J Oral Laser Applications 6 (2006), No. 2 (05.06.2006)
The Short-term Effect of Diode Laser (980 nm) Treatment on Aggressive Periodontitis. Evaluation of Clinical and Microbiological Parameters
Kamma, Joanna J./Vasdekis, Vassilis G. S./Romanos, George E.
Purpose: The purpose of the present study was to compare the short-term effect of scaling and root planing alone (SRP), diode laser (980 mn) treatment alone (LAS), and SRP combined with LAS (SRP+LAS) on clinical and microbial parameters in aggressive periodontitis (AgP).
Materials and Methods: Thirty AgP patients (14 men, 16 women) aged 41.8 ± 6.2 years, 18 smokers, 12 nonsmokers, participated in this study. Clinical assessments of plaque (Pl), bleeding upon probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL) were made prior to treatment. Four plaque samples were randomly obtained from each individual, one in each quadrant. Following baseline (BL) clinical evaluation, each quadrant randomly received the following treatment modalities: SRP, SRP+LAS, LAS, CRL. A 980-nm diode laser (SmilePro980, Biolitec, Jena, Germany) was used for the laser treatment in a continuous focused mode and 2 W power setting. Subgingival plaque samples were collected from the same sites in each quadrant 2, 6, and 12 weeks after treatment. Clinical parameters were also recorded at the same time intervals. The level of Porphyromonas gingivalis, Tannerella forsythia (Bacteroides forsythus), Actinobacillus actinomycetemcomitans, Treponema denticola, and total bacterial load was evaluated using ssrRNA probes (IAI Pado Test 4.5, Institut für Angewandte Immunologie).
Results: Repeated measures analysis showed a significant time effect on bacterial counts, which were decreased following the three treatment modalities in all quadrants. They did not reach baseline levels 12 weeks after treatment. SRP+LAS showed lower bacterial levels than SRP or LAS at every time point after treatment. For T. forsythia, there was a significant time-by-treatment interaction effect, showing that each treatment had a different performance over time (F = 6.51, p = 0.001). Similar effects were observed for total bacterial load (F = 6.90, p = 0.003). Regarding P. gingivalis and T. denticola, time effects were significant (F = 6.84, p = 0.009, and F = 12.45, p<0.001, resp). Treatment effects were significant for P. gingivalis (F = 7.96, p = 0.003). It is noteworthy that the SRP+LAS mean levels for all bacteria at the final follow-up point were never higher than the corresponding levels of the other treatments immediately after treatment (0.346 vs 0.369 for T. forsythia, 0.266 vs. 0.548 for P. gingivalis, 0.155 vs 0.211 for T. denticola, and 3.580 vs 6.798 for total bacterial load. At the control sites, the bacterial counts showed no significant decrease.
Conclusion: Diode (980 nm) laser-assisted treatment with SRP showed a superior effect over SRP or LAS alone in both clinical and microbial parameters of AgP over a monitoring period of 12 weeks
Keywords: aggressive periodontitis, microbiology, periodontal pathogens, scaling and root planing, laser treatment