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Published in: Lasers in Medical Science 1/2013

01-01-2013 | Original Article

A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus

Authors: Radmila Obradović, Ljiljana Kesić, Dragan Mihailović, Slobodan Antić, Goran Jovanović, Aleksandar Petrović, Snežana Peševska

Published in: Lasers in Medical Science | Issue 1/2013

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Abstract

Diabetes mellitus (DM) and chronic periodontitis are common chronic diseases in adults in the world population. DM has a strong influence on the oral cavity and represents a risk factor for gingivitis and periodontitis. Low-level laser therapy (LLLT) has proven effective in the reduction of inflammation and swelling. The aim of the present study was to evaluate the efficacy of LLLT in diabetic periodontitis through histological analysis. A total of 300 diabetics with chronic periodontal disease and teeth indicated for extraction were assigned into six equal groups. In the groups 1 and 4, indicated teeth were extracted before treatment, and in the rest of the groups upon completion of the entire treatment. All patients received oral hygiene instructions and full-mouth conservative periodontal treatment. In groups 3 and 6, LLLT was applied (670 nm, 5 mW, 2 J/cm2, 16 min, 5 days). Histologic findings of gingival tissue treated with LLLT showed expressed healing, as is evident by the absence of inflammatory cells. Tissue edema could not be seen, and the number of blood vessels was reduced. In the gingival lamina, propria pronounced collagenization and homogenization were present. It can be concluded that LLLT has shown efficacy in the treatment of periodontitis in diabetics. Because of more pronounced alterations of periodontium in diabetics, the use of LLLT is of particular importance.
Literature
1.
go back to reference Southerland JH, Taylor GW, Offenbacher S (2005) Diabetes and periodontal infection: making the connection. Clin Diabetes 23(4):171–178CrossRef Southerland JH, Taylor GW, Offenbacher S (2005) Diabetes and periodontal infection: making the connection. Clin Diabetes 23(4):171–178CrossRef
2.
go back to reference Taiyeb-Ali TB, Raman RPC (2000) Vaithilingam RD (2011) relationship between periodontal disease and diabetes mellitus: an Asian perspective. Periodontology 56:258–268CrossRef Taiyeb-Ali TB, Raman RPC (2000) Vaithilingam RD (2011) relationship between periodontal disease and diabetes mellitus: an Asian perspective. Periodontology 56:258–268CrossRef
3.
go back to reference Natto ZS, Al-Zahrani MS (2010) Periodontal bone loss and self-reported medical conditions in a dental school patient population. J Int Acad Periodontol 12(4):104–109PubMed Natto ZS, Al-Zahrani MS (2010) Periodontal bone loss and self-reported medical conditions in a dental school patient population. J Int Acad Periodontol 12(4):104–109PubMed
4.
go back to reference Lalla E, Park DB, Papapanou PN, Lamster IB (2008) Oral disease burden in Northern Manhattan patients with diabetes mellitus. Am J Public Health 98(Suppl 1):91–94CrossRef Lalla E, Park DB, Papapanou PN, Lamster IB (2008) Oral disease burden in Northern Manhattan patients with diabetes mellitus. Am J Public Health 98(Suppl 1):91–94CrossRef
5.
go back to reference Teeuw WJ, Gerdes VEA, Loos BG (2010) Effect of periodontal treatment on glycemic control of diabetic patients. A systematic review and meta-analysis. Diabetes Care 33(2):421–427PubMedCrossRef Teeuw WJ, Gerdes VEA, Loos BG (2010) Effect of periodontal treatment on glycemic control of diabetic patients. A systematic review and meta-analysis. Diabetes Care 33(2):421–427PubMedCrossRef
6.
go back to reference Nassar H, Kantarci A, van Dyke TE (2007) Diabetic periodontitis: a model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000 43(1):233–244 Nassar H, Kantarci A, van Dyke TE (2007) Diabetic periodontitis: a model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000 43(1):233–244
