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Do lasers and photodynamic therapy have a purpose in periodontal treatment?

Posted by Z Dental Group - September 18th, 2012

I was asked by a organizing cabinet of Europerio 7 to benefaction a stream systematic justification on lasers and photodynamic therapy. Since a assembly was essentially dental hygienists, a many engaging and applicable emanate is: “What is a outcome of these technologies in non surgical therapy achieved by a dental hygienists?”

Dental hygienists are indeed specialists in this field. During non surgical therapy procedures, we would like to grasp a rebate in bacterial board on a base aspect to levels allied with gingival health. We consider this by noticing a rebate in probing slot depth, rebate of levels of supra and underling gingival microbial load, benefit of connection level, and impediment a course of disease. Scaling and base formulation (SRP) are essential tools of this success and therefore stays a bullion customary in non surgical therapy.(1,2)

LASER means Light Amplification by Stimulated Emission of Radiation. It is a light that can have several wavelengths. Currently, opposite laser systems are on a marketplace for intraoral use. Depending on a wavelength, they are called diode, Nd:YAG, Er:YAG or CO2.

Frequently, laser therapy is used as a fascinating and constant choice to a normal scalpel surgery. It is simply means to reshape oral soothing tissues and boost homeostasis by heat-induced coagulation and occlusion of arterioles, venules and capillaries. The advantages of a use of LASER record is that it gives a transparent and manifest surgical field, it has a bactericidal effect, and causes reduction pain, flourishing and recovering time.

As we know from a pathogenesis of periodontal infection, periodontitis is a plaque-induced illness with an initial microbial challenge. The horde inflammatory response is critical and risk factors minister to ionization and course of a disease. The question, therefore, is: “Do lasers/photodynamic therapy have a purpose in non surgical therapy achieved by a dental hygienists?”

Based on a top turn of justification presented in systematic reviews, a Er:AYg laser seems a many promising. In vitro studies uncover that they are effective in radicular waste dismissal and base smoothing, nonetheless a clinical efficacy stays argumentative given no statistical disproportion could be obtained.(3,4,5)

The U.S. Food and Drug Administration (FDA) authorized a Nd:YAG laser for soothing hankie diagnosis in a oral cavity. However, there is no justification to support a superiority of a Nd:YAG over normal modalities of periodontal therapy.(3,4,6)

The diode laser can used alone possibly in multiple with a print sensitizer. The multiple is improved famous as photodynamic therapy, has been studied, and a end is that there is no justification that this therapy, possibly as an eccentric diagnosis or as an adjunctive therapy, is an choice to normal scaling and base planning.(7,8,5)

This justification supports a American Academy of Periodontology (AAP) in a matter that says that now there is minimal justification to support a use of a laser for a purpose of subgingival debridement possibly as mono therapy or as an accessory to SRP.(9) However, Schwartz also resolved that a investigate conducted to date has indicated that a use of laser is safe.(3)

1. Cobb CM. Non-surgical slot therapy: Mechanical.Ann Periodontol 1996;1:443-490.
2. Cobb CM. Clinical significance of non-surgical periodontal therapy: An evidence-based viewpoint of scaling and base planing. J Clin Periodontol 2002; 29(Suppl. 2):6-16.
3. Schwarz F, Aoki A, Becker J, Sculean A. Laser focus in non-surgical periodontal therapy: A systematic review. J Clin Periodontol 2008; 35(Suppl. 8):29-44.
4. Cobb CM, Low SB, Coluzzi DJ. Lasers and a diagnosis of ongoing periodontitis. Dent Clin North Am 2010; 54:35-53.
5. Sgolastra F, Petrucci A, Gatto R, and Monaco A. Effectiveness of diode laser as adjunctive therapy to scaling base formulation in a diagnosis of ongoing periodontitis: a meta-analysis. Lasers in Medical Science, May 2012, Volume 27, Issue 3, pp 661-673.
6. Slot DE, Kranendonk AA, Paraskevas S, and Van der Weijden F. The Effect of a Pulsed Nd:YAG Laser in Non-Surgical Periodontal Therapy. J Periodontol, 2009 July, 80 (7), 1041-1056.
7. Atieh MA. Photodynamic therapy as an adjunctive diagnosis for ongoing periodontitis: a meta-analysis. Lasers Med Sci. 2010 Jul;25(4):605-13. Epub 2009 Dec 19. PubMed PMID: 20024665.
8. Azarpazhooh A, Shah PS, Tenenbaum HC, Goldberg MB. The outcome of photodynamic therapy for periodontitis: A systematic examination and meta-analysis. J Periodontol 2010; 81:4-14.
9. American Academy of Periodontology Statement on a Efficacy of Lasers in a Non-Surgical Treatment of Inflammatory Periodontal Disease. J Periodontol, 2011 April, 82 (4): 513 – 514.

Dagmar Else Slot, RDH, MSc, is a researcher during a Periodontology Department, ACTA University Amsterdam a Netherlands.

To review some-more articles created by Dagmar Else Slot, go to articles.

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