Skip to main content
Top
Published in: Lasers in Medical Science 4/2011

01-07-2011 | Original Article

Adjunctive Nd:YAG laser application in chronic periodontitis: clinical, immunological, and microbiological aspects

Authors: Clara Gómez, Arantza Domínguez, Ana Isabel García-Kass, Juan Antonio García-Nuñez

Published in: Lasers in Medical Science | Issue 4/2011

Login to get access

Abstract

In recent years, the use of laser radiation has been investigated as an alternative or adjunctive tool to conventional procedures employed in the treatment of periodontal disease. Various beneficial characteristics of Nd:YAG laser radiation, such as hemostatic and bactericidal effects, might lead to improved treatment outcomes. The objective of the present study was to examine the clinical, microbiological, and anti-inflammatory efficacy of Nd:YAG laser periodontal pocket irradiation as an adjunct to scaling and root planing (SRP). Thirty patients with chronic periodontitis (CP) were randomly assigned in parallel groups to receive SRP alone or SRP followed by Nd:YAG laser (λ = 1,064 nm) (SRP+NDL). Probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI) were recorded, and samples of gingival crevicular fluid (GCF) and subgingival microbiota were taken at baseline and post-therapy (4 and 8 weeks after treatment). The laser therapy was performed 1 day after the SRP procedure. The GCF samples were analyzed for interleukin-1beta (IL-1β), tumor necrosis factor alpha (TNF-α), and total antioxidative status (TAS). Microbiological samples were cultured and analyzed for ten bacteria. No statistically significant differences were detected for clinical or microbiological variables between SRP and SRP+NDL treatments. However, levels of IL-1 β in GCF were significantly lower after SRP+NDL treatment when compared to IL-1 β levels obtained by SRP alone after 4 weeks of treatment. Levels of TNF-α were significantly lower after the SRP+NDL treatment during post-therapy. TAS of GCF increased during post-therapy after the SRP+NDL treatment. However, after SRP alone, it remained constant. In this short-term clinical study Nd:YAG laser radiation in the treatment of CP is showed to be a potential adjunct to conventional SRP.
Literature
1.
go back to reference Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–7PubMedCrossRef Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–7PubMedCrossRef
2.
go back to reference Potera C (1999) Forging a link between biofilms and disease. Science 19(283)(5409):1837–1839 Potera C (1999) Forging a link between biofilms and disease. Science 19(283)(5409):1837–1839
3.
go back to reference Socransky SS, Haffajee AD (2002) Dental biofilms: difficult therapeutic targets. Periodontol 28:12–55CrossRef Socransky SS, Haffajee AD (2002) Dental biofilms: difficult therapeutic targets. Periodontol 28:12–55CrossRef
4.
go back to reference Waterman WH, Sha’afi RI (1995) A mitogen-activated protein kinase independent pathway involved in the phosphorylation and activation of cytosolic phospholipase A2 in human neutrophils stimulated with tumor necrosis factor-alpha. Biochem Biophys Res Commun 209 (Suppl.1): 271–278 Waterman WH, Sha’afi RI (1995) A mitogen-activated protein kinase independent pathway involved in the phosphorylation and activation of cytosolic phospholipase A2 in human neutrophils stimulated with tumor necrosis factor-alpha. Biochem Biophys Res Commun 209 (Suppl.1): 271–278
5.
go back to reference Batista AC, Silva TA, Chun JH, Lara VS (2002) Nitric oxide synthesis and severity of human periodontal disease. Oral Dis 8 (Suppl.5):254–260 Batista AC, Silva TA, Chun JH, Lara VS (2002) Nitric oxide synthesis and severity of human periodontal disease. Oral Dis 8 (Suppl.5):254–260
6.
go back to reference Chapple ILC (1997) Reactive oxygen species and antioxidants in inflammatory diseases. J Clin Periodontol 24(Suppl 5):287–296PubMedCrossRef Chapple ILC (1997) Reactive oxygen species and antioxidants in inflammatory diseases. J Clin Periodontol 24(Suppl 5):287–296PubMedCrossRef