7.
go back to reference Nishimura F, Iwamoto Y, Soga Y (2007) The periodontal host response with diabetes. Periodontol 2000 43(1):245–253 Nishimura F, Iwamoto Y, Soga Y (2007) The periodontal host response with diabetes. Periodontol 2000 43(1):245–253
8.
go back to reference Graves DT, Liu R, Oates TW (2007) Diabetes-enhanced inflammation and apoptosis: impact on periodontal pathosis. Periodontol 2000 45(1):128–137 Graves DT, Liu R, Oates TW (2007) Diabetes-enhanced inflammation and apoptosis: impact on periodontal pathosis. Periodontol 2000 45(1):128–137
9.
go back to reference Liu R, Bal HS, Desta T, Krothapalli N, Alyassi M, Luan Q, Graves DT (2006) Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation. J Dent Res 85(6):510–514PubMedCrossRef Liu R, Bal HS, Desta T, Krothapalli N, Alyassi M, Luan Q, Graves DT (2006) Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation. J Dent Res 85(6):510–514PubMedCrossRef
10.
go back to reference Lappin DF, Eapen B, Robertson D, Young J, Hodge PJ (2009) Markers of bone destruction and formation and periodontitis in type 1 diabetes mellitus. J Clin Periodontol 36(8):634–641PubMedCrossRef Lappin DF, Eapen B, Robertson D, Young J, Hodge PJ (2009) Markers of bone destruction and formation and periodontitis in type 1 diabetes mellitus. J Clin Periodontol 36(8):634–641PubMedCrossRef
11.
go back to reference Iacopino AM (2001) Periodontitis and diabetes interrelationships: the role of inflammation. Ann Periodontol 6:125–137PubMedCrossRef Iacopino AM (2001) Periodontitis and diabetes interrelationships: the role of inflammation. Ann Periodontol 6:125–137PubMedCrossRef
12.
go back to reference Houreld NN, Abrahamse H (2008) Laser light influences cellular viability and proliferation in diabetic-wounded fibroblast cells in a dose- and wavelength-dependent manner. Lasers Med Sci 23:11–18PubMedCrossRef Houreld NN, Abrahamse H (2008) Laser light influences cellular viability and proliferation in diabetic-wounded fibroblast cells in a dose- and wavelength-dependent manner. Lasers Med Sci 23:11–18PubMedCrossRef
13.
go back to reference Posten W, Wrone DA, Jeffrey SD, Arndt KA, Sirunya S, Murad A (2005) Low-level laser therapy for wound healing: mechanism and efficacy. Dermatol Surg 31(3):334–340PubMedCrossRef Posten W, Wrone DA, Jeffrey SD, Arndt KA, Sirunya S, Murad A (2005) Low-level laser therapy for wound healing: mechanism and efficacy. Dermatol Surg 31(3):334–340PubMedCrossRef
14.
go back to reference Rabelo SB, Villaverde AB, Nicolau RA, Salgado MAC, Melo MDS, Pacheco MTT (2006) Comparison between wound healing in induced diabetic and nondiabetic rats after low-level laser therapy. Photomed Laser Surg 24(4):474–479PubMedCrossRef Rabelo SB, Villaverde AB, Nicolau RA, Salgado MAC, Melo MDS, Pacheco MTT (2006) Comparison between wound healing in induced diabetic and nondiabetic rats after low-level laser therapy. Photomed Laser Surg 24(4):474–479PubMedCrossRef
15.
go back to reference Hagiwara S, Iwasaka H, Okuda K, Noguchi T (2007) GaAlAs (830 nm) Low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med 39(10):797–802PubMedCrossRef Hagiwara S, Iwasaka H, Okuda K, Noguchi T (2007) GaAlAs (830 nm) Low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med 39(10):797–802PubMedCrossRef
16.
go back to reference Peševska S, Nakova M, Ivanovski K et al. (2010) Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment. Lasers Med Sci 25(5):647–650PubMedCrossRef Peševska S, Nakova M, Ivanovski K et al. (2010) Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment. Lasers Med Sci 25(5):647–650PubMedCrossRef
17.
go back to reference Reddy K (2004) Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg 22(2):141–150PubMedCrossRef Reddy K (2004) Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg 22(2):141–150PubMedCrossRef
