, Dusp5, and Tgfr1 expression. Low-level Er:YAG laser irradiation, especially at 3.9 J/cm2 without a major temperature elevation, enhanced fibroblast proliferation, via TGF-β and the MAPK signaling pathway following IEG expression.
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Affiliation(s)
- Peiya Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiromi Niimi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomomitsu Hirota
- Division of Molecular Genetics, Research Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tsuyoshi Shimohira
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keita Toyoshima
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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11
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Zhang H, Zhang C, Pan L, Chen Y, Bian Z, Yang Y, Ke T, Sun W, Chen L, Tan J. Low-level Nd:YAG laser inhibiting inflammation and oxidative stress in human gingival fibroblasts via AMPK/SIRT3 axis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 251:112845. [PMID: 38244301 DOI: 10.1016/j.jphotobiol.2024.112845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Photobiomodulation is extensively employed in the management of chronic inflammatory diseases such as periodontitis because of its anti-inflammatory and antioxidant effects. This study used low-level Nd:YAG laser to investigate the mechanism of photobiomodulation as well as the role of adenosine monophosphate-activated protein kinase (AMPK) and Sirtuins (SIRT) 3 in it, providing new clues for the treatment of periodontitis. METHODS Human gingival fibroblasts (HGFs) were extracted from gingiva and stimulated with LPS. The suitable parameters of Nd:YAG laser were chosen for subsequent experiments by detecting cell viability. We assessed the level of inflammation and oxidative stress as well as AMPK and SIRT3. The mechanism for AMPK targeting SIRT3 modulating the anti-inflammatory and antioxidant effects of photobiomodulation was explored by the AMPK inhibitor (Compound C) test, cell transfection, western blot, and immunofluorescence. RESULTS HGFs were isolated and identified, followed by the identification of optimal Nd:YAG laser parameters (60 mJ, 15 Hz, 10s) for subsequent experimentation. With this laser, inflammatory factors (IL-6, TNF-α, COX2, and iNOS) decreased as well as the phosphorylation and nuclear translocation of NFκB-P65. SOD2 was up-regulated but reactive oxygen species (ROS) was down-regulated. The laser treatment exhibited enhancements in AMPK phosphorylation and SIRT3 expression. The above effects could all be reversed by Compound C. Silencing AMPK or SIRT3 by siRNA, the down-regulation of COX2, iNOS, and ROS by laser was inhibited. SIRT3 was down-regulated when the AMPK was silenced. CONCLUSION Low-level Nd:YAG laser activated AMPK-SIRT3 signaling pathway, facilitating the anti-inflammatory and antioxidative activity.
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Affiliation(s)
- Haizheng Zhang
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenyi Zhang
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lai Pan
- Dental Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yifan Chen
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zirui Bian
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuxuan Yang
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ting Ke
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weilian Sun
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lili Chen
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China..
| | - Jingyi Tan
- Department of Periodontology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China..
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12
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Cui A, Sun Y, Zhu K, Zou H, Yue Z, Ding Y, Song X, Chen J, Ji N, Wang Q. Low-level laser therapy alleviates periodontal age-related inflammation in diabetic mice via the GLUT1/mTOR pathway. Lasers Med Sci 2024; 39:36. [PMID: 38236306 DOI: 10.1007/s10103-024-03987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
Diabetes mellitus (DM) is a chronic age-related disease that was recently found as a secondary aging pattern regulated by the senescence associated secretory phenotype (SASP). The purpose of this study is to detect the potential efficacy and the specific mechanisms of low-level laser therapy (LLLT) healing of age-related inflammation (known as inflammaging) in diabetic periodontitis. Diabetic periodontitis (DP) mice were established by intraperitoneal streptozotocin (STZ) injection and oral P. gingivalis inoculation. Low-level laser irradiation (810 nm, 0.1 W, 398 mW/cm2, 4 J/cm2, 10 s) was applied locally around the periodontal lesions every 3 days for 2 consecutive weeks. Micro-CT and hematoxylin-eosin (HE) stain was analyzed for periodontal soft tissue and alveolar bone. Western blots, immunohistochemistry, and immunofluorescence staining were used to evaluate the protein expression changes on SASP and GLUT1/mTOR pathway. The expression of aging-related factors and SASP including tumor necrosis factor-α, interleukin (IL)-1β, and IL-6 were reduced in periodontal tissue of diabetic mice. The inhibitory effect of LLLT on GLUT1/mTOR pathway was observed by detecting the related factors mTOR, p-mTOR, GLUT1, and PKM2. COX, an intracytoplasmic photoreceptor, is a key component of the anti-inflammatory effects of LLLT. After LLLT treatment a significant increase in COX was observed in macrophages in the periodontal lesion. Our findings suggest that LLLT may regulate chronic low-grade inflammation by modulating the GLUT1/mTOR senescence-related pathway, thereby offering a potential treatment for diabetic periodontal diseases.
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Affiliation(s)
- Aimin Cui
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yuezhang Sun
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kangjian Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Haonan Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ziqi Yue
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yi Ding
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiuxiu Song
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jiao Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ning Ji
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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Wang CW, Di Gianfilippo R, Kaciroti N, Ou A, Feng SW, Wang HL. Stability of peri-implantitis surgical reconstructive therapy-a (> 2 years) follow-up of a randomized clinical trial. Clin Oral Investig 2023; 28:30. [PMID: 38147180 DOI: 10.1007/s00784-023-05457-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This follow-up study aimed to report the 24- and 30-month outcomes of a cohort previously enrolled in a randomized clinical trial on surgical reconstructive treatment of peri-implantitis. METHODS Twenty-four patients were diagnosed with peri-implantitis and treated with surgical reconstructive therapy with or without the adjunctive use of Er:YAG laser. Within-group and between-group comparisons were tested with mixed model with repeated measures. RESULTS Regarding peri-implant pocket depth (PPD) reduction (control vs. laser test group) between 6 months (- 1.85 vs. - 2.65 mm) and 30 months (- 1.84 vs. - 3.04 mm), the laser group showed statistically significant changes but not the control group. In terms of radiographic marginal bone loss (RMBL) at 6 months (- 1.1 vs. - 1.46 mm) to 24 months (- 1.96 vs. - 2.82 mm), both groups showed statistical difference compared to baseline. The six explanted implants all were featured by severe peri-implantitis and mostly with no or limited keratinized tissue (< 2 mm) at baseline and membrane exposure after surgery. Among the 15 retained cases, eight cases achieved more than 50% peri-implant bone level gain. CONCLUSIONS Within the limitation and follow-up time frame of this trial, the outcome of the surgical reconstructive therapy sustained or improved in most of the cases. However, 25% of the implants with severe peri-implantitis failed 2 years after the surgical reconstructive therapy. The use of Er:YAG laser favors PPD reduction in the longer term up to 30 months. CLINICAL RELEVANCE Longer-term follow-up on reconstructive therapy of peri-implantitis revealed sustained or improved stability in certain cases, but the survival of implants with severe peri-implantitis has its limitation, especially when there is limited keratinized tissue (< 2 mm or no KT). TRIAL REGISTRATION Clinical Trials Registration Number: NCT03127228 and HUM00160290.
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Affiliation(s)
- Chin-Wei Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Alice Ou
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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14
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Karas M, Gunpinar S. The use of low level laser therapy in conjunction with diode laser-assisted and conventional vestibuloplasty: Comparison of wound healing and vestibular depth gain. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101476. [PMID: 37086896 DOI: 10.1016/j.jormas.2023.101476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND The aim of this study is to compare wound healing and vestibular depth gain in individuals undergoing vestibule deepening surgery using diode laser and conventional technique and to further investigate the possible wound healing effect of low-level laser therapy (LLLT). MATERIAL AND METHODS 52 systemically healthy individuals with insufficient vestibular depth in the region of teeth 33-43 in the lower jaw were included. Following nonsurgical periodontal treatment, patients were divided into four groups as follows: a) diode laser (L); b) diode laser + LLLT; c) conventional surgery and d) conventional surgery + LLLT. Vestibular depth and horizontal wound size measurements of the individuals were recorded using digital calipers. Reepithelization was evaluated via an image analysis program. RESULTS Vestibular depth measurements were found to be higher in the conventional surgery groups compared to that of diode laser groups after the operation, while the results were not statistically different between groups (p >0.05). Reepithelization area did not differ between groups in the evaluated time periods (p >0,05). On the other hand, horizontal wound shrinkage was significantly higher in the conventional surgery group than that of diode laser. CONCLUSIONS Within the limits of this study, both methods yielded in vestibule depth gain. On the other hand, LLLT did not have an additional positive effect on mucosal wound healing. As a clinical relevance, the results are valuable for clinicians in terms of showing that suturing of the mucosal flap formed following vestibule deepening should not be necessary in laser assisted surgery for attaining more vestibule depth.
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Affiliation(s)
- Mert Karas
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Turkey
| | - Sadiye Gunpinar
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Turkey.
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15
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Al-Aali KA, Alzaid AA, Alsaloum M, Alanazi KK, Almujel SH. Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery. Photobiomodul Photomed Laser Surg 2023; 41:703-709. [PMID: 38011738 DOI: 10.1089/photob.2023.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.
