Application of a Diode Laser in the Reduction of Targeted Periodontal Pathogens

Abstract

Introduction:Periodontal disease belongs to a group of diseases with more than one cause, it is a disease of a multifactorial etiology. Although bacteria are the main cause of the disease, immunoinflammatory reaction of the host is responsible for the majority of destructive changes in periodontal tissue. The main issue in the evaluation of the success of periodontal therapy is the pluralism of the bacteria and their dynamic changes during the duration, on the one hand, and the possible inaccuracy of classical microbiological analysis in determination of the dominant role of a microorganism, or the success of its reduction or elimination, on the other. Thanks to advances of microbiology and technological development, it is possible to make an assessment of specific microorganisms in a large number of samples of sub-gingival plaque with extreme precision, using checkerboard DNA-DNA hybridization and method of polymerase chain reaction (PCR). The development of laser technology and the discovery of its significant antimicrobial effects have introduced and presented this treatment modality as a possible auxiliary method of periodontitis treatment.Materials and Methods:The sample for the study estimating the efficiency of application of diode lasers in the reduction of periodontal pockets consisted of 1164 periodontal pockets in 24 subjects of both sexes. For laser irradiation of periodontal pockets a diode laser was used, a low-power laser (SmilePro 980, Biolitec, Germany), working in a mode precisely tuned for treatment of periodontal pockets. All subjects underwent: general anamnesis, periodontal status, and orthopantogram radiograph analysis. Following a standard periodontal preparation, a sample of subgingival plaque was collected for molecular-biological analysis (real-time PCR method) prior to laser irradiation of periodontal pockets, immediately following the irradiation, and during the control examination 3 months after irradiation.Results:The results of the molecular-biological analysis of target periodontal pathogens Actinobacillus (Aggregatibacter) actinomycetemcomitans (AA) and Porphyromonas gingivalis (PG) isolated from periodontal pockets prior to laser irradiation, immediately after laser irradiation, and at the control examination after 3 months were processed statistically (using real-time PCR method). The results showed that there was a statistically significant decrease in CT values for the tested bacteria immediately after treatment and the control examination, compared with the level of CT values for the same bacteria before treatment.Conclusions:Based on the obtained results, we concluded that diode laser irradiation reduces the number of active periodontal pathogens. We believe that the use of diode lasers, as a supplementary method in the treatment of periodontal disease, is extremely useful and efficient, and can be recommended as part of standard clinical practice.

Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention

“…Thanks to curettage effect, the laser eliminates the sulcular epithelium infected in a total and complete way than conventional methods of treatment with manual tools (30), without any kind of damage to the underlying connective tissue and reducing the bacterial load of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis (31), which easily penetrate within the sulcular epithelium. Furthermore there is a scientific evidence on the direct antimicrobial effect of diode laser against levels of Targeted Periodontal Pathogens (32). According to Kreisler (2005) the greatest reduction in the degree of tooth mobility and probing depth in the group of patients who underwent SRP + laser therapy can be mainly attributed not to the killing of bacteria in periodontal pockets, but rather to the complete removal of infected sulcular epithelium, which leads to greater attack of the connective tissue (33).…”

The antibacterial effect of the combined Er,Cr:YSGG and 940 nm diode laser therapy in treatment of periodontitis: a pilot study

“…Gojkov-Vukelic M. et al (2013) demonstrated a statistically significant decrease in Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis immediately and 3 months after the baseline [12]. The significant antibacterial effects against major pathogens such as Prevotella intermedia, Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis were demonstrated for Er,Cr:YSGG laser-assisted periodontal therapy in a 6-month follow-up study conducted by Gutknecht et all [13].…”

“…The use of lasers has been proposed for its bactericidal and detoxifying effect, but also for its capacity to stimulate local healing [10][11][12][13][14]. Despite the literature data showing controversial results and conclusions of various laser wavelengths used in periodontal therapy, only a few researches aimed to investigate the synergic effect promoted by the combination of different laser categories.…”

Evaluation of Effectiveness of Photodynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis

“…However, many other studies, including that of Birang et al, 27 have shown that the use of diode laser or chlorhexidine gel, as adjunctive techniques, is more effective than mechanical debridement alone in the treatment of chronic periodontitis, concluding that if routine mechanical debridement is combined with diode laser or chlorhexidine gel, it will be more effective in improving the clinical and microbiologic parameters. Gojkov-Vakelic et al 28 showed that use of diode laser beams decreased the number of active pathogens in periodontal pockets. On the other hand, the results of studies done by Moritz et al 29 and Angelov et al 30 showed that treatment with diode laser might improve periodontal pockets and periodontal parameters.…”