18.
go back to reference Bayat M, Abdi S, Javadieh F, Mohsenifar Z, Rashid MR (2009) The effects of low-level laser therapy on bone in diabetic and nondiabetic rats. Photomed Laser Surg 27(5):703–708PubMedCrossRef Bayat M, Abdi S, Javadieh F, Mohsenifar Z, Rashid MR (2009) The effects of low-level laser therapy on bone in diabetic and nondiabetic rats. Photomed Laser Surg 27(5):703–708PubMedCrossRef
19.
go back to reference Obradović R, Lj K, Peševska S (2009) Influence of low-level laser therapy on biomaterial osseointegration: a mini-review. Lasers Med Sci 24(3):447–451PubMedCrossRef Obradović R, Lj K, Peševska S (2009) Influence of low-level laser therapy on biomaterial osseointegration: a mini-review. Lasers Med Sci 24(3):447–451PubMedCrossRef
20.
go back to reference Aykol G, Baser U, Maden I et al. (2011) The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol 82(3):481–488PubMedCrossRef Aykol G, Baser U, Maden I et al. (2011) The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol 82(3):481–488PubMedCrossRef
21.
go back to reference Lalla E (2007) Periodontal infections and diabetes mellitus: when will the puzzle be complete? J Clin Periodontol 34:913–916PubMedCrossRef Lalla E (2007) Periodontal infections and diabetes mellitus: when will the puzzle be complete? J Clin Periodontol 34:913–916PubMedCrossRef
22.
go back to reference Matthews J, Jokstad A, Clarkson J (2009) Weak evidence suggests scaling and root planing may help people with Diabetes improve glycemic control. J Am Dent Assoc 140(9):1144–1145PubMed Matthews J, Jokstad A, Clarkson J (2009) Weak evidence suggests scaling and root planing may help people with Diabetes improve glycemic control. J Am Dent Assoc 140(9):1144–1145PubMed
23.
go back to reference Nanci A, Bosshardt DD (2006) Structure of periodontal tissues in health and disease. Periodontol 2000 40(1):11–28CrossRef Nanci A, Bosshardt DD (2006) Structure of periodontal tissues in health and disease. Periodontol 2000 40(1):11–28CrossRef
24.
go back to reference Silva JAF, Lorencini M, Reis JRR, Carvalho HF, Cagnon VHA, Stach-Machado DR (2008) The influence of type I diabetes mellitus in periodontal disease induced changes of the gingival epithelium and connective tissue. Tissue Cell 40(4):283–292 Silva JAF, Lorencini M, Reis JRR, Carvalho HF, Cagnon VHA, Stach-Machado DR (2008) The influence of type I diabetes mellitus in periodontal disease induced changes of the gingival epithelium and connective tissue. Tissue Cell 40(4):283–292
25.
go back to reference Lee W, Aitken S, Sodek J, McCulloch CAG (2006) Evidence of a direct relationship between neutrophil collagenase activity and periodontal tissue destruction in vivo: role of active enzyme in human periodontitis. J Periodontal Res 30(1):23–33CrossRef Lee W, Aitken S, Sodek J, McCulloch CAG (2006) Evidence of a direct relationship between neutrophil collagenase activity and periodontal tissue destruction in vivo: role of active enzyme in human periodontitis. J Periodontal Res 30(1):23–33CrossRef
26.
go back to reference Mealey BL, Rethman MP (2003) Periodontal disease and diabetes mellitus. Bidirectional relationship. Dent Today 22(4):107–113PubMed Mealey BL, Rethman MP (2003) Periodontal disease and diabetes mellitus. Bidirectional relationship. Dent Today 22(4):107–113PubMed
27.
go back to reference Mealey BL, Oates TW (2006) Diabetes mellitus and periodontal diseases. J Periodontol 77(8):1289–1303PubMedCrossRef Mealey BL, Oates TW (2006) Diabetes mellitus and periodontal diseases. J Periodontol 77(8):1289–1303PubMedCrossRef
28.
