Skip to main content
Erschienen in: Lasers in Medical Science 8/2022

22.07.2022 | Original Article

Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure—a randomised controlled split-mouth clinical trial

verfasst von: Thaneshwar Patila, Sunaina Shetty Y, Gopinath Vivekanandan, Raghavendra M. Shetty, Betul Rahman, Saaid Al Shehadat, Shishir Ram Shetty

Erschienen in: Lasers in Medical Science | Ausgabe 8/2022

Einloggen, um Zugang zu erhalten

Abstract

Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study’s limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.
Literatur
1.
Zurück zum Zitat Nunn ME (2000) Understanding the etiology of periodontitis: an overview of periodontal risk factors. Periodontol 2003(32):11–23 Nunn ME (2000) Understanding the etiology of periodontitis: an overview of periodontal risk factors. Periodontol 2003(32):11–23
2.
Zurück zum Zitat Slots J (2017) Periodontitis: facts, fallacies and the future. Periodontol 2000 75(1):7–23CrossRef Slots J (2017) Periodontitis: facts, fallacies and the future. Periodontol 2000 75(1):7–23CrossRef
3.
Zurück zum Zitat Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS et al (2018) A new classification scheme for periodontal and peri-implant diseases and conditions - introduction and key changes from the 1999 classification. J Clin Periodontol 45(Suppl 20):S1–S8PubMed Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS et al (2018) A new classification scheme for periodontal and peri-implant diseases and conditions - introduction and key changes from the 1999 classification. J Clin Periodontol 45(Suppl 20):S1–S8PubMed
4.
Zurück zum Zitat Pagliaro U, Nieri M, Rotundo R, Cairo F, Carnevale G, Esposito M et al (2008) Clinical guidelines of the Italian Society of Periodontology for the reconstructive surgical treatment of angular bony defects in periodontal patients. J Periodontol 79(12):2219–2232CrossRef Pagliaro U, Nieri M, Rotundo R, Cairo F, Carnevale G, Esposito M et al (2008) Clinical guidelines of the Italian Society of Periodontology for the reconstructive surgical treatment of angular bony defects in periodontal patients. J Periodontol 79(12):2219–2232CrossRef
5.
Zurück zum Zitat Heitz-Mayfield LJ, Lang NP (2013) Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts. Periodontol 2000 62(1):218–31CrossRef Heitz-Mayfield LJ, Lang NP (2013) Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts. Periodontol 2000 62(1):218–31CrossRef
6.
Zurück zum Zitat Lasserre JF, Brecx MC, Toma S (2018) Oral microbes, biofilms and their role in periodontal and peri-implant diseases. Materials (Basel) 11(10):1802CrossRef Lasserre JF, Brecx MC, Toma S (2018) Oral microbes, biofilms and their role in periodontal and peri-implant diseases. Materials (Basel) 11(10):1802CrossRef
7.
Zurück zum Zitat Graziani F, Karapetsa D, Mardas N, Leow N, Donos N (2018) Surgical treatment of the residual periodontal pocket. Periodontol 2000 76(1):150–63CrossRef Graziani F, Karapetsa D, Mardas N, Leow N, Donos N (2018) Surgical treatment of the residual periodontal pocket. Periodontol 2000 76(1):150–63CrossRef
8.
Zurück zum Zitat Lobo TM, Pol DG (2015) Evaluation of the use of a 940 nm diode laser as an adjunct in flap surgery for treatment of chronic periodontitis. J Indian Soc Periodontol 19(1):43–48CrossRef Lobo TM, Pol DG (2015) Evaluation of the use of a 940 nm diode laser as an adjunct in flap surgery for treatment of chronic periodontitis. J Indian Soc Periodontol 19(1):43–48CrossRef
9.
10.