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Affiliation(s)
- Khulud A Al-Aali
- Prosthodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdulaziz A Alzaid
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammad Alsaloum
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khalid K Alanazi
- Department of Conservative Dental Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Saad Hamad Almujel
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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16
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Takeuchi Y, Aoki A, Hiratsuka K, Chui C, Ichinose A, Aung N, Kitanaka Y, Hayashi S, Toyoshima K, Iwata T, Arakawa S. Application of Different Wavelengths of LED Lights in Antimicrobial Photodynamic Therapy for the Treatment of Periodontal Disease. Antibiotics (Basel) 2023; 12:1676. [PMID: 38136710 PMCID: PMC10740818 DOI: 10.3390/antibiotics12121676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Therapeutic light has been increasingly used in clinical dentistry for surgical ablation, disinfection, bio-stimulation, reduction in inflammation, and promotion of wound healing. Photodynamic therapy (PDT), a type of phototherapy, has been used to selectively destroy tumor cells. Antimicrobial PDT (a-PDT) is used to inactivate causative bacteria in infectious oral diseases, such as periodontitis. Several studies have reported that this minimally invasive technique has favorable therapeutic outcomes with a low probability of adverse effects. PDT is based on the photochemical reaction between light, a photosensitizer, and oxygen, which affects its efficacy. Low-power lasers have been predominantly used in phototherapy for periodontal treatments, while light-emitting diodes (LEDs) have received considerable attention as a novel light source in recent years. LEDs can emit broad wavelengths of light, from infrared to ultraviolet, and the lower directivity of LED light appears to be suitable for plaque control over large and complex surfaces. In addition, LED devices are small, lightweight, and less expensive than lasers. Although limited evidence exists on LED-based a-PDT for periodontitis, a-PDT using red or blue LED light could be effective in attenuating bacteria associated with periodontal diseases. LEDs have the potential to provide a new direction for light therapy in periodontics.
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Affiliation(s)
- Yasuo Takeuchi
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Koichi Hiratsuka
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan;
| | | | - Akiko Ichinose
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
- Waseda Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Nay Aung
- Laser Light Dental Clinic Periodontal and Implant Center, Yangon 11241, Myanmar;
| | - Yutaro Kitanaka
- Department of Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Sakura Hayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Keita Toyoshima
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Shinich Arakawa
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
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17
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Takemura S, Mizutani K, Mikami R, Nakagawa K, Hakariya M, Sakaniwa E, Saito N, Kominato H, Kido D, Takeda K, Aoki A, Iwata T. Enhanced periodontal tissue healing via vascular endothelial growth factor expression following low-level erbium-doped: yttrium, aluminum, and garnet laser irradiation: In vitro and in vivo studies. J Periodontol 2023. [PMID: 38009257 DOI: 10.1002/jper.23-0458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND This study aimed to investigate the effects of low-level erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser irradiation on periodontal tissue healing and regeneration through angiogenesis in vivo and in vitro studies. METHODS Intrabony defects were surgically created in the bilateral maxilla molar of rats. The defects were treated by open flap debridement (OFD) with Er:YAG laser, including low-level laser irradiation (LLLI) to bone and blood clot surfaces, or conventional procedures. The mRNA expression of vascular endothelial growth factor (VEGF) in the surgical sites was quantified using real-time polymerase chain reaction. The decalcified specimens were prepared for histometric analysis. Also, LLLI was performed on human umbilical vein endothelial cells to evaluate the effects on angiogenesis. Cell proliferation, VEGF expression, and tube formation were assessed. In addition, capsazepine (CPZ), a selective inhibitor of transient receptor potential vanilloid 1 (TRPV1), treatment was performed before LLLI for the same assays. RESULTS OFD using Er:YAG laser did not generate thermal damage on bone or root surfaces. LLLI accelerated hemostasis by coagulation of the superficial layers of blood clots in the laser-treated group. Postoperative healing was sound in all animals in both groups. VEGF expression and bone formation were significantly increased in the laser-treated group compared to those in the conventional treatment group. In vitro, cell proliferation and VEGF expression were significantly increased in the LLLI group compared to the control group. Tube-formation assays showed that LLLI significantly promoted angiogenesis. CPZ treatment significantly suppressed VEGF expression and tube formation following LLLI. CONCLUSIONS This study suggests that Er:YAG laser irradiation may promote periodontal tissue healing by enhancing angiogenetic effect of endothelial cells via TRPV1.
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Affiliation(s)
- Shu Takemura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Keita Nakagawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Masahiro Hakariya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Eri Sakaniwa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Natsumi Saito
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Hiromi Kominato
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Daisuke Kido
- Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
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Kong YQ, Dong XX, Zhao JZ, An PG, Li YZ, Ma R, Tang YJ, Liu J, Cheng ML, Li Q. The Use of 810 and 1064 nm Lasers on Dental Implants: In Vitro Analysis of Temperature, Surface Alterations, and Biological Behavior in Human Gingival Fibroblasts. Photobiomodul Photomed Laser Surg 2023; 41:644-654. [PMID: 37638820 DOI: 10.1089/photob.2023.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Objective: The primary objective of this study was to evaluate the safety of 810 and 1064 nm laser treatment on dental implants. Background: Peri-implantitis is a challenge for clinicians and researchers. Methods: A pig mandible model was used to evaluate temperature increases during laser irradiation. Surface alterations on processed pure titanium discs were analyzed via scanning electron microscopy and measurement of surface contact angles. Processed titanium discs were cocultured in vitro with human gingival fibroblasts; subsequently, cell proliferation was measured. Results: The maximum temperature and time to reach each threshold were comparable. No surface alterations were detected after 810 nm laser irradiation, whereas surface cracks were observed after 1064 nm laser irradiation under the parameter setting of 31.84 W/cm2. Compared with unaltered processed pure titanium discs, the proliferation of human gingival fibroblasts was significantly greater on altered processed pure titanium discs. Conclusions: The use of either 810 or 1064 nm laser treatments may increase the risk of thermal damage in terms of increased temperature if the parameter setting is not warranted. In addition, the use of 1064 nm laser treatment could lead to changes in pure titanium discs that do not negatively affect cell proliferation. Further investigations of laser-assisted therapy are necessary to improve guidelines concerning the treatment of peri-implantitis. Clinical trial registration number: 2021-P2-098-01.
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Affiliation(s)
- Ya-Qun Kong
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Xi Dong
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ji-Zhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pu-Gen An
- Department of Maxillofacial Surgery, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | - Yi-Zhou Li
- Department of Stomatology, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Rui Ma
- Second Outpatient Department of Peking University School of Stomatology, Beijing, China
| | - You-Jia Tang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Juan Liu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Meng-Lin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qian Li
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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19
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Pamuk F, Lütfioğlu M, Paksoy T, Koyuncuoglu CZ, Polat NG, Cifcibasi E, Yildirim S, Kantarci A. Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3-4, Grade C periodontitis patients: a split-mouth, randomized control study. Clin Oral Investig 2023; 27:6439-6449. [PMID: 37709984 DOI: 10.1007/s00784-023-05248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
AIM To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system. MATERIALS AND METHODS Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA. RESULTS Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05). CONCLUSION Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels. CLINICAL RELEVANCE LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.
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Affiliation(s)
- F Pamuk
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.
- Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey.
| | - M Lütfioğlu
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - T Paksoy
- Hamidiye Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - C Z Koyuncuoglu
- Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey
| | - N G Polat
- Clinical Laboratory, Unit of Immunology and Allergy, Koç University Hospital, Istanbul, Turkey
| | - E Cifcibasi
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul, Turkey
| | - S Yildirim
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - A Kantarci
- Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
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20
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Vinaya KC, Awinashe V, Patil DB, Babaji P, Mahabob N, Shetty BK, Parihar AS. Intrabony defect management with a bone graft (hydroxyapatite and β-tricalcium phosphate) alone and in combination with a diode laser: A randomized control trial. Tzu Chi Med J 2023; 35:338-342. [PMID: 38035062 PMCID: PMC10683525 DOI: 10.4103/tcmj.tcmj_316_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/07/2023] [Accepted: 04/12/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives The current research was conducted to evaluate the use of a diode laser and a bone graft (hydroxyapatite [HA] + β-tricalcium phosphate [β-TCP]) in healing of intrabony defects. Materials and Methods In this split-mouth evaluation, 40 patients with bilateral intrabony defects were treated with, Group I (control) - bone graft alone (HA + β-TCP) and Group II, (test) - bone graft with a diode laser. The clinical and radiologic parameters of all patients, such as plaque index (PI), probing depth (PD), gingival index (GI), gingival recession (GR), and relative clinical attachment level (RCAL) were recorded at baseline, after 3 months and after 6 months. Results Reductions in PI, PD, GI, GR, and RCAL were found after 6 months. Furthermore, significant differences were displayed in the intra-group comparison while those of the inter-group evaluation (P > 0.05) were insignificant. Conclusion In both groups, considerable decrease in intrabony pockets was discovered; however, the inter-group comparison was insignificant in relation to GR and RCAL.