7.
go back to reference Chapple ILC, Brock GR, Milward MR, Ling N, Matthews JB (2007) Compromised GCF total antioxidant capacity in periodontitis: cause or effect? J Clin Periodontol 34:103–110PubMedCrossRef Chapple ILC, Brock GR, Milward MR, Ling N, Matthews JB (2007) Compromised GCF total antioxidant capacity in periodontitis: cause or effect? J Clin Periodontol 34:103–110PubMedCrossRef
8.
go back to reference Abbas AK, Litchtman AH, Pober JS (2000) Cellular and molecular immunology, chapter 3, 4th edn. WB Saunders, Philadelphia Abbas AK, Litchtman AH, Pober JS (2000) Cellular and molecular immunology, chapter 3, 4th edn. WB Saunders, Philadelphia
9.
go back to reference Gowen M, Mundy GR (1986) Actions of recombinant IL-α and interferon-α on bone resorption in vitro. J Immunol 136:2478–2482PubMed Gowen M, Mundy GR (1986) Actions of recombinant IL-α and interferon-α on bone resorption in vitro. J Immunol 136:2478–2482PubMed
10.
go back to reference Billingham ME (1987) Cytokines as inflammatory mediators. Br Med Bull 43:350–357PubMed Billingham ME (1987) Cytokines as inflammatory mediators. Br Med Bull 43:350–357PubMed
11.
go back to reference Takatis DN, Schneerberger G, Dziak R (1988) Recombinant interleukin-1 stimulates prostraglandin E2 production by osteoblastic cells: synergy with parathyroid hormone. Calc Tiss Inter 42:358–362CrossRef Takatis DN, Schneerberger G, Dziak R (1988) Recombinant interleukin-1 stimulates prostraglandin E2 production by osteoblastic cells: synergy with parathyroid hormone. Calc Tiss Inter 42:358–362CrossRef
12.
go back to reference Bertolini DR, Nedwin GE, Bringman TS, Smith DD, Mundy GR (1986) Stimulation of bone resorption and inhibition of bone formation in vitro by human tumor necrosis factors. Nature 319:516–518PubMedCrossRef Bertolini DR, Nedwin GE, Bringman TS, Smith DD, Mundy GR (1986) Stimulation of bone resorption and inhibition of bone formation in vitro by human tumor necrosis factors. Nature 319:516–518PubMedCrossRef
13.
go back to reference Meikle MC, Atkinson SJ, Ward RV, Murphy J, Reynolds JJ (1989) Gingival fibroblasts degrade type 1 collagen films when stimulated with tumor necrosis factor and IL-1 evidence that breakdown is mediated by metalloproteinase. J Periodontal Res 24:207–213PubMedCrossRef Meikle MC, Atkinson SJ, Ward RV, Murphy J, Reynolds JJ (1989) Gingival fibroblasts degrade type 1 collagen films when stimulated with tumor necrosis factor and IL-1 evidence that breakdown is mediated by metalloproteinase. J Periodontal Res 24:207–213PubMedCrossRef
14.
go back to reference Graves DT, Cochran D (2003) The contribution of interleukin-1 and tumor necrosis factor to periodontal tissue destruction. J Periodontol 74:391–401PubMedCrossRef Graves DT, Cochran D (2003) The contribution of interleukin-1 and tumor necrosis factor to periodontal tissue destruction. J Periodontol 74:391–401PubMedCrossRef
15.
go back to reference Hock J, Krishnan V, Onyia J, Bidwell J, Milas J, Stanislaus D (2001) Osteoblast apoptosis and bone turnover. J Bone Min Res 16:975–984CrossRef Hock J, Krishnan V, Onyia J, Bidwell J, Milas J, Stanislaus D (2001) Osteoblast apoptosis and bone turnover. J Bone Min Res 16:975–984CrossRef
16.
go back to reference Cugini MA, Haffajee AD, Smith C, Kent RL Jr, Sokransky SS (2000) The effect of scaling and root planning on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27:30–36PubMedCrossRef Cugini MA, Haffajee AD, Smith C, Kent RL Jr, Sokransky SS (2000) The effect of scaling and root planning on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27:30–36PubMedCrossRef
17.
go back to reference Kreisler M, Meyer Ch, Daubländer M, Willershausen-Zönnchen B, d’Hoedt B (2001) Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: an in vitro study. J Periodontol 72:1312–1317PubMedCrossRef Kreisler M, Meyer Ch, Daubländer M, Willershausen-Zönnchen B, d’Hoedt B (2001) Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: an in vitro study. J Periodontol 72:1312–1317PubMedCrossRef