Zurück zum Zitat Choung HW, Lee SH, Ham AR, Lee NR, Kim B, Pang KM et al (2019) Effectiveness of low-level laser therapy with a 915 nm wavelength diode laser on the healing of intraoral mucosal wound: an animal study and a double-blind randomized clinical trial. Medicina (Kaunas) 55(8):405CrossRef Choung HW, Lee SH, Ham AR, Lee NR, Kim B, Pang KM et al (2019) Effectiveness of low-level laser therapy with a 915 nm wavelength diode laser on the healing of intraoral mucosal wound: an animal study and a double-blind randomized clinical trial. Medicina (Kaunas) 55(8):405CrossRef
11.
Zurück zum Zitat Heidari M, Fekrazad R, Sobouti F, Moharrami M, Azizi S, Nokhbatolfoghahaei H et al (2018) Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery. Lasers Med Sci 33(8):1639–1645CrossRef Heidari M, Fekrazad R, Sobouti F, Moharrami M, Azizi S, Nokhbatolfoghahaei H et al (2018) Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery. Lasers Med Sci 33(8):1639–1645CrossRef
12.
Zurück zum Zitat Jonnalagadda BD, Gottumukkala S, Dwarakanath CD, Koneru S (2018) Effect of diode laser-assisted flap surgery on postoperative healing and clinical parameters: a randomized controlled clinical trial. Contemp Clin Dent 9(2):205–212CrossRef Jonnalagadda BD, Gottumukkala S, Dwarakanath CD, Koneru S (2018) Effect of diode laser-assisted flap surgery on postoperative healing and clinical parameters: a randomized controlled clinical trial. Contemp Clin Dent 9(2):205–212CrossRef
13.
Zurück zum Zitat Khan F, Chopra R, Sharma N, Agrawal E, Achom M, Sharma P (2021) Comparative evaluation of the efficacy of diode laser as an adjunct to modified Widman flap surgery for the treatment of chronic periodontitis: a randomized split-mouth clinical trial. J Indian Soc Periodontol 25(3):213–219CrossRef Khan F, Chopra R, Sharma N, Agrawal E, Achom M, Sharma P (2021) Comparative evaluation of the efficacy of diode laser as an adjunct to modified Widman flap surgery for the treatment of chronic periodontitis: a randomized split-mouth clinical trial. J Indian Soc Periodontol 25(3):213–219CrossRef
14.
Zurück zum Zitat Derikvand N, Chinipardaz Z, Ghasemi S, Chiniforush N (2016) The versatility of 980 nm diode laser in dentistry: a case series. J Lasers Med Sci 7(3):205–208CrossRef Derikvand N, Chinipardaz Z, Ghasemi S, Chiniforush N (2016) The versatility of 980 nm diode laser in dentistry: a case series. J Lasers Med Sci 7(3):205–208CrossRef
15.
Zurück zum Zitat Romanos GE, Henze M, Banihashemi S, Parsanejad HR, Winckler J, Nentwig GH (2004) Removal of epithelium in periodontal pockets following diode (980 nm) laser application in the animal model: an in vitro study. Photomed Laser Surg 22(3):177–183CrossRef Romanos GE, Henze M, Banihashemi S, Parsanejad HR, Winckler J, Nentwig GH (2004) Removal of epithelium in periodontal pockets following diode (980 nm) laser application in the animal model: an in vitro study. Photomed Laser Surg 22(3):177–183CrossRef
16.
Zurück zum Zitat Silveira PC, Streck EL, Pinho RA (2007) Evaluation of mitochondrial respiratory chain activity in wound healing by low-level laser therapy. J Photochem Photobiol B 86(3):279–282CrossRef Silveira PC, Streck EL, Pinho RA (2007) Evaluation of mitochondrial respiratory chain activity in wound healing by low-level laser therapy. J Photochem Photobiol B 86(3):279–282CrossRef
17.
Zurück zum Zitat Cobb CM (2017) Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 75(1):205–95CrossRef Cobb CM (2017) Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 75(1):205–95CrossRef
18.
Zurück zum Zitat Karlsson MR, Diogo Lofgren CI, Jansson HM (2008) The effect of laser therapy as an adjunct to non-surgical periodontal treatment in subjects with chronic periodontitis: a systematic review. J Periodontol 79(11):2021–2028CrossRef Karlsson MR, Diogo Lofgren CI, Jansson HM (2008) The effect of laser therapy as an adjunct to non-surgical periodontal treatment in subjects with chronic periodontitis: a systematic review. J Periodontol 79(11):2021–2028CrossRef
