Early Clinical Effectiveness of ER:Yag Laser in Association with the Red Complex of Bacteria in the Initial Treatment of Moderate Chronic Periodontitis

Abstract

Summary Chronic periodontitis is a result of polymicrobial infection and its treatment aims removal of dental calculus and biofi lm from the periodontal pocket. Many hand and power-driven instruments are created for this purpose. In recent years, lasers are widely discussed tools for periodontal therapy. The aim of the present study is to evaluate the early microbiological and clinical effectiveness of the Er:YAG laser in the treatment of chronic periodontitis. 30 patients with moderate chronic periodontitis were enrolled in the study. Using a split-mouth design they were treated either with Er:YAG laser (chisel tip, 100 mJ, 15 Hz, 5-6 water spray)-test group or with Gracey curettes- control group. Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing and plaque presence were evaluated at baseline and one month after the therapy. Microbiological samples were taken from the deepest four pockets of each quadrant from 20 randomly selected patients (n = 80). They were evaluated using real time PCR for periodontal pathogens from the red complex (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia). One month after therapy in the control group PPD decreased from 4.59 mm to 3.36 mm, the CAL gain was 1.09 mm and the reduction of bleeding and plaque - from 87.9% to 33.7% and from 75.9% to 40.9%, respectively. In the test group PPD decreased from 4.58 mm to 3.15 mm, the CAL gain was 1.37mm and the reduction of bleeding and plaque was from 85.6% to 25.9% one month after the treatment. The results were statistically significant in favour of the laser group (p < 0.05). Microbiological analysis revealed that the pathogens from the red complex decreased 3 times in the control and 6 times in the test group. Therefore, the Er:YAG laser demonstrate pronounced early effectiveness in chronic periodontitis treatment and would be appropriate alternative of the conventional periodontal therapy.

Aesthetic rehabilitation through crown lengthening laser surgery and zirconium CAD/CAM veneers: a multidisciplinary case report

“…Since the Er:YAG laser is approved from FDA for bone surgery in 2004 it is used in various osseous procedures including crown lengthening (14). There are reports from the literature demonstrating lots of benefits of the laser like bactericidal effectiveness, less discomfort and vibrations to the patient, no tissue damage and healing complications, effectiveness in bone surgery (15,16). In the present study is noticed that the Er:YAG laser is effective not only in removing soft (excessive gingiva) and hard (bone) tissues, but it can be safe during the surgery without causing more bleeding or other side effects.…”

Antibacterial effect of using the Er:YAG laser or Er,Cr:YSGG laser compared to conventional instrumentation method—a literature review

“…A total of 193 articles were possible to be included. Initial screening of the titles and abstract resulted in the further consideration of 179 publications to be excluded, and these 179 were excluded on the basis of studies that presented data on probing depth, clinical attachment level, and bleeding on probing (57); animal studies (44); studies that presented data on effect of erbium lasers on the root surface (33); literature reviews (31); and studies that presented data on calculus removal activity of the erbium lasers or conventional instruments (14), whereas the remaining (14) publications have been obtained and analyzed in full text.…”

“…Furthermore, concluded that the microbiological analysis revealed that the pathogens from the red complex decreased 3 times in the control group (SRP) and 6 times in the test group (Er:YAG laser). Therefore, the Er:YAG laser demonstrates pronounced early effectiveness in chronic periodontitis treatment and would be an appropriate alternative to the conventional periodontal therapy; also, Er:YAG laser possesses a well-defined effectiveness in the treatment of moderate chronic periodontitis in the early healing period, which would be a prerequisite for long-term positive therapeutic outcomes [14].…”

“…This thin, initial biofilm has been almost always present on the tooth surface as it forms immediately after cleaning [2]. An initial few layers (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) of the biofilm consist mostly gram-positive cocci bacteria, followed by some gram-positive rods and filaments, and a very small amount of gram-negative cocci. The gram-positive cocci species involved in this conditioning layer include, but are not limited to, S t re p t o c o c c u s m u t a n s , S t r e p t o c o c c u s m i t i s , Streptococcus sanguis, Streptococcus oralis, Rothia dentocariosa, and Staphylococcus epidermidis.…”

Er:Yag Laser Root Modification for Single Root Recession Class III Coverage – Case Report

“…Last 20 years Er:YAG lasers are increasingly applied in periodontal procedure, since they can be applied for soft as well as for hard tissue treatment. Some of their properties and advantages include antibacterial action, predictable calculus removal, minimal root substance removal, and favor of cell attachment [5,6,7].…”