18.
go back to reference Kreisler M, Kohnen W, Marinello C, Schoof J, Langnau E, Jansen B, d’Hoedt B (2003) Antimicrobial efficacy of semiconductor laser irradiation on implant surfaces. Int J Oral Maxillofacial Implants 18:706–711 Kreisler M, Kohnen W, Marinello C, Schoof J, Langnau E, Jansen B, d’Hoedt B (2003) Antimicrobial efficacy of semiconductor laser irradiation on implant surfaces. Int J Oral Maxillofacial Implants 18:706–711
19.
go back to reference Liu CM, Hou LT, Wong MY, Lan WH (1999) Comparison of Nd:YAG laser versus scaling and root planning in periodontal therapy. J Periodontol 70:1276–1282PubMedCrossRef Liu CM, Hou LT, Wong MY, Lan WH (1999) Comparison of Nd:YAG laser versus scaling and root planning in periodontal therapy. J Periodontol 70:1276–1282PubMedCrossRef
20.
go back to reference Schwarz F, Sculean A, Berakdar M, Szathmari L, Georg T, Becker J (2003) 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 32:359–366PubMedCrossRef Schwarz F, Sculean A, Berakdar M, Szathmari L, Georg T, Becker J (2003) 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 32:359–366PubMedCrossRef
21.
go back to reference Schwarz F, Aoki A, Sculean A, Becker J (2009) The impact of laser application on periodontal and peri-implant wound healing. Periodontol 51:79–108CrossRef Schwarz F, Aoki A, Sculean A, Becker J (2009) The impact of laser application on periodontal and peri-implant wound healing. Periodontol 51:79–108CrossRef
22.
go back to reference Chapple ILC, Landini G, Griffiths GS, Patel NC, Ward RSN (1999) Calibration of the Periotron 8000® and 6000® by polynomial regression. J Periodontal Res 34:79–86PubMedCrossRef Chapple ILC, Landini G, Griffiths GS, Patel NC, Ward RSN (1999) Calibration of the Periotron 8000® and 6000® by polynomial regression. J Periodontal Res 34:79–86PubMedCrossRef
23.
go back to reference Ben Hatit Y, Blum R, Severin C, Maquin M, Jabro MH (1996) The effects of a pulsed Nd:YAG laser on subgingival bacterial flora on cementum: an in vivo study. J Clin Laser Med Surg 14:137–143PubMed Ben Hatit Y, Blum R, Severin C, Maquin M, Jabro MH (1996) The effects of a pulsed Nd:YAG laser on subgingival bacterial flora on cementum: an in vivo study. J Clin Laser Med Surg 14:137–143PubMed
24.
go back to reference Neill ME, Melloning JT (1997) Clinical efficacy of the Nd:YAG laser for combination periodontitis therapy. Pract Periodontics Aesthet Dent 9 (Suppl.6):1–5 Neill ME, Melloning JT (1997) Clinical efficacy of the Nd:YAG laser for combination periodontitis therapy. Pract Periodontics Aesthet Dent 9 (Suppl.6):1–5
25.
go back to reference Radvar M, MacFarlane TW, MacKenzie D, Whitters CJ, Payne AP, Kinane DF (1996) An evaluation of the Nd:YAG laser in periodontal pocket therapy. British Dent J 57:180–185 Radvar M, MacFarlane TW, MacKenzie D, Whitters CJ, Payne AP, Kinane DF (1996) An evaluation of the Nd:YAG laser in periodontal pocket therapy. British Dent J 57:180–185
26.
go back to reference Bader HI (2000) Use of laser in periodontic. Dent Clin North Am 44:779–91PubMed Bader HI (2000) Use of laser in periodontic. Dent Clin North Am 44:779–91PubMed
27.
go back to reference Gómez C, Bisheimer M, Costela A, García-Moreno I, García A, García JA (2009) Evaluation of the effects of Er:YAG and Nd:YAG lasers and ultrasonic instrumentation on root surfaces. Photomed Laser Surg 27:43–48PubMedCrossRef Gómez C, Bisheimer M, Costela A, García-Moreno I, García A, García JA (2009) Evaluation of the effects of Er:YAG and Nd:YAG lasers and ultrasonic instrumentation on root surfaces. Photomed Laser Surg 27:43–48PubMedCrossRef
28.
go back to reference Miyazaki A, Yamaguchi T, Nishikata J, Okuda K, Suda S, Orima K, Kobayashi T, Yamazaki K, Yoshikawa E, Yoshie H (2003) Effects of Nd:YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodontitis patients. J Periodontol 74:175–180PubMedCrossRef Miyazaki A, Yamaguchi T, Nishikata J, Okuda K, Suda S, Orima K, Kobayashi T, Yamazaki K, Yoshikawa E, Yoshie H (2003) Effects of Nd:YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodontitis patients. J Periodontol 74:175–180PubMedCrossRef