go back to reference Pesevska S, Nakova M, Gjorgoski I, Angelov N, Ivanovski K, Nares S, Andreana S (2011) Effect of laser on TNF-alpha expression in inflamed human gingival tissue. Laser Med Sci. doi:10.1007/s10103-011-0898-x Pesevska S, Nakova M, Gjorgoski I, Angelov N, Ivanovski K, Nares S, Andreana S (2011) Effect of laser on TNF-alpha expression in inflamed human gingival tissue. Laser Med Sci. doi:10.​1007/​s10103-011-0898-x
29.
go back to reference Angelov N, Pesevska S, Nakova M, Gjorgoski I, Ivanovski K, Angelova D, Hoffmann O, Andreana S (2009) Periodontal treatment with a low-level diode laser: clinical findings. Gen Dent 57(5):510–513PubMed Angelov N, Pesevska S, Nakova M, Gjorgoski I, Ivanovski K, Angelova D, Hoffmann O, Andreana S (2009) Periodontal treatment with a low-level diode laser: clinical findings. Gen Dent 57(5):510–513PubMed
30.
31.
go back to reference Houreld N, Abrahamse H (2007) In vitro exposure of wounded diabetic fibroblast cells to a helium-neon laser at 5 and 16 J/cm2. Photomed Laser Surg 25(2):78–84PubMedCrossRef Houreld N, Abrahamse H (2007) In vitro exposure of wounded diabetic fibroblast cells to a helium-neon laser at 5 and 16 J/cm2. Photomed Laser Surg 25(2):78–84PubMedCrossRef
32.
go back to reference Garcia VG, Fernandes LA, de Almeida JM, Bosco AF, Nagata MJH, Martins TM, Okamoto TO, Theodoro LH (2009) Comparison between laser therapy and non-surgical therapy for periodontitis in rats treated with dexamethasone. Laser Med Sci 25(2):197–206CrossRef Garcia VG, Fernandes LA, de Almeida JM, Bosco AF, Nagata MJH, Martins TM, Okamoto TO, Theodoro LH (2009) Comparison between laser therapy and non-surgical therapy for periodontitis in rats treated with dexamethasone. Laser Med Sci 25(2):197–206CrossRef
33.
go back to reference Bingöl U, Altan L, Yurtkuran M (2005) Low-power laser treatment for shoulder pain. Photomed Laser Surg 23(5):459–464PubMedCrossRef Bingöl U, Altan L, Yurtkuran M (2005) Low-power laser treatment for shoulder pain. Photomed Laser Surg 23(5):459–464PubMedCrossRef
34.
go back to reference Logan KM, Clements BA (2001) Low-intensity laser therapy (830 nm) in the management of minor post-surgical wounds: a controlled clinical study. Laser Surg Med 28:27–32CrossRef Logan KM, Clements BA (2001) Low-intensity laser therapy (830 nm) in the management of minor post-surgical wounds: a controlled clinical study. Laser Surg Med 28:27–32CrossRef
35.
go back to reference Reddy GK, Stepno-Bihel LL, Ekwemena CS (2001) Laser photostimulation accelerate wound healing in diabetic rats. Wound Repair Regen 9(3):248–255PubMedCrossRef Reddy GK, Stepno-Bihel LL, Ekwemena CS (2001) Laser photostimulation accelerate wound healing in diabetic rats. Wound Repair Regen 9(3):248–255PubMedCrossRef
36.
go back to reference Byrnes KR, Barna L, Chenault VM, Waynant RW, Ilev IK, Longo L, Miracco C, Johnson B, Anders JJ (2004) Photobiomodulation improves cutaneous wound healing in an animal model of Type II Diabetes. Photomed Laser Surg 22(4):281–290PubMedCrossRef Byrnes KR, Barna L, Chenault VM, Waynant RW, Ilev IK, Longo L, Miracco C, Johnson B, Anders JJ (2004) Photobiomodulation improves cutaneous wound healing in an animal model of Type II Diabetes. Photomed Laser Surg 22(4):281–290PubMedCrossRef
37.
go back to reference Maiya GA, Kumar P, Rao L (2005) Effect of low intensity Helium-Neon (He-Ne) laser irradiation on diabetic wound healing dynamics. Photomed Laser Surg 23(2):187–190PubMedCrossRef Maiya GA, Kumar P, Rao L (2005) Effect of low intensity Helium-Neon (He-Ne) laser irradiation on diabetic wound healing dynamics. Photomed Laser Surg 23(2):187–190PubMedCrossRef
Metadata
Title
A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus
Authors
Radmila Obradović
Ljiljana Kesić
Dragan Mihailović
Slobodan Antić
Goran Jovanović
Aleksandar Petrović
Snežana Peševska
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Lasers in Medical Science / Issue 1/2013
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-012-1058-7

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