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Affiliation(s)
- K. C. Vinaya
- Department of Prosthodontics, Sharavathi Dental College, Shivamogga, Karnataka, India
| | - Vaibhav Awinashe
- Department of Prosthodontics, College of Dentistry in Ar Rass, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Dipak Baliram Patil
- Department of Dentistry, BKL Walawalkar Rural Medical College and Hospital, Chiplun, Maharashtra, India
| | - Prashant Babaji
- Department of Pediatric Dentistry, Sharavathi Dental College, Shivamogga, Karnataka, India
| | - Nazargi Mahabob
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Faisal University, Al Hofuf, Kingdom of Saudi Arabia
| | - B Kaushik Shetty
- Department of Orthodontics and Dentofacial Orthopedics, NITTE (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Mangalore, Karnataka, India
| | - Anuj Singh Parihar
- Department of Periodontics, People’s Dental Academy, Bhopal, Madhya Pradesh, India
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21
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Aoki A, Mizutani K, Mikami R, Ohsugi Y, Kobayashi H, Akizuki T, Taniguchi Y, Takeuchi Y, Katagiri S, Sasaki Y, Komaki M, Meinzer W, Izumi Y, Iwata T. Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol 2023; 94:1187-1199. [PMID: 37015852 DOI: 10.1002/jper.22-0552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Taniguchi Dental Clinic, Sapporo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiyuki Sasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University (KDU), Yokosuka, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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22
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Patil S, Bhandi S, Alzahrani KJ, Alnfiai MM, Testarelli L, Soffe BW, Licari FW, Awan KH, Tanaka E. Efficacy of laser in re-osseointegration of dental implants-a systematic review. Lasers Med Sci 2023; 38:199. [PMID: 37658921 DOI: 10.1007/s10103-023-03860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the treatment of peri-implantitis to achieve re-osseointegration. An electronic literature search was performed supplemented by a manual search to identify studies published until January 2022. Articles that evaluated re-osseointegration in peri-implantitis sites in animal models following laser therapy or antimicrobial photodynamic therapy (aPDT) were included. Case reports, case series, systematic reviews, and letters to the editor were excluded. Risk of bias and GRADE assessment were followed to evaluate the quality of the evidence. Six studies out of 26 articles identified on electronic search were included in this review. The studies included animal studies conducted on canine models. Four out of six studies reported a higher degree of re-osseointegration following treatment of implants with laser therapy. The findings suggest that laser decontamination shows potential in enhancing re-osseointegration, particularly with the Er: YAG laser, which effectively decontaminated implant surfaces. However, conflicting outcomes and limitations in the evidence quality warrant caution in drawing definitive conclusions. Based on the limited available evidence, laser therapy may show a higher degree of re-osseointegration of implants than mechanical debridement.
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Affiliation(s)
- Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA.
- Centre of Molecular Medicine and Diagnostics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
| | - Shilpa Bhandi
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
- Department of Cariology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Khalid J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Mrim M Alnfiai
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Burke W Soffe
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Frank W Licari
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Kamran H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
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23
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Elemek E, Gelmez YM, Hekimoğlu ER, Eşrefoğlu M. Clinical and histological comparison of healing by steel scalpel, diode laser, and radiofrequency in palatal wound: An animal study. Niger J Clin Pract 2023; 26:1264-1272. [PMID: 37794538 DOI: 10.4103/njcp.njcp_578_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed macroscopic and microscopic observations. Aims This study aimed to clinically and histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and radiofrequency. Materials and Methods An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats weighing 289-428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2, 4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated. Results The epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001). Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups. Conclusions Palatal wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However, almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient knowledge and experience.
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Affiliation(s)
- E Elemek
- Department of Periodontology, Faculty of Dentistry, Gelişim University, İstanbul, Turkey
| | - Y M Gelmez
- Department of Immunology, Aziz Sancar Institute of Experimental Medicine, İstanbul University, İstanbul, Turkey
| | - E R Hekimoğlu
- Department of Histology and Embryology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
| | - M Eşrefoğlu
- Department of Histology and Embryology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
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24
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Ginesin O, Mayer Y, Gabay E, Rotenberg D, Machtei EE, Coyac BR, Bar-On Y, Zigdon-Giladi H. Revealing leukocyte populations in human peri-implantitis and periodontitis using flow cytometry. Clin Oral Investig 2023; 27:5499-5508. [PMID: 37490117 DOI: 10.1007/s00784-023-05168-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To identify, quantify, and characterize leukocyte populations in PI and periodontitis using flow cytometry. METHODS Fresh biopsies from human PI and periodontitis lesions were processed to a single-cell suspension. The immune cell types were identified using flow cytometry. RESULTS Twenty-one biopsies were obtained and analyzed corresponding to fourteen PI and seven periodontitis samples. Participants' average age was 63.95 ± 14.77 years without a significant difference between PI and periodontitis patients, the female/male ratio was 8/12, and mean PD was 8.5 ± 2.17. High similarity was found between periodontitis and PI in the main immune cell types. Out of the leukocytes, the PMN proportion was 40% in PI and 33% in periodontitis. T-cells 22% in PI and 18% in periodontitis. Similar proportions of B-cells 10% and macrophages 6% were found in PI and periodontitis. Dendritic and NK cells were found in low proportions (~ 1%) in PI and periodontitis. T-cell sub-analysis showed that CD4-positive were more prevalent than CD8-positive in both diseases (CD4/CD8 ratio of 1.2). CONCLUSION With the use of flow cytometry analysis, the leukocyte populations in human peri-implantitis and periodontitis were classified. In PI and periodontitis, we identified similar proportions of specific (CD4/CD8) and innate (dendritic and NK) immune cells. These results corroborate previous histological studies. CLINICAL RELEVANCE Flow cytometry analysis can be used to identify and quantify immune cells in PI and periodontitis, including sub-classification of T cells (CD4/8) as well as detection of cells that require multiple markers for identification (such as dendritic cells).
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Affiliation(s)
- Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel.
| | - Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Eran Gabay
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Daniel Rotenberg
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Eli Eliahu Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Benjamin R Coyac
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel
| | - Yotam Bar-On
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Hadar Zigdon-Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel
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25
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Han Y, Zhu J, Hu S, Li C, Zhang X. Nd:YAG laser therapy on postoperative pain, swelling, and trismus after mandibular third molar surgery: a randomized double-blinded clinical study. Lasers Med Sci 2023; 38:176. [PMID: 37541966 DOI: 10.1007/s10103-023-03836-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/22/2023] [Indexed: 08/06/2023]
Abstract
This study aims to evaluate the effect of Nd:YAG laser therapy (NdLT) on postoperative pain, swelling, and trismus after mandibular third molar (M3) surgery. Three hundred patients were randomly divided into the Nd group (n = 100), medication group (n = 100), and Nd+medication (Nd+m) group (n = 100). The WHARFE classification system was used to assess surgical difficulty. After surgery, the Nd group was irradiated by the Nd:YAG laser in very long-pulsed mode (VLP, pulse duration 1 ms, 20 Hz, 4 W, R21-C3) in 6 regions of the extraction socket with a total energy of 300 J. For the medication group, dexamethasone 0.75 mg and loxoprofen 60 mg were prescribed immediately and every 12 h thereafter for 3 days. The Nd+m group received both treatments mentioned above. Pain assessment was performed at 6, 24, 48, and 72 h postoperatively using the visual analog scale (VAS). Swelling was evaluated by changes in the distance from (1) the tragus to the labial commissure, (2) the tragus to the pogonion, and (3) the mandibular angle to the lateral canthus preoperatively and 72 h postoperatively. Trismus was assessed by the change in maximum mouth opening. Groups Nd and Nd+m had lower VAS scores at 6 h, 24 h, and 48 h (F = 13.80, p = 0.00), but the difference between the two groups was not significant (F = 1.34, p = 0.11). However, no significant difference was observed at 72 h (p = 0.10). There was no significant difference in swelling or trismus among the three groups (p > 0.05). NdLT is an effective approach to improve complications after M3 surgery.
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Affiliation(s)
- Yang Han
- Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China.
| | - Jie Zhu
- Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China
| | - Suning Hu
- Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China
| | - Cong Li
- Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China
| | - Xiqian Zhang
- Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China
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26
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Calce L, Hafeez M, Hou W, Romanos GE. Thermal Effects of 445-nm Diode Laser Irradiation on Titanium and Ceramic Implants. J ORAL IMPLANTOL 2023; 49:401-406. [PMID: 37527174 DOI: 10.1563/aaid-joi-d-22-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/13/2023] [Accepted: 06/01/2023] [Indexed: 08/03/2023]
Abstract
This study aimed to evaluate temperature changes in titanium and ceramic implants after using a 445-nm diode laser under different in vitro conditions. Titanium (Ti) and ceramic (Zr) dental implants were placed into a bone analog, and an intrabony defect was created at each implant. A 445-nm diode laser was used to irradiate the defects for 30 seconds, noncontact, at 2 W in continuous wave (c.w.) and pulsed mode. The experiment was done at room temperature (21.0 ± 1°C) and in a water bath (37.0 ± 1°C). Two thermocouple probes were used to record real-time temperature changes (°C) at the coronal part of the implant (Tc) and the apex (Ta). The temperature was recorded at time 0 (To) and after 30 seconds of irradiation (Tf). The average temperature change was calculated, and a descriptive analysis was conducted (P < .05). The Ti implant resulted in the highest ΔT values coronally (29.6°C) and apically (6.7°C) using continuous wave at 21°C. The Zr implant increased to 26.4°C coronally and 5.2°C apically. In the water bath, the coronal portion of the Ti and Zr implants rose to 14.2°C and 14.01°C, respectively, using continuous waves. The ΔT values for Ti were 11.9°C coronally and 1.7°C apically when placed in a water bath using pulsed mode. The lowest ΔT occurred on the Zr implant with ΔTc and ΔTa of 4.8°C and 0.78°C, respectively. Under in vitro conditions, the 445-nm diode laser in pulsed mode seems to be safe for use on ceramic implants and should be used with caution on titanium implants.