29.
go back to reference Faizuddin M, Bharathi SH, Rohini NV (2003) Estimation of interleukin-1 beta levels in the gingival crevicular fluid in health and in inflammatory periodontal disease. J Periodontal Res 38:111–114PubMedCrossRef Faizuddin M, Bharathi SH, Rohini NV (2003) Estimation of interleukin-1 beta levels in the gingival crevicular fluid in health and in inflammatory periodontal disease. J Periodontal Res 38:111–114PubMedCrossRef
30.
go back to reference Goutoudi P, Diza E, Arvantidou M (2004) Effect of periodontal therapy on crevicular fluid interleukin-1β and interleukin-10 levels in chronic periodontitis. J Dent 32:511–520PubMedCrossRef Goutoudi P, Diza E, Arvantidou M (2004) Effect of periodontal therapy on crevicular fluid interleukin-1β and interleukin-10 levels in chronic periodontitis. J Dent 32:511–520PubMedCrossRef
31.
go back to reference Orozco A, Gemmel E, Bickel M, Seymour GJ (2006) Interleukin 1β, interleukin-12 and interleukin-18 levels in gingival fluid and serum of patients with gingivitis and periodontitis. Oral Microbiol Immunol 21:256–260PubMedCrossRef Orozco A, Gemmel E, Bickel M, Seymour GJ (2006) Interleukin 1β, interleukin-12 and interleukin-18 levels in gingival fluid and serum of patients with gingivitis and periodontitis. Oral Microbiol Immunol 21:256–260PubMedCrossRef
32.
go back to reference Shimizu N, Yamaguchi M, Goseki T, Shibata Y, Takiguchi A, Iwasawa T, Abiko Y (1995) Inhibition of prostaglandin E2 and interleukin 1β production by low-power laser irradiation in stretched human periodontal ligament cells. J Dent Res 74:1382–1388PubMedCrossRef Shimizu N, Yamaguchi M, Goseki T, Shibata Y, Takiguchi A, Iwasawa T, Abiko Y (1995) Inhibition of prostaglandin E2 and interleukin 1β production by low-power laser irradiation in stretched human periodontal ligament cells. J Dent Res 74:1382–1388PubMedCrossRef
33.
go back to reference Funk JO, Kruse A, Kirchner H (1992) Cytokine production after helium-neon laser irradiation in cultures of human peripheral blood mononuclear cells. J Photochem Photobiol B: Biol 16:347–355CrossRef Funk JO, Kruse A, Kirchner H (1992) Cytokine production after helium-neon laser irradiation in cultures of human peripheral blood mononuclear cells. J Photochem Photobiol B: Biol 16:347–355CrossRef
34.
go back to reference Kana J, Hutschenreiter G, Haina D, Waidelich W (1981) Effect of low-power density irradiation on healing of open skin wounds in rats. Arch Surg 116:294–296 Kana J, Hutschenreiter G, Haina D, Waidelich W (1981) Effect of low-power density irradiation on healing of open skin wounds in rats. Arch Surg 116:294–296
35.
go back to reference Safavi SM, Kazemi B, Esmaeili M, Fallah A (2008) Effects of low-level He-Ne laser irradiation on the gene expression of IL-1β, TNF-α, IFN, TGF, bFGF, and PDGF in rat’s gingival. Lasers Med Sci 23:331–335PubMedCrossRef Safavi SM, Kazemi B, Esmaeili M, Fallah A (2008) Effects of low-level He-Ne laser irradiation on the gene expression of IL-1β, TNF-α, IFN, TGF, bFGF, and PDGF in rat’s gingival. Lasers Med Sci 23:331–335PubMedCrossRef
36.
go back to reference Domínguez A, Gómez C, García-Kass AI, García-Núñez JA (2010) IL-1β, TNF-α, total antioxidative status and microbiological findings in chronic periodontitis treated with fluorescence-controlled Er:YAG laser radiation. Lasers Surg Med 42:24–31PubMedCrossRef Domínguez A, Gómez C, García-Kass AI, García-Núñez JA (2010) IL-1β, TNF-α, total antioxidative status and microbiological findings in chronic periodontitis treated with fluorescence-controlled Er:YAG laser radiation. Lasers Surg Med 42:24–31PubMedCrossRef
37.
go back to reference Teng YT (2003) The role of oxygen radicals in human disease with particular acquired immunity and periodontal disease progression. Crit Rev Oral Dis 6:138–151 Teng YT (2003) The role of oxygen radicals in human disease with particular acquired immunity and periodontal disease progression. Crit Rev Oral Dis 6:138–151
