The Effects of Diode Laser (980 nm Wavelength) and Chlorhexidin Gel in the Treatment of Chronic Periodontitis
Journal of Lasers in Medical Sciences,
Vol. 2 No. 4 (2011),
8 February 2012
INTRODUCTION: The aim of the present study was to investigate the effects of SRP assisted by the two clinical treatment methods of diode laser or Chlorhexidine Gel applications in comparison with SRP alone.
METHODS: Eight patients with moderate to severe chronic periodontitis, each with at least three pockets 4–7 mm deep, were selected for this study. Over 66 pockets were selected and randomly treated by either scaling and root planning (SRP) alone, or by SRP + diode laser (1.5 W,980 nm,30sec, continuous wave)(laser group),or by SRP + chlorhexidine gel-xanthan based (gel group). The clinical indices (probing pocket depth [PPD], clinical attachment level [CAL], and papillary bleeding index [PBI] mean score) and microbiological index (total bacterial count [TBC]) before, 1 month and three months after treatment were measured and evaluated.
RESULTS: The results showed that SRP assisted by chlorhexidine gel and diode laser therapies exhibits better results than SRP alone in reducing PPD, improving clinical CAL, and reducing PBI mean score and TBC (p < 0.05) both at one month and three months follow ups. Comparison of clinical indices between the laser group and the gel group showed no significant differences at neither of the follow up stages, but in 3 months follow up interval, the TBC reduction in the laser group was significantly more than the gel group (P < 0.05).
CONCLUSION: Treatment with diode laser or chlorhexidine gel as an adjunct to SRP may improve periodontal and microbiological indices compared to SRP alone. Diode laser showed better bactericidal effects in long term.
- diode laser
- periodontal pocket
- chronic periodontitides
How to Cite
Hancok EB, Newell DH. Antimicrobials in periodontal practice. Dent Clin North Am; 1994; 38:719-31.
Goodson JM. Pharmacokinetic principles controlling efficacy of oral therapy. J Dent Res 1989; 68:1625-32.
Greenstein G, Polson A. The role of local drug delivery in the management of periodontal diseases: A comprehensive review. J Periodontol 1998; 69:507-20.
Killoy WJ, Polson AM. Controlled local delivery of antimicrobials in the treatment of periodontitis. Dent Clin North Am 1998; 42:263-83.
Walsh TF, Unsal E, Davis LG, Yilmaz O. The effect of irrigation of chlorhexidine and saline on plaque vitality. J Clin Periodontol 1995;22:262–4.
Pappalardo S, Baglio OA, Cappello C, Guarrera S, De BM, Petruzzi M, et al. Local delivery of antimicrobial drugs in the treatment of chronic adult periodontitis. Minerva Stomatol 2006;55(11-12): 655-61.
Daneshmand N, Jorgensen MG, Nowzari H, Morrison JL, Slots J. Initial effect of controlled release chlorhexidine on subgingival microorganisms. J Periodontal Res 2002; 37(5): 375-9.
Grisi DC, Salvador SL, Figueiredo LC, Souza SL, Novaes AB, Grisi MF. Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters of periodontal syndrome. J Clin Periodontol 2002; 29(10): 875-81.
Vinholis AH, Figueiredo LC, Aarcantonio JE, Marcantonio E, Salvador SL, Goissis G. Subgingival utilization of a 1% chlorhexidine collagen gel for the treatment of periodontal pockets. A clinical and microbiologic study. Braz Dent J 2001; 12:209-13.
Dinca A, Straul SL, Mesaros M, Rusu D, BentaA,Onisei A,et al. Periodontal nonsurgical therapy with chlorhexidine xanthan based gel chlosite: A randomized split mouth study on 51 cases. Int Poster J Dent Oral Med 2007;9(1):341.
Birang R, Yaghini J, Teymouri F, Jamshidi M, Mir M. Gutknecht. Comparative evaluation of the effect of Nd:YAG Laser and chlorhexidine gel, A randomized clinical study. Int Mag Laser Dent 2009; 1(4):24-7.
de Paula Eduardo C, de Freitas PM, Esteves-Oliveira M, Aranha AC, Ramalho KM, Simoes A,et al. Laser phototherapy in the treatment of periodontal disease. Lasers Med Sci. 2010; 25(6):781-92.
Braun A, Dehn C, Krause F, Jepsen S. Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol. 2008; 35(10):877-84.
Schwarz F, Sculean A, Berakdar M, Szathmari L, Georg T, Becker J. In vivo and in vitro effects of an Er:YAG laser, a GaAlAs diode laser, and scaling and root planning on periodontally diseased root surfaces: a comparative histologic study. Lasers Surg Med 2003; 32(5):359–66.
Miyazaki A, Yamaguchi T, Nishikata J, Okuda K, Suda S, Orima K, et al. Effects of Nd: YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodontitis patients . J Periodontol 2003; 74:175-80.
Schwarz F, Sculean A, Georg T, Reich E. Periodontal treatment with an Er: YAG laser compared to scaling and root planning: A controlled clinical study. J Periodontol 2001; 72: 361-67.
Schwarz F, Sculean A, Berakdar M, Georg T, Reich E, Becker J. periodontol treatment with an Er: Y AG laser or scaling and root planning: A 2- year follow up split - mouth study. J Periodontol 2003; 74: 590 - 6.