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Affiliation(s)
- Loredana Calce
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Maryam Hafeez
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, New York
| | - Georgios E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, and Phototherapy, School of Dental Medicine, Stony Brook University, Stony Brook, New York
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Al-Hamoudi N. Clinical and Radiographic Outcomes of Adjunctive Photodynamic Therapy for Treating Peri-Implant Mucositis Among Cigarette Smokers and Diabetics: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2023; 41:378-388. [PMID: 37506360 DOI: 10.1089/photob.2023.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Objective: This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical and radiographic outcomes among cigarette smokers and diabetics with peri-implant mucositis (piM). Methods: Randomized controlled trials, assessing the clinical and radiographic parameters of aPDT versus MD alone among smokers and diabetics with piM, were included in the study. Meta-analyses were conducted to calculate the standard mean difference with a 95% confidence interval. The methodological quality of the included studies was assessed utilizing the modified Jadad quality scale. Results: The meta-analyses found statistically significant differences between the impact of adjunct aPDT and MD alone on the peri-implant plaque index (PI), probing depth (PD), and bleeding on probing among smokers and diabetics with piM at the final follow-up visit. However, no significant differences were found between the impact of adjunct aPDT and MD alone on the peri-implant crestal bone loss among smokers and diabetics with piM at the final follow-up. Conclusions: The application of aPDT as an adjunctive to MD demonstrated improved scores of the peri-implant clinical parameters among smokers and diabetics with piM in comparison with MD alone.
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Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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28
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Bechir ES. The Clinical and Microbiological Effects of LANAP Compared to Scaling and Root Planing Alone in the Management of Periodontal Conditions. Diagnostics (Basel) 2023; 13:2450. [PMID: 37510194 PMCID: PMC10378219 DOI: 10.3390/diagnostics13142450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this study was to evaluate the efficiency of two therapeutic procedures clinically and microbiologically in the management of periodontally affected teeth: scaling and root planing alone and the laser-assisted new attachment procedure (LANAP). Molecular biological determinations of bacterial markers through the polymerase chain reaction (real-time PCR) method with standard PET tests (species-specific DNA probes at a time) were used for the quantification of three of the most important periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola). Both nonsurgical periodontal therapies were proven effective in patients with chronic periodontal disease; however, LANAP was associated with a greater reduction in pocket depth and improved clinical outcomes, associated with a significant decrease in the amount of Porphyromonas gingivalis. The clinical results included a decrease in periodontal pocket depth, bleeding on probing, and dental plaque, with LANAP having better overall outcomes than SRP alone. The use of Nd:YAG lasers in LANAP therapy is a safe and effective procedure that is well accepted by patients.
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Affiliation(s)
- Edwin Sever Bechir
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
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29
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Pergolini D, Palaia G, De Angelis R, Rocchetti F, Podda GM, Tenore G, Del Vecchio A, Relucenti M, Romeo U. SEM Evaluation of Thermal Effects Produced by a 445 nm Laser on Implant Surfaces. Dent J (Basel) 2023; 11:148. [PMID: 37366671 DOI: 10.3390/dj11060148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this in vitro study was to evaluate thermal effects on implant surfaces using a 445 nm diode laser (Eltech K-Laser Srl, Treviso, Italy) with different power settings and irradiation modalities. Fifteen new implants (Straumann, Basel, Switzerland) were irradiated to evaluate surface alteration. Each implant was divided into two zones: the anterior and posterior areas. The anterior coronal areas were irradiated with a distance of 1 mm between the optical fiber and the implant; the anterior apical ones were irradiated with the fiber in contact with the implant. Instead, the posterior surfaces of all of the implants were not irradiated and used as control surfaces. The protocol comprised two cycles of laser irradiation, lasting 30 s each, with a one-minute pause between them. Different power settings were tested: a 0.5 W pulsed beam (T-on 25 ms; T-off 25 ms), a 2 W continuous beam and a 3 W continuous beam. Lastly, through a scanning electron microscopy (SEM) analysis, dental implants' surfaces were evaluated to investigate surface alterations. No surface alterations were detected using a 0.5 W laser beam with a pulsed mode at a distance of 1 mm. Using powers of irradiation of 2 W and 3 W with a continuous mode at 1 mm from the implant caused damage on the titanium surfaces. After the irradiation protocol was changed to using the fiber in contact with the implant, the surface alterations increased highly compared to the non-contact irradiation modality. The SEM results suggest that a power of irradiation of 0.5 W with a pulsed laser light emission mode, using an inactivated optical fiber placed 1 mm away from the implant, could be used in the treatment of peri-implantitis, since no implant surface alterations were detected.
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Affiliation(s)
- Daniele Pergolini
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gaspare Palaia
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Riccardo De Angelis
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Federica Rocchetti
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gian Marco Podda
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Alessandro Del Vecchio
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Michela Relucenti
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Human Anatomy, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
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Shiba T, Komatsu K, Watanabe T, Takeuchi Y, Nemoto T, Ohsugi Y, Katagiri S, Shimogishi M, Marukawa E, Iwata T. Peri-implantitis management by resective surgery combined with implantoplasty and Er:YAG laser irradiation, accompanied by free gingival graft: a case report. Ther Adv Chronic Dis 2023; 14:20406223231174816. [PMID: 37324409 PMCID: PMC10265339 DOI: 10.1177/20406223231174816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/24/2023] [Indexed: 06/17/2023] Open
Abstract
The optimal method for decontamination of implant surfaces for peri-implantitis treatment remains controversial. In recent years, erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation and implantoplasty (IP) (i.e. mechanical modification of the implant) have been reported to be effective in decontaminating implant surfaces during the surgical treatment. Also, a lack of adequate keratinized mucosa (KM) around the implant is known to be associated with more plaque accumulation, tissue inflammation, attachment loss, and mucosal recession, increasing the risk of peri-implantitis. Therefore, free gingival graft (FGG) has been recommended for gaining adequate KM around the implant. However, the necessity of acquiring KM for the treatment of peri-implantitis using FGG remains unclear. In this report, we applied the apically positioned flap (APF) as resective surgery for peri-implantitis treatment in conjunction with IP and Er:YAG laser irradiation to polish/clean the implant surface. Furthermore, FGG was conducted simultaneously to create additional KM, which increased the tissue stability and contributed to the positive results. The two patients were 64 and 63 years old with a history of periodontitis. The removal of granulation tissue and debridement of contaminated implant surfaces were performed with Er:YAG laser irradiation post flap elevation and then modified smooth surfaces mechanically using IP. Er:YAG laser irradiation was also utilized to remove the titanium particles. In addition, we performed FGG to increase the width of KM as a vestibuloplasty. Peri-implant tissue inflammation and progressive bone resorption were not observed, and both patients maintained good oral hygiene conditions until the 1-year follow-up appointment. Bacterial analysis via high-throughput sequencing revealed proportional decreases in bacteria associated with periodontitis (Porphyromonas, Treponema, and Fusobacterium). To the best of our knowledge, this study is the first to describe peri-implantitis management and bacterial change before and after procedures by resective surgery combined with IP and Er:YAG laser irradiation for peri-implantitis treatment, accompanied by FGG for increasing KM around the implants.
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Affiliation(s)
- Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku 1138510, Tokyo, Japan
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Keiji Komatsu
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takayasu Watanabe
- Department of Chemistry, Nihon University School of Dentistry, Chiyoda-ku, Japan
| | - Yasuo Takeuchi
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Bunkyo-ku 1138510, Tokyo, Japan
| | - Takashi Nemoto
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Masahiro Shimogishi
- Department of Regenerative and Reconstructive Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Eriko Marukawa
- Department of Regenerative and Reconstructive Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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31
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Tavelli L, Barootchi S, Stefanini M, Zucchelli G, Giannobile WV, Wang HL. Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting. Periodontol 2000 2023; 92:90-119. [PMID: 36583690 DOI: 10.1111/prd.12466] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/26/2022] [Indexed: 12/31/2022]
Abstract
Palatal-tissue harvesting is a routinely performed procedure in periodontal and peri-implant plastic surgery. Over the years, several surgical approaches have been attempted with the aim of obtaining autogenous soft-tissue grafts while minimizing patient morbidity, which is considered the most common drawback of palatal harvesting. At the same time, treatment errors during the procedure may increase not only postoperative discomfort or pain but also the risk of developing other complications, such as injury to the greater palatine artery, prolonged bleeding, wound/flap sloughing, necrosis, infection, and inadequate graft size or quality. This chapter described treatment errors and complications of palatal harvesting techniques, together with approaches for reducing patient morbidity and accelerating donor site wound healing. The role of biologic agents, photobiomodulation therapy, local and systemic factors, and genes implicated in palatal wound healing are also discussed.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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32
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Yukna RA. Clinical evaluation of Laser-Assisted New Attachment Procedure ® (LANAP ®) surgical treatment of chronic periodontitis: a retrospective case series of 1-year results in 22 consecutive patients. J Periodontal Implant Sci 2023; 53:173-183. [PMID: 36468483 PMCID: PMC10315259 DOI: 10.5051/jpis.2202580129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/14/2022] [Accepted: 10/12/2022] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure® (LANAP®) surgery as a single treatment modality. METHODS As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. RESULTS All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. CONCLUSIONS Within the limits of this case series, LANAP® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.
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Affiliation(s)
- Raymond A Yukna
- Advanced Periodontal Therapies, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Anschutz Medical Center, Aurora, CO, USA.
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Nowak-Terpiłowska A, Zeyland J, Hryhorowicz M, Śledziński P, Wyganowska M. Influence of Three Laser Wavelengths with Different Power Densities on the Mitochondrial Activity of Human Gingival Fibroblasts in Cell Culture. Life (Basel) 2023; 13:life13051136. [PMID: 37240781 DOI: 10.3390/life13051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/24/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Phototherapy plays a key role in wound healing and tissue regeneration. The use of lasers has the potential to become an effective and minimally invasive treatment in periodontal and peri-implant disease. The aim of this study was to evaluate the influence of three laser wavelengths with the combination of parameters such as power density and energy density on human gingival fibroblasts (hGFs) in vitro culture. Isolated cells were seeded in 96-well plates with culture medium (DMEM, Dulbecco's modified Eagle's medium) supplemented with 10% fetal bovine serum (FBS). After 24 h cells were irradiated (1064, 980 and 635 nm, various energy density value). After 24, 48 and 72 h, cells were evaluated for viability. Data were analyzed by ANOVA followed by Tukey's HSD test. We found the best outcomes for hGFs irradiated with laser 1064 nm for all combinations of power output (50/400/1000 mW) and energy dose (3/25/64 J/cm2) after 48 h and 72 h compared with control group. Cell viability increase ranged from 0.6× (3 J/cm2, 50 mW) to 1.3× (64 J/cm2, 1000 mW). Our findings indicate that the appropriate use of low-level laser irradiation (LLLI) can increase the proliferation rate of cultured cells. The use of LLLI can be extremely useful in tissue engineering and regenerative medicine.
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Affiliation(s)
| | - Joanna Zeyland
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, 60-632 Poznan, Poland
| | - Magdalena Hryhorowicz
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, 60-632 Poznan, Poland
| | - Paweł Śledziński
- Department of Genome Engineering, Institute of Bioorganic Chemistry, Polish Academy of Science, 61-704 Poznań, Poland
| | - Marzena Wyganowska
- Department of Dental Surgery, Periodontology and Oral Mucosa Diseases, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Freire BL, Abreu LG, Costa FO, Cota LOM, Esteves-Lima RP. Effect of photobiomodulation adjunct to periodontal therapy on individuals with type 2 diabetes mellitus regarding periodontal clinical parameters: a systematic review and meta-analysis. Lasers Med Sci 2023; 38:116. [PMID: 37140820 DOI: 10.1007/s10103-023-03782-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/25/2023] [Indexed: 05/05/2023]
Abstract
The purpose of this study is to evaluate the scientific evidence on the impact of photobiomodulation adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus (T2DM). The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. A protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO #CRD42022310756). The research was carried out in seven databases, with no restrictions regarding the year of publication. Our work included studies that compared periodontal clinical parameters among individuals undergoing non-surgical periodontal therapy associated with photobiomodulation and a control group of individuals undergoing non-surgical periodontal treatment. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and a 95% confidence interval (CI) were provided. Three hundred forty-one studies were identified, of which eight studies were included. The meta-analysis demonstrated that photobiomodulation adjunctive to periodontal therapy in individuals with diabetes resulted in a greater reduction in probing depth and greater attachment gain in comparison to periodontal treatment alone (p < 0.05). The included studies exhibited a low risk of bias. Photobiomodulation adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameters in individuals with T2DM.
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Affiliation(s)
- Bárbara Lopes Freire
- Periodontology Division, Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University de Minas Gerais, Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Fernando Oliveira Costa
- Periodontology Division, Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University de Minas Gerais, Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Luís Otávio Miranda Cota
- Periodontology Division, Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University de Minas Gerais, Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Rafael Paschoal Esteves-Lima
- Periodontology Division, Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University de Minas Gerais, Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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Nahas P, Houeis S, Chamboredon R, Heysselaer D, Zeinoun T, Nammour S. Assessment of the Periodontal Cementum Ablation Depth during Root Planing by an Er:YAG Laser at Different Energy Densities: An Ex Vivo Study. Dent J (Basel) 2023; 11:dj11050116. [PMID: 37232767 DOI: 10.3390/dj11050116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION An important and non-adapted delivered energy of Er:YAG laser can eliminate the total thickness of root cementum during root planing. Conversely, the preservation of a partial layer of cementum covering the roots is vital for any periodontal ligament regeneration. Thus, the assessment of the cementum ablation depth produced by each energy density of Er:YAG laser is essential before considering its use for the periodontal planing and treatment of the cementum and root surfaces. AIM OF THE STUDY Assessment of the cementum ablation depth at different energy densities of the Er:YAG laser is the aim of this study. MATERIALS AND METHODS A total of 48 human caries free molars were collected and used in this study. Areas to be irradiated were delimited by two longitudinal grooves (0.5 mm depth). Roots were divided randomly into four groups (4 × n = 12). An Er:YAG laser (2.94 µm) was used with a side-firing tip (R600T) with a 600 µm diameter and a frequency of 20 Hz combined with a cooling system of air 6 mL/min and water 4 mL/min. We used a super short pulse mode (SSP: pulse duration: 50 μs). We used a single irradiation passage backward from apex to cervical parts at 1 mm/s with a slight contact and at an angle of 15° to 30° between the tip and the root surface. Different energies were selected: 30 mJ, 40 mJ, 50 mJ, and 60 mJ. RESULTS Microscopic observations showed that the average of the ablation depth increased with the increase of the delivered energy from 30 mJ to 60 mJ. Mean values of the ablation depths were respectively as follows: 43.75 ± 4.89 µm for the energy of 30 mJ, 50.05 ± 3.72 µm for 40 mJ, 65.56 ± 10.35 µm for 50 mJ, and 74.80 ± 15.23 µm for 60 mJ. A statistically significant difference existed between the ablation depth of all groups. CONCLUSION Based on our results, the depth of cementum debridement is related to the level of the delivered energy. The lowest energy levels (30 mJ and 40 mJ) can ablate the root cementum surface for a variable depth from 43.75 ± 4.89 μm to 50.05 ± 3.72 μm.
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Affiliation(s)
- Paul Nahas
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Lebanese University, Hadath campus, Beirut 1003, Lebanon
| | - Saad Houeis
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Remi Chamboredon
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Daniel Heysselaer
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Toni Zeinoun
- Department of Oral and Maxillo-Facial Surgery, Dean of Faculty of Dental Medicine, Lebanese University, Beirut 1003, Lebanon
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
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36
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Suardi N, Germanam SJ, Rahim NAYM. Acoustic evaluation of photobiomodulation effect on in vitro human blood samples. Lasers Med Sci 2023; 38:99. [PMID: 37059895 DOI: 10.1007/s10103-023-03766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/04/2023] [Indexed: 04/16/2023]
Abstract
Although positive photobiomodulation response on wound healing, tissue repair, and therapeutic treatment has been widely reported, additional works are still needed to understand its effects on human blood. This research carried out acoustic measurements using A-scan (GAMPT) ultrasonic techniques to elucidate the photobiomodulation effects on in vitro human blood samples as therapeutic treatment measures. The human blood samples were irradiated using a 532-nm laser with different output laser powers (60 and 80 mW) at various exposure times. The ultrasonic velocity measured in the human blood samples after laser irradiation showed significant changes, most of which were within the acceptance limit for soft tissues (1570 [Formula: see text] 30 m/s). Abnormal cells (echinocyte and crenation) were observed due to excessive exposure during laser treatment.
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Affiliation(s)
- Nursakinah Suardi
- School of Physics, Universiti Sains Malaysia, 11800, Penang, Malaysia.
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Kottmann L, Franzen R, Conrads G, Wolfart S, Marotti J. Effect of Er,Cr:YSGG laser with a side-firing tip on decontamination of titanium disc surface: an in vitro and in vivo study. Int J Implant Dent 2023; 9:7. [PMID: 37067627 PMCID: PMC10110821 DOI: 10.1186/s40729-023-00469-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/31/2023] [Indexed: 04/18/2023] Open
Abstract
PURPOSE To evaluate the effectiveness of an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser with side-firing tip in decontamination of titanium (Ti) disc. METHODS In the first test series, 29 Ti-discs were contaminated with Staphylococcus aureus and treated as follows: positive control (no treatment); Perioflow; Laser A (0.75 W, 100 Hz), Laser B (1.5 W, 30 Hz); Laser C (no radiation, 60% water); and Laser D (no radiation, 50% water). For bacterial quantification, colony forming units (CFU, vital cells only) and quantitative PCR (qPCR, vital and devital cells) were performed. In a second test series, 92 Ti-discs were used, contaminated with in vivo-grown biofilm and treated as follows: positive control (no treatment); Perioflow; Laser E (1.5 W, 30 Hz), and Laser F (no radiation, 50% water). Considering the different and unknown culture conditions, quantification of bacteria was performed by broad-spectrum bacterial qPCR only. Based on the assumption that all cells of an organism contain an equivalent complement of genetic information, genome equivalent (GE) determination ensured the detection of the different intact and semi-intact genomes, regardless of type of bacterial species and vitality, circumvent the inherent bias of cultures. RESULTS The GE values were significantly reduced by all interventions in both test series, compared to the positive control group (p < 0.001). In the first test series with S. aureus as model organism, Perioflow yielded a lower GE than the Laser groups A-D (all p < 0.025). The number of CFUs was significantly reduced in the intervention groups compared to the positive control (p < 0.001), except for Laser A (p = 0.157) and Laser D (p = 0.393). In the second test series, none of the pairwise comparisons of the intervention conditions showed a significant difference (Perioflow vs. Laser E: p = 0.732; Perioflow vs. Laser F: p = 0.590; Laser E vs. Laser F: p = 0.379). CONCLUSION The Er,Cr:YSGG laser with side-firing tip and Perioflow were equally capable of effectively decontaminating a Ti-disc surface. It is assumed that the bacterial reduction was largely due to the mechanical effect of the air and water stream.
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Affiliation(s)
- Lucia Kottmann
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany
| | - Rene Franzen
- AALZ Aachen Dental Laser Center, Aachen, NRW, Germany
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany
| | - Georg Conrads
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany
| | - Juliana Marotti
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical Faculty, RWTH Aachen University, Aachen, NRW, Germany.
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, 4058, Basel, Basel-Stadt, Switzerland.
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Adjunctive Nd:YAG laser irradiation in the treatment of stage III/IV periodontitis: a 12-month, randomized, controlled trial. Clin Oral Investig 2023:10.1007/s00784-023-04908-4. [PMID: 36795248 DOI: 10.1007/s00784-023-04908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical efficacy of the adjunctive use of Nd:YAG laser (1064 nm) to full-mouth scaling and root planning (FMS), in stage III/IV periodontitis patients. MATERIALS AND METHODS Sixty stage III/IV periodontitis patients were randomly assigned to three groups. The control group received FMS, laser 1 group received combined FMS/single Nd:YAG laser irradiation (3 W, 150 mJ, 20 Hz,100 μs), and laser 2 group received combined FMS/double Nd:YAG laser irradiation with 1-week interval (2.0 W, 200 mJ, 10 Hz, 100 μs). PD, CAL, FMPS, GI, FMBS, and GR were evaluated at baseline, 6 weeks, 3, 6, and 12 months after treatment. Patient-reported outcomes were evaluated 1 week after treatment. RESULTS A significant improvement (p < 0.001) for all clinical parameters was observed during the entire study period, with the exception of mean CAL gain for the laser 2 group at 12 months. The percentage of pockets ≤ 4 mm was significantly higher compared to baseline for all groups throughout the study, with no inter-group differences at any time point. Patient-reported analgesic consumption was higher for laser 1 group. CONCLUSIONS The adjunctive use of Nd:YAG laser irradiation was similarly effective to FMS alone, during the entire study period. A slightly higher, though not statistically significant improvement was reported for PD at 6 and 12 months after a single post-FMS application of Nd:YAG laser for pocket epithelium removal and coagulation. CLINICAL RELEVANCE Additional Nd:YAG laser application for sulcular epithelium removal and coagulation may provide minor long-term improvements compared to FMS or laser irradiation for pocket disinfection and detoxification. TRIAL REGISTRATION ISRCTN26692900. Registration date: 09/06/2022.
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Misra P, Kalsi R, Anand Arora S, Singh KS, Athar S, Saini A. Effect of Low-Level Laser Therapy on Early Wound Healing and Levels of Inflammatory Mediators in Gingival Crevicular Fluid Following Open Flap Debridement. Cureus 2023; 15:e34755. [PMID: 36909061 PMCID: PMC9999105 DOI: 10.7759/cureus.34755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction Low-level laser therapy (LLLT) has a beneficial effect on pain relief and wound healing. This study aims at a clinical evaluation of early wound healing and a biochemical evaluation of inflammatory mediators in gingival crevicular fluid (GCF) following LLLT with an open flap debridement (OFD) in periodontal therapy. Material and methods This randomized controlled trial included 40 chronic periodontitis patients with bilateral attachment loss, pocket depths of 5 mm affecting at least two quadrants, and radiographic evidence of horizontal bone loss. 120 control sites were randomly selected to receive OFD, and contralateral 120 test sites received bio-stimulation with a diode laser (890 nm) after OFD. The wound healing index was recorded at the 1st and 2nd weeks, and clinical parameters such as the plaque index, gingival index, pocket probing depth, clinical attachment level, and GCF inflammatory mediators were evaluated at baseline, 3, and 6 months. Results From the start of the study to 6 months later, there was a statistically significant drop in plaque index, gingival index, probing pocket depth, and gain clinical attachment levels in both groups. However, when the two groups were compared, there were no significant differences at any time intervals. GCF inflammatory mediators tumor necrosis factor (TNF) alpha and matrix metalloproteinases (MMP-8) decrease, and osteoprotegerin (OPG) levels increase in both the test group and control group from baseline to 3 months and 6 months. In intergroup comparisons, there was a statistically significant reduction in the test group as compared to the control group at 6 months. There was a decline in gingival crevicular fluid - interleukin-6 (GCF IL-6) levels from baseline to 3 months and 6 months in both the groups but when analysed statistically, the results were not significant on intergroup and intragroup comparison at any time interval. The Landry Wound Healing Index values in the 1st and 2nd weeks were showing statistically significant improved healing in the test group as compared to the control group. There was significantly better wound healing at sites where a diode laser was used. Conclusion LLLT increases early wound healing after periodontal surgical procedures.
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Affiliation(s)
- Priyanka Misra
- Department of Periodontics, ITS Dental College, Greater Noida, IND
| | - Rupali Kalsi
- Department of Periodontology, Government Institute of Medical Sciences, Noida, IND
| | | | | | - Simoona Athar
- Department of Periodontics, ITS Dental College, Greater Noida, IND
| | - Anchal Saini
- Department of Periodontics, ITS Dental College, Greater Noida, IND
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Zheng Y, Dong X, Chen S, He Y, An J, Liu M, He L, Zhang Y. Low-level laser therapy prevents medication-related osteonecrosis of the jaw-like lesions via IL-1RA-mediated primary gingival wound healing. BMC Oral Health 2023; 23:14. [PMID: 36627695 PMCID: PMC9832759 DOI: 10.1186/s12903-022-02678-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) is a serious debilitating disease caused by anti-resorption and anti-angiogenesis drugs, significantly affecting patients' quality of life. Recent studies suggested that primary gingival wound healing may effectively prevent the development of MRONJ. This study aimed to evaluate the effects of low-level light therapy (LLLT) on promoting gingival wound healing in extraction sockets of MRONJ-like mice and preventing the occurrence of MRONJ. Furthermore, we explored underlying mechanisms. METHODS Mice were randomly divided into the Ctrl, Zol, and Zol + LLLT groups. Administration of zoledronate and tooth extraction of bilateral maxillary second molars were used to build the MRONJ model, and LLLT was locally administered into the tooth sockets to examine the effect of LLLT. Next, to explore the function of IL-1RA, we performed LLLT with interleukin-1 receptor antagonist (IL-1RA) neutralizing antibody (named Zol + LLLT + IL-1RA NAb group) or negative control antibodies for tooth extraction in subsequent rescue animal experiments. Stereoscope observations, micro-computed tomography, and histological examination were conducted to evaluate gingival wound healing and bone regeneration in tooth sockets. The effects of LLLT on the migration capacities of zoledronate-treated epithelial cells were assessed in vitro. RESULTS LLLT promoted primary gingival wound healing without exposed necrotic bone. Micro-computed tomography results showed higher bone volume and mineral density of the tooth sockets after LLLT. Histology analysis showed complete gingival coverage, obvious bone regeneration, and reduced soft tissue inflammation, with down-regulated pro-inflammation cytokines, like interleukin-1 beta (IL-1β) and tumor necrosis factor-α (TNF-α), and up-regulated IL-1RA expression in the gingival tissue in the LLLT group. The rescue assay further showed that the effects of LLLT promoting gingival wound healing and preventing MRONJ might be partially abolished by IL-1RA neutralizing antibodies. In vitro studies demonstrated that LLLT accelerated zoledronate-treated epithelial cell migration. CONCLUSIONS LLLT might promote primary gingival wound healing and contribute to subsequent bone regeneration of the tooth extractions in MRONJ-like lesions via IL-1RA-mediated pro-inflammation signaling suppression.
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Affiliation(s)
- Yi Zheng
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Xian Dong
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Shuo Chen
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Yang He
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Jingang An
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Meng Liu
- grid.11135.370000 0001 2256 9319Laser and Cosmetic Surgery Division, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Linhai He
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China ,grid.11135.370000 0001 2256 9319First Clinical Division, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
| | - Yi Zhang
- grid.11135.370000 0001 2256 9319Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081 People’s Republic of China
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Management of Aberrant Frenal Attachments in Adults by Scalpel Method and 980 nm Diode Laser. Case Rep Dent 2023; 2023:7258637. [PMID: 36643590 PMCID: PMC9833900 DOI: 10.1155/2023/7258637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Treatment modalities like electrosurgery and lasers have emerged as effective painless alternatives to scalpel methods for a frenectomy. The present case series involves ten patients, diagnosed with abnormal frenal attachments. Frenectomy was performed by 980 nm diode laser and scalpel methods. Scalpel frenectomy was performed as described by Archer and Kruger. Laser-assisted frenectomy was performed by a hemostat-guided incision using a 980 nm diode laser tip in a paintbrush motion. It was observed that Visual Analogue Scale (VAS) pain scores in patients who underwent scalpel frenectomy were comparatively higher than the laser-treated patients. In contrast, wound healing scores were higher in the scalpel group, suggesting early wound healing in the scalpel-treated patients.
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Epstein JB, Arany PR, Yost SE, Yuan Y. Medication-Related Osteonecrosis of the Jaw: Successful Medical Management of Complex Maxillary Alveolus with Sinus Involvement. Case Rep Oncol 2023; 16:397-413. [PMID: 37384201 PMCID: PMC10294216 DOI: 10.1159/000529502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 06/30/2023] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) in cancer patients presents a considerable challenge in management. Current management is primarily based on interventions in a limited number of cases assessing a single approach. Medical management typically is reported to include antimicrobial therapy with or without surgery. Advances in the understanding of pathogenesis have led to the investigation of additional medical interventions for early-stage necrosis. We present 3 patients with advanced-stage MRONJ of the maxilla using combined medical modalities including antimicrobial therapy, photobiomodulation therapy, pentoxifylline, vitamin E, and synthetic parathyroid hormone. All patients had a good outcome and avoided surgical intervention. We also report biological and functional imaging that may assist in more effective diagnosis and management of MRONJ. The 3 patients reported suggest that combined medical management should be considered in all cases of MRONJ (including stage III) prior to determining if surgical intervention is required. Functional imaging with a technetium bone scan or positron emission tomography scan correlated with diagnosis and confirmed resolution in patients. We present 3 challenging MRONJ patients that were effectively managed with a combined medical and nonsurgical therapy that demonstrated good clinical outcomes avoiding surgical interventions.
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Affiliation(s)
- Joel B. Epstein
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Praveen R. Arany
- Department of Oral Biology, Surgery, and Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
| | - Susan E. Yost
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Yuan Yuan
- Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Roy S, Singh DK, Manohar B. Comparative evaluation of postoperative pain and tissue response in patients undergoing conventional flap surgeries with or without 940 nm diode laser exposure - A randomized clinical study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:417. [PMID: 36824074 PMCID: PMC9942145 DOI: 10.4103/jehp.jehp_568_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/07/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Over the past few years, a growing body of evidence has allowed us to ascertain that the initiation of periodontitis stems from the existence of oral microbial biofilm and that this requires definitive treatment. Owing to its exceptional usability, affordability, and antibacterial activity, the "diode laser" (DL) has increasingly become a popular and important tool in a dentist's armamentarium. However, there is a scarcity of scientific evidence on the utility and advantages of using "diode laser" in periodontal flap surgery. The study aimed to determine the efficacy of 940 nm diode laser exposure in combination with conventional periodontal flap surgery for the treatment of chronic periodontitis to evaluate postoperative discomfort and clinical parameters. MATERIALS AND METHODS A total of 10 subjects (7 males and 3 females) with generalized chronic periodontitis were recruited and completed the study without any dropouts. For this split-mouth study, 40 sample sites with pocket probing depth (PPD) 5-7 mm post periodontal Phase I therapy were selected. The quadrants were randomly allocated to Groups A, B, C, and D using the fish bowl lottery method. Kirkland flap surgery with laser and modified Widman flap (MWF) with laser were performed in Group A and C, respectively, while Kirkland flap surgery and MWF surgery were performed in Group B and Group D. Clinical parameters including visual analog scale (VAS) score and gingival inflammation were determined at 3rd and 7th day postoperatively while PPD, clinical attachment level (CAL), and sulcus bleeding index (SBI) were recorded at baseline and 6 months following treatment. Wilcoxon signed-rank test and Kruskal-Wallis test were used for intra-group and inter-group comparison of parameters, respectively. RESULTS Statistically significant difference was attained with postoperative discomfort in laser-assisted groups on 1st and 3rd day postoperatively (P < 0.001). There was no significant difference in the proportion of subjects with gingival inflammation. A statistically significant reduction in mean PPD at 6 months postoperatively was seen among all study groups (P < 0.05) but the inter-group difference was not statistically significant. SBI score reduced significantly from baseline to 6 months follow-up among all four groups (P < 0.05). However, we did not find the inter-group difference to be statistically non-significant. CONCLUSION Diode laser as an adjunct to the surgical procedure can demonstrate appreciable benefits by increasing the CAL and minimizing the postoperative pain and the probing pocket, but such additional effects were not observed with gingival inflammation.
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Affiliation(s)
- Sonali Roy
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Dhirendra K. Singh
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Balaji Manohar
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences- KIIT Deemed to be University, Bhubaneswar, Odisha, India
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Bayrak M, Kocak-Oztug NA, Gulati K, Cintan S, Cifcibasi E. Influence of Clinical Decontamination Techniques on the Surface Characteristics of SLA Titanium Implant. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4481. [PMID: 36558334 PMCID: PMC9784882 DOI: 10.3390/nano12244481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/04/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The study aims: 1. To perform diode laser, titanium (Ti) brush, and Ti curette treatment on sandblasted and acid-etched (SLA) Ti surfaces, with/without H2O2 and CHX, 2. To investigate the influence of decontamination techniques on implant surface topography and hydrophilicity. Diode laser, Ti brush, and Ti curette treatments were performed on the Grade 4 Ti discs, with/without treatment with 3% H2O2 solution or 0.2% CHX. Surface characteristics were investigated via SEM, optical profilometry, and water contact angle meter. SEM findings revealed flat and scratched areas when treated with Ti curette and Ti brush. For diode laser, SEM showed melting in specific areas. Ra and Rt values were lower in all test groups than in the control group (p < 0.05). The adjunctive chemical treatment showed negligible effects in SEM images and surface roughness measurements compared to laser and mechanical treatment-only groups. H2O2 treatment resulted in enhanced hydrophilicity in either treatment modalities with a significant difference compared to the negative control group (p < 0.05). In all test groups, the hydrophilicity was enhanced compared to the negative control group (p < 0.05). Diode laser treatment had the least disruptive effect on the Ti surface characteristics. The use of other mechanical methods caused significant alterations in the surface roughness.
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Affiliation(s)
- Meltem Bayrak
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
- Institute of Graduate Studies in Health Sciences, Department of Periodontology, Istanbul University, Istanbul 34126, Turkey
| | - Necla Asli Kocak-Oztug
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
| | - Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
| | - Serdar Cintan
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
| | - Emine Cifcibasi
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
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The In Vitro Effect of Laser Irradiation (Er:YAG and CO 2) and Chemical Reagents (Hydrogen Peroxide, Sodium Hypochlorite, Chlorhexidine, or Sodium Fluoride) Alone or in Combination on Reducing Root Caries Bacteria. Int J Mol Sci 2022; 23:ijms232415732. [PMID: 36555374 PMCID: PMC9779214 DOI: 10.3390/ijms232415732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Lasers have been used for the treatment of dentinal hypersensitivity and bacterial reductions in periodontology. The purpose of this in vitro study was to evaluate the effect of Carbon Dioxide (CO2) and Erbium-doped Yttrium Aluminum Garnet (Er:YAG) lasers with chlorhexidine (CHX), hydrogen peroxide (H2O2), sodium hypochlorite (NaOCl), or sodium fluoride (NaF) on the viability of oral bacteria associated with root caries. (2) Streptococcus mutans, Streptococcus sanguinis, and Enterococcus faecalis were grown in Brain Heart Infusion (BHI) broth, diluted to an OD660 of 0.5, and treated with antiseptics with or without simultaneous irradiation with the Er:YAG and CO2 lasers for 30 s repeated three times. The treatment groups consisted of 1: no treatment, 2: 0.5% H2O2 alone, 3: 0.5% NaOCl alone, 4: 0.12% CHX alone, 5: 2% NaF alone, 6: laser alone, 7: laser with 0.5% H2O2, 8: laser with 0.5% NaOCl, 9: laser with 0.12% CHX, and 10: laser with 2% NaF for both lasers. The microbial viability was determined through plating and viable colonies were counted, converted into CFU/mL, and transformed into log form. The statistical analysis was performed using a two-tailed paired t-test. (3) The use of CO2 and Er:YAG lasers alone failed to show statistically significant antibacterial activity against any of the bacteria. The only effective monotreatment was CHX for S. mutans. The combined treatment of 0.5% NaOCl with Er:YAG produced the greatest reduction in overall viability. (4) The combination of the Er:YAG laser with 0.5% NaOCl resulted in the largest reduction in bacterial survival when compared to monotherapies with antimicrobial solutions or lasers.
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Lin T. Er:YAG laser-assisted comprehensive periodontal pocket therapy (Er-LCPT) under microscope in a severe periodontitis with type 2 diabetes mellitus patient: A case report. J Dent Sci 2022; 18:924-926. [PMID: 37021233 PMCID: PMC10068365 DOI: 10.1016/j.jds.2022.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/18/2022] [Indexed: 12/13/2022] Open
Affiliation(s)
- Taichen Lin
- Corresponding author. School of Dentistry, Chung Shan Medical University, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
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Tan KS. Erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+ in periodontal diseases: Two case reports and review of the literature. World J Clin Cases 2022; 10:12337-12344. [PMID: 36483816 PMCID: PMC9724513 DOI: 10.12998/wjcc.v10.i33.12337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/05/2022] [Accepted: 10/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The goal of periodontal disease treatment is to completely remove bacteria and promote wound healing. The erbium-doped yttrium aluminum garnet (Er:YAG) laser is commonly used to treat periodontal disease. Advanced platelet-rich fibrin+ (A-PRF+) secrets growth factors that accelerates soft- and hard-tissue regeneration and wound healing. Herein I present 2 cases of patients with oral diseases treated with a combination of Er:YAG laser and A-PRF+.
CASE SUMMARY Case 1 was a female with pocket depth bone loss over 8 mm and infection of tooth 31 and 41, and severe advanced periodontitis with grade III mobility. Case 2 was a male with tooth 22 root end apical swelling and infection and alveolar bony defects. Clinical outcomes were recorded at 6 and 36 mo. In case 1, the Er:YAG laser was used to perform open flap debridement (100 mJ/pulse, 15 Hz) and remove calculus and granulation tissue (50 mJ/pulse, 30 Hz). In case 2 the laser was used to create a semilunar full thickness flap incision (80 mJ/pulse, 20 Hz) and eliminate the pathogen (100 mJ/pulse, 15 Hz). In both patients, A-PRF+ mixed with bone was used to fill bone defects, and A-PRF+ autologous membranes were used to cover tension-free primary flaps. There was no recurrent infection at 36 mo, and tissue regeneration and would healing occurred.
CONCLUSION Debridement with an Er:YAG laser followed by treatment with A-PRF+ is effective for the treatment periodontal diseases with bone defects.
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Affiliation(s)
- Kai-Seng Tan
- Dentistry, Ritz Digital Dental Clinic, New Taipei 238, Taiwan
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Ayna M, Spille J, Açil Y, Weitkamp JT, Wiltfang J, Esen C, Gülses A. Investigation of Topographical Alterations in Titanium-Zirconium-Alloy Implant Threads following Er:YAG Irradiation. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7889. [PMID: 36431373 PMCID: PMC9696102 DOI: 10.3390/ma15227889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The aim of the current experimental study was to comparatively assess the surface alterations in titanium and titanium-zirconium alloy implants in terms of thread pitch topography after irradiation with an Er:YAG laser, which is recommended in the literature for its sterilizing effect in the treatment of contaminated implant surfaces. Roxolid® and SLA® (Sand-blasted, Large-grit, Acid-etched) implants from Straumann® company with the same macro topography were investigated. The surface treatment was carried out using a wavelength of 2940 nm, 60 s irradiation time, a frequency of 10 Hz, and energies between 120 mJ and 250 mJ. The alterations were quantitatively analyzed by conducting roughness analysis via white light interferometry and qualitatively using SEM images. Roxolid® could particularly maintain its surface topography at a level of 160 mJ. At an energy level of 250 mJ, the surface properties of the pitch could be significantly altered for the first time. Compared to the Standard Plus dental implants studied, no distinct removal of the material from the surface was detected. The alloy properties of Roxolid® confirm the manufacturer's statement in terms of stability and could offer advantages in peri-implantitis management if decontamination has been selected. However, as a part of a respective strategy, smoothening of a Roxolid® implant surface requires a significantly higher energy level compared to SLA-Standard® dental implants.
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Affiliation(s)
- Mustafa Ayna
- Department of Periodontology, Bonn University, 53111 Bonn, Germany
| | - Johannes Spille
- Department of Oral and Maxillofacial Surgery, Christian Albrecht University, 24105 Kiel, Germany
| | - Yahya Açil
- Department of Oral and Maxillofacial Surgery, Christian Albrecht University, 24105 Kiel, Germany
| | - Jan-Tobias Weitkamp
- Department of Oral and Maxillofacial Surgery, Christian Albrecht University, 24105 Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, Christian Albrecht University, 24105 Kiel, Germany
| | - Cemal Esen
- Laser Technology, Ruhr University, 44801 Bochum, Germany
| | - Aydin Gülses
- Department of Oral and Maxillofacial Surgery, Christian Albrecht University, 24105 Kiel, Germany
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Zhao M, Qiu F, Song J, Zhang C, Liu T, Wu M. The effects of Twinlight laser treatment on the titanium surface proliferation and osteogenic differentiation of mesenchymal stem cells. BMC Oral Health 2022; 22:409. [PMID: 36123683 PMCID: PMC9484218 DOI: 10.1186/s12903-022-02448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study aimed to observe the effects of a Twinlight laser on the titanium surface proliferation of inflammatory Mesenchymal stem cells (MSCs), inflammatory cytokine expression, and osteogenic differentiation. METHODS The MSCs were collected from bone tissue of healthy individuals.The cellular inflammatory model was established with 1 μg/mL lipopolysaccharide (LPS).Under the cellular inflammatory model,divided into five groups: the normal control group (C); the inflammatory control group (L); Er:YAG laser group (L + E); Nd:YAG laser group (L + N); Er:YAG laser and Nd:YAG laser group (L + E + N). The treated cells were inoculated onto titanium disks.The normal and inflammatory MSCs on the surface of titanium surface were examined by CCK-8, scanning election microscopy (SEM), quantitative real-time polymerase chain reaction (qRT‑PCR) and other methods for their proliferation, growth pattern, expression of inflammatory factors Interleukin-6 (IL-6), Interleukin-8 (IL-8) and osteogenic genes Runx2 (Runt-related transcription factor 2) and alkaline phosphatase (ALP), providing the theoretical basis and experimental data for the Twinlight laser-assisted treatment of peri-implantitis. Statistical analyses were performed using a Student's t test with SPSS 17.0 software. RESULTS Through observation using SEM, the cell densities of the L + E + N, L + E, and L + N groups were similar, but cell bodies in the L + E + N group were fuller and each had more than two pseudopodia. The expression level of IL-6 mRNA in the L, L + N, L + E, and L + E + N groups was higher than in group C (P < 0.05), and the expression level of IL-8 mRNA in the L + E + N group was significantly lower than in group L (P < 0.0001). On day 7, the expression level of ALP mRNA in the L, L + N, L + E, and L + E + N groups was lower than in group C (P < 0.05). On day 14, there was no significant difference in the expression level of ALP mRNA among the L + N, L + E + N, and C groups (P > 0.05). On day 7, the expression level of RUNX2 mRNA in the L + E + N group was higher than in group L (P < 0.001). On day 14, the expression level of RUNX2 mRNA in the L + E + N group was higher than in group L (P < 0.01). CONCLUSION Twinlight laser treatment promoted cell proliferation, inhibited the expression of inflammatory cytokines, and effectively enhanced the osteogenic differentiation of cells on a titanium surface.
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Affiliation(s)
- Mengzhen Zhao
- Hebei Key Laboratory of Stomatology, Department of Periodontology (II), Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Zhongshan East Road 383, Shijiazhuang, 050017, Hebei, People's Republic of China
- Hebei Key Laboratory of Stomatology, Department of Laser Medicine, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, Hebei, People's Republic of China
| | - Feng Qiu
- Hebei Medical University, Zhongshan East Road 361, Shijiazhuang, 050017, Hebei, People's Republic of China
| | - Jianing Song
- Hebei Key Laboratory of Stomatology, Department of Periodontology (II), Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Zhongshan East Road 383, Shijiazhuang, 050017, Hebei, People's Republic of China
- Hebei Key Laboratory of Stomatology, Department of Laser Medicine, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, Hebei, People's Republic of China
| | - Congcong Zhang
- Hebei Key Laboratory of Stomatology, Department of Periodontology (II), Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Zhongshan East Road 383, Shijiazhuang, 050017, Hebei, People's Republic of China
- Hebei Key Laboratory of Stomatology, Department of Laser Medicine, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, Hebei, People's Republic of China
| | - Taohong Liu
- Hebei Key Laboratory of Stomatology, Department of Periodontology (II), Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Zhongshan East Road 383, Shijiazhuang, 050017, Hebei, People's Republic of China
- Hebei Key Laboratory of Stomatology, Department of Laser Medicine, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, Hebei, People's Republic of China
| | - Mingxuan Wu
- Hebei Key Laboratory of Stomatology, Department of Periodontology (II), Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Zhongshan East Road 383, Shijiazhuang, 050017, Hebei, People's Republic of China.
- Hebei Key Laboratory of Stomatology, Department of Laser Medicine, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, Hebei, People's Republic of China.
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The Effect of an Er, Cr: YSGG Laser Combined with Implantoplasty Treatment on Implant Surface Roughness and Morphologic Analysis: A Pilot In Vitro Study. J Funct Biomater 2022; 13:jfb13030133. [PMID: 36135568 PMCID: PMC9504904 DOI: 10.3390/jfb13030133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Although laser irradiation and implantoplasty (IP) are both treatment options for peri-implantitis, no studies have yet combined these two treatment solutions. The aim of this study was to identify the effect of an Er, Cr: YSGG laser on the IP surface. In experiment 1, TiUnite anodized surface implants were treated with an Er, Cr: YSGG laser at 0.5 to 2 W on the panel energy setting and 20 Hz under water irrigation. In experiment 2, all implant surfaces were treated with the IP procedure first, then irradiated with the Er, Cr: YSGG laser. All samples were analyzed by stereomicroscopy, scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and surface topography. Stereomicroscopy and SEM revealed no obvious surface change at any energy setting once the surface was polished with the IP procedure, whereas damage was caused to the TiUnite original implant surface when the Er, Cr: YSGG laser panel energy was set at 1 W or higher. EDS showed no significant difference in element composition once the surface was polished with the IP procedure, while a compositional change was detected when the Er, Cr: YSGG laser panel energy was set to 0.5 W or higher to irradiate the original TiUnite surface. Surface roughness may be related to laser irradiation energy, but no significant changes occurred following IP. These results indicated that the Er, Cr: YSGG laser may have little effect on the post-IP surface compared with the virgin TiUnite surface.
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