19.
Zurück zum Zitat Sultan N, Jafri Z, Sawai M, Bhardwaj A (2020) Minimally invasive periodontal therapy. J Oral Biol Craniofac Res 10(2):161–165CrossRef Sultan N, Jafri Z, Sawai M, Bhardwaj A (2020) Minimally invasive periodontal therapy. J Oral Biol Craniofac Res 10(2):161–165CrossRef
20.
Zurück zum Zitat Kaur DS, Siddharth DM, Gupta DR, Gupta DS (2021) The effect of low-level diode (GaAlAs) laser therapy as an adjunct to non surgical periodontal treatment in subjects with chronic periodontitis – a clinical study. J Eur J Mol Clin Med 8(2):959–973 Kaur DS, Siddharth DM, Gupta DR, Gupta DS (2021) The effect of low-level diode (GaAlAs) laser therapy as an adjunct to non surgical periodontal treatment in subjects with chronic periodontitis – a clinical study. J Eur J Mol Clin Med 8(2):959–973
21.
Zurück zum Zitat Sanz-Moliner JD, Nart J, Cohen RE, Ciancio SG (2013) The effect of an 810-nm diode laser on postoperative pain and tissue response after modified Widman flap surgery: a pilot study in humans. J Periodontol 84(2):152–158CrossRef Sanz-Moliner JD, Nart J, Cohen RE, Ciancio SG (2013) The effect of an 810-nm diode laser on postoperative pain and tissue response after modified Widman flap surgery: a pilot study in humans. J Periodontol 84(2):152–158CrossRef
22.
Zurück zum Zitat Lesaffre E, Philstrom B, Needleman I, Worthington H (2009) The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med 28(28):3470–3482CrossRef Lesaffre E, Philstrom B, Needleman I, Worthington H (2009) The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med 28(28):3470–3482CrossRef
23.
Zurück zum Zitat Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H (2018) Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol 89:S173–S182CrossRef Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H (2018) Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol 89:S173–S182CrossRef
24.
Zurück zum Zitat Silness J, Loe H (1964) Periodontal disease in pregnancy. II. Correlation between Oral Hyg Periodontal Cond 22:121–35 Silness J, Loe H (1964) Periodontal disease in pregnancy. II. Correlation between Oral Hyg Periodontal Cond 22:121–35
25.
Zurück zum Zitat Loe H, Silness J (1963) Periodontal disease in pregnancy. I Prevalence Severity 21:533–551 Loe H, Silness J (1963) Periodontal disease in pregnancy. I Prevalence Severity 21:533–551
26.
Zurück zum Zitat Mombelli A, van Oosten MA, Schurch E Jr, Land NP (1987) The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 2(4):145–151CrossRef Mombelli A, van Oosten MA, Schurch E Jr, Land NP (1987) The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 2(4):145–151CrossRef
27.
Zurück zum Zitat Mikami R, Mizutani K, Sasaki Y, Iwata T, Aoki A (2020) Patient-reported outcomes of laser-assisted pain control following non-surgical and surgical periodontal therapy: a systematic review and meta-analysis. PLoS ONE 15(9):e0238659CrossRef Mikami R, Mizutani K, Sasaki Y, Iwata T, Aoki A (2020) Patient-reported outcomes of laser-assisted pain control following non-surgical and surgical periodontal therapy: a systematic review and meta-analysis. PLoS ONE 15(9):e0238659CrossRef
28.
Zurück zum Zitat Nammour S, El Mobadder M, Maalouf E, Namour M, Namour A, Rey G et al (2021) Clinical evaluation of diode (980 nm) laser-assisted nonsurgical periodontal pocket therapy: a randomized comparative clinical trial and bacteriological study. Photobiomodul Photomed Laser Surg 39(1):10–22CrossRef Nammour S, El Mobadder M, Maalouf E, Namour M, Namour A, Rey G et al (2021) Clinical evaluation of diode (980 nm) laser-assisted nonsurgical periodontal pocket therapy: a randomized comparative clinical trial and bacteriological study. Photobiomodul Photomed Laser Surg 