38.
go back to reference Brock GR, Matthews J, Butterworth C, Chapple ILC (2002) Plasma and crevicular fluid antioxidant defense in periodontitis and health. J Dent Res 81 (Spec Iss A): Abstract 1524 Brock GR, Matthews J, Butterworth C, Chapple ILC (2002) Plasma and crevicular fluid antioxidant defense in periodontitis and health. J Dent Res 81 (Spec Iss A): Abstract 1524
39.
go back to reference Tsai CC, Chen HS, Chen SL, Ho YP, Ho KY, Wu YM, Hung CC (2005) Lipid peroxidation: a possible role in the induction and progression of chronic periodontitis. J Periodontal Res 40:378–384PubMedCrossRef Tsai CC, Chen HS, Chen SL, Ho YP, Ho KY, Wu YM, Hung CC (2005) Lipid peroxidation: a possible role in the induction and progression of chronic periodontitis. J Periodontal Res 40:378–384PubMedCrossRef
40.
go back to reference Gibson MT, Mangat D, Gagliano G, Wilson M, Fletcher J, Bulman J, Newman HN (1994) Evaluation of the efficacy of a redox agent in the treatment of chronic periodontitis. J Clin Periodontol 21:690–700PubMedCrossRef Gibson MT, Mangat D, Gagliano G, Wilson M, Fletcher J, Bulman J, Newman HN (1994) Evaluation of the efficacy of a redox agent in the treatment of chronic periodontitis. J Clin Periodontol 21:690–700PubMedCrossRef
41.
go back to reference Wilson M, Gibson M, Strahan D, Harvey W (1992) A preliminary evaluation of the use of a redox agent in the treatment of chronic periodontitis. J Periodontal Res 27:522–527PubMedCrossRef Wilson M, Gibson M, Strahan D, Harvey W (1992) A preliminary evaluation of the use of a redox agent in the treatment of chronic periodontitis. J Periodontal Res 27:522–527PubMedCrossRef
42.
go back to reference Ower PC, Ciantar M, Newman HN, Wilson M, Bulman JS (1995) The effects on chronic periodontitis of a subgingivally-placed redox agent in a slow release device. J Clin Periodontol 22:494–500PubMedCrossRef Ower PC, Ciantar M, Newman HN, Wilson M, Bulman JS (1995) The effects on chronic periodontitis of a subgingivally-placed redox agent in a slow release device. J Clin Periodontol 22:494–500PubMedCrossRef
43.
go back to reference Sbordone L, Ramaglia L, Gulleta E, Iacono V (1990) Recolonization of the subgingival microflora after scaling and root planning in human periodontitis. J Periodontol 61:579–584PubMed Sbordone L, Ramaglia L, Gulleta E, Iacono V (1990) Recolonization of the subgingival microflora after scaling and root planning in human periodontitis. J Periodontol 61:579–584PubMed
44.
go back to reference Socransky SS, Haffajee AD, Cugini MA, Smit C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144PubMedCrossRef Socransky SS, Haffajee AD, Cugini MA, Smit C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144PubMedCrossRef
45.
go back to reference Harper DS, Robinson PJ (1987) Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planning. J Clin Periodontol 14:190–196PubMedCrossRef Harper DS, Robinson PJ (1987) Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planning. J Clin Periodontol 14:190–196PubMedCrossRef
46.
go back to reference Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P, Sperr W (1997) Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study. J Clin Laser Med Surg 15:33–37PubMed Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P, Sperr W (1997) Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study. J Clin Laser Med Surg 15:33–37PubMed
Metadata
Title
Adjunctive Nd:YAG laser application in chronic periodontitis: clinical, immunological, and microbiological aspects
Authors
Clara Gómez
Arantza Domínguez
Ana Isabel García-Kass
Juan Antonio García-Nuñez
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Lasers in Medical Science / Issue 4/2011
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-010-0795-8

Other articles of this Issue 4/2011

Lasers in Medical Science 4/2011 Go to the issue