Shahabouei M, Shirani AM, Navabakbar F, Montazeri PM, Birang R,Mir M, et al. The clinical and microbial evaluation of Nd: YAG laser in periodontal pocket healing. J Oral Laser Appl 2007; 7: 233-8.
Birang R,Yaghini J, Shirani AM. Comparative study of dentin surface changes following Nd: YAG and Er: YAG Lasers irradiation and implications for hypersensitivity . J oral laser applications 2008;8: 25-31.
Birang R, Poursamimi J, Gutknecht N, Lampart F, Mir M. Comparative evaluation of the effect of Nd: YAG Er- YAG laser in dentin hypersensitivity treatment. Lasers Med Sci 2007; 22(1):21-4.
Schwarz F, Aoki A, Becker J, Sculean A. Laser application in non-surgical periodontal therapy: a systematic review. J Clin Periodontol. 2008; 35(8 Suppl):29-44.
Sjostrom L, Friskopp J. Laser treatment as an adjunct to debridement of periodontal pockets. Swed Dent J 2002; 26(2):51–7.
Kreisler M, Al Haj H, d’Hoedt B. Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing. Lasers Surg Med 2005; 37:350-5.
Moritz A, Schoop U, Goharkhay K, Schauer P, DoertbudakO,Wernisch J, et al. Treatment of periodontal pockets with a diode laser. Lasers Surg Med 1998; 22:302–11.
Romanos GE, Henze M, Banihashemi S, Parsanejad HR, Winckler J, Nentwig GH. Removal of epithelium in periodontal pockets following diode (980 nm) laser application in the animal model: an in vitro study. Photomed Laser Surg 2004; 22(3):177–83.
Cobb CM. Lasers in periodontics: a review of the literature. J Periodontol. 2006; 77(4):545-64.
Angelov N, Pesevska S, Nakova M, Gjorgoski I, Ivanovski K, Angelova D, et al. Periodontal treatment with a lowlevel diode laser: clinical findings. Gen Dent. 2009; 57(5):510-3
Caruso U, Nastri L, Piccolomini R, dErcole S, Mazza C, Guida L. Use of diode laser 980 nm as adjunctive therapy in the treatment of chronic periodontitis: A randomized controlled clinical trial. New Microbiol 2008; 31:513-8.
Borrajo JL, Varela LG, Castro GL, Rodríguez-Nuñez I, Torreira MG. Diode laser (980 nm) as adjunct to scaling and root planing. Photomed Laser Surg. 2004; 22(6):509-12.
Kamma JJ, Vasdekis VG, Romanos GE. The effect of diode laser (980 nm) treatment on aggressive periodontitis: evaluation of microbial and clinical parameters. Photomed Laser Surg. 2009; 27(1):11-9.
Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T. Effect of gallium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med 2002; 30(1):60–6.
Nussbaum EL, Lilge L, Mazzulli T. Effects of 810 nm laser irradiation on in vitro growth of bacteria: Comparison of continuous wave and frequency modulated light. Lasers Surg Med 2002; 31:343-51.
Wilson M. Lethal photosensitization of oral bacteria and its potential application in the photodynamic therapy of oral infections. Photochem Photobiol Sci 2004; 3:412–8.
Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P, et al. Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study. J Clin Laser Med Surg 1997; 15:33-7.
Komerik N, Wilson M, Poole S. The effect of photodynamic action on two virulence factors of gram-negative bacteria. Photochem Photobiol Sci 2000;72(5):676–80.
Ryden H, Persson L, Preber H, Bergstrom J. Effect of low level energy laser irradiation on gingival inflammation.Swed Dent J 1994; 18:35-41.
Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P, et al. Bacterial reduction in periodontal pockets through irradiation with a diode laser: A pilot study. J Clin Laser Med Surg 1997; 15:33-7.
Safavi SM, Kazemi B, Esmaeili M, Fallah A, Modarresi A, Mir M. Effects of low-level He-Ne laser irradiation on the gene expression of IL-1beta, TNF-alpha, IFNgamma, TGF-beta, bFGF, and PDGF in rat’s gingiva. Lasers Med Sci 2008; 23:331–5.
Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 2007; 18:34–8.
Cheng RH, Leung WK, Corbet EF. Non-surgical periodontal therapy with adjunctive chlorhexidine use in adults with down syndrome: a prospective case series. J Periodontol 2008; 79:379-85.
Perinetti G, Paolantonio M, Cordella C, D’Ercole S, Serra E, Piccolomini R. Clinical and microbiological effects of subgingival administration of two active gels on persistent pockets of chronic periodontitis patients. J Clin Periodontol 2004; 31(4):273-81.
Theodoro LH, Haypek P, Bachmann L, Garcia VG, Sampaio JEC, Zezell DM et al. Effect of Er:YAG and diode laser irradiation on the root surface: morphological and thermal analysis. J Periodontol 2003; 74(6):838–43.
Kreisler M, Meyer Ch, Daublander M, Willershausen-Zonnchen B, d’Hoedt B. Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: An in vitro study. J Periodontol 2001; 72:1312–7.
- Abstract Viewed: 834 times
- PDF Downloaded: 744 times