Low Level Laser Therapy in the Treatment of Intra-Osseous Defect- A Case Report

Abstract

A 45-year-old male patient reported to the Department of Periodontology, Krishnadevaraya College of Dental Sciences and Hospital, Bangalore for management of dull and nagging pain since 4 days in 45 and 46. Intraoral examination revealed generalized periodontal pockets (4-7 mm), Grade II furcation involvement in 46 and localized periodontal abscess in respect to 44 and 45. Radiographically, 44 and 45 demonstrated moderate angular bone loss with a deeper component distally. The case was diagnosed as moderate chronic periodontitis with chronic localized periodontal abscess at 44 and 45. A comprehensive treatment plan including non-surgical and presumptive surgical therapy including use of LLLT and bone graft was presented before the patient and signed informed consent was obtained.On day 1, intra-sulcular emergency abscess drainage was carried out at 44 and 45. Non-surgical periodontal therapy consisting of full mouth scaling and root planing was completed within next three weeks, with follow-up up of three months. The clinical parameters were recorded [Table/ Fig-1,2]. Observing optimal plaque control, good patient compliance and deep residual pockets, decision for surgical treatment was made and informed to the patient.

Photobiomodulation Therapy (PBMT) Applied in Bone Reconstructive Surgery Using Bovine Bone Grafts: A Systematic Review

“…Efforts to minimize complications and the time needed to heal by improving the process and enhancing biocompatibility has led to the emergence of PBMT-associated biomaterial application in the world literature [12,31]. Bovine bone is listed as the most frequently used type of graft in the literature for the reconstructive bone process [15,20,[36][37][38][39].…”

“…A range of wavelength parameters-from 618 to 830 nm [12,37,46,[48][49][50][51][52][53][54]-was used, along with variation in energy density, application time and type of laser used, even with similar types of lesions. Most articles used the infrared light spectrum [12,15,18,20,22,33,45,46,48,49,[51][52][53][54], including the study on humans [36], with promotion of new (local) formations and increased protein and genes of osteoblastic factors. PBMT involves radiation from the red to infrared regions, with the latter being most cited in the literature as effective in the early stages of bone repair during the reconstruction process.…”

“…The two articles employing rabbits involved the calvaria [33] and tibia [18]. The only article in humans [36] was on the alveolar bone due to periodontal disease. The use of bovine bone in its inorganic phase was observed in 10 studies [12,15,20,22,33,37,47,[52][53][54] versus six using the organic phase [18,46,[48][49][50][51]; only one study [45] did not offer a distinction.…”

“…The wavelength parameter employed in the studies covered a wide range of values, from 618 to 830 nm. This included one study for each of 618 nm [37], 660 nm [47], 780 nm [22] and 790 nm [18], three studies with 808 nm [15,20,45], two studies with 810 nm [33,36], and nine studies with 830 nm [12,46,[48][49][50][51][52][53][54], as shown in Figure 2. Regarding the type of laser used in the studies, eight studies employed GaAlAs lasers (44.44%), one study cites the use of a light-emitting diode (LED) (5.55%), two specified the use of a diode laser (11.11%) and 7 researches did not mention the type of laser (38.88%).…”

“…The literature cites as necessary in the reconstruction of bone defects three simultaneous conditions: (i) osteoconductive properties; (ii) inductive properties; and (iii) the presence of bone-forming cells [35]. As an alternative material, bovine bone graft [15,20,[36][37][38][39] is the most widely used due to its biocompatibility characteristics, as indicated in reconstructive areas related to traumatology, cranio-maxillary surgery, facial prosthetic rehabilitation, skeletal aging and esthetic aging [28]. Physical methods, such as low-intensity ultrasound (LIPUS) [40] and photobiomodulation therapy (PBMT), have the potential to improve the bone reconstruction process, acting or not in combination with bone grafts.…”