A evaluation of Er, Cr:YSGG laser application in addition to scaling and root planing in patients with early - moderate periodontitis

Show simple item record Kelbauskienė, Solveiga 2017-08-21T08:08:59Z 2017-08-21T08:08:59Z 2011
dc.description.abstract Thirty patients with the diagnosis of early or moderate periodontitis, between 26 and 58 years of age were included in the study. The patient selection criteria were: no periodontal treatment received within the last 12 months, no systemic diseases, that could influence the outcome of the therapy, no use of systemic antibiotics at least 6 months prior to, during and 12 months after the treatment, non smokers and not pregnant. The study was performed according to a split-mouth design, on single-rooted teeth. A total of 278 teeth exhibiting gingival inflammation with positive bleeding on probing, subgingival calculus and a probing depth more than 3 mm were selected for examination. Of 1668 examined sites, 1088 sites exhibited the probing depth > 3 to 6 mm. Every participant received both types of treatment using different mouth quadrants. On one side, the teeth were treated by scaling and root planing only, the teeth of the contra-lateral side were treated by Er;Cr:YSGG laser immediately after SRP. Laser, at a setting of 1W, 10% air and 15% water, was used to remove the inner epithelial lining to the depth of the pocket, 5mm of oral epithelium near the free gingival margin and to condition the root surface. At the baseline and 2, 3, 6, 12 months after the treatment “visible plaque level”, bleeding on probing (BOP), gingival recession (GR), probing pocket depth (PPD) and clinical attachment level (CAL) were measured. Twenty root slices, obtained from ten human teeth, which were extracted for periodontal reasons, were used in vitro study. All root slices were instrumented using ultrasonic scaler and manual currets, ten of them after instrumentation were additionally irradiated by laser. All the specimen after instrumentation and after incubation with human gingival fibroblasts suspension were observed by scanning electron microscopy (SEM). The results of the present clinical and in vitro studies indicate that:1) bleeding on probing reduced significantly over the 12 months period in periodontal patients, irrespective of the treatment method used. However, laser application in addition to root scaling and planing was more effective in maintaining the reduced bleeding on probing than root scaling and planing alone (p<0.001); 2) both treatment methods – root scaling and planing with additional laser application as well as root scaling and planing alone, were equally effective in long-term dental plaque reduction in periodontal patients: after 12 months the visible plaque levels were similar to those obtained at baseline, immediately after supragingival cleaning procedure; 3) the gingival recession was more pronounced in quadrants treated with scaling and root planing alone during the entire study period. In quadrants treated by scaling root planing with additional laser application, gingival recession mean values 12 months after the treatment did not differ from those obtained at baseline; 4) periodontal treatment of early-to-moderate periodontitis, either by means of root scaling and planing alone or, with an additional application of laser, resulted in a significant reduction of periodontal pocket depth over 12 months, but the mean periodontal pocket depth reduction was more pronounced in the quadrants treated by SRP+ laser; 5) the gain in clinical attachment levels was significantly greater in the quadrants treated with scaling root planing and laser and it was a result of decreased periodontal pocket depth and not related to gingival recession; 6) Er, Cr:YSGG laser used in combination with scaling root planing application may offer a promising periodontal therapy for etching root surfaces for better fibroblasts attachment.
dc.description.abstract IŠVADOS 1. Dantenų kraujavimas tyrimo metu mažėjo taikant abu gydymo metodus. Tačiau papildomas gydymas lazeriu buvo veiksmingesnis kontroliuojant sumažėjusį dantenų kraujavimą, palyginti su šaknų grandymo ir lyginimo metodu. 2. Abiem gydymo metodais vienodai veiksmingai kontroliuojamas dantų paviršių apnašų susidarymas. Po 12 mėn. dantų, turinčių apnašų, papli¬timas buvo panašus į tyrimo pradžioje nustatytą jų paplitimą. 3. Dantenų recesijos vidurkio pokytis buvo reikšmingai didesnis taikant šaknų grandymo ir lyginimo metodą visais tyrimo etapais. Gydant la¬zeriu recesijos vidurkis po 12 mėn. nesiskyrė nuo pradinių duomenų. 4. Apydančio kišenių gylio vidurkis reikšmingai kito abiejų tyrimo grupių viso tyrimo laikotarpiu. Tačiau didesnį kišenių gylio vidurkio sumažė¬jimą nustatėme burnos ketvirtadaliuose, kuriuose buvo naudotas lazeris. 5. Klinikinio dantenų prisitvirtinimo atsinaujinimas buvo didesnis burnos ketvirtadaliuose, kuriuose papildomai naudotas lazeris, ir tai lėmė ne padidėjusi dantenų recesija, o sumažėjęs apydančio kišenių gylis. 6. Papildomas lazerio naudojimas skatina fibroblastų prisitvirtinimą ant šaknų paviršių.
dc.language.iso eng
dc.subject Er
dc.subject Cr:YSGG laser
dc.subject Scaling
dc.subject Root planing
dc.subject Clinical attachment level
dc.subject Er
dc.subject Cr:YSGG lazeris
dc.subject Apydantis
dc.subject Regeneracija
dc.subject Skale
dc.title A evaluation of Er, Cr:YSGG laser application in addition to scaling and root planing in patients with early - moderate periodontitis
dc.title.alternative Lengvo ir vidutinio sunkumo apydančio audinių uždegimo gydymo ER,CR:YSGG lazeriu bei šaknų grandymo ir lyginimo metodų lyginamoji analizė
dc.type Daktaro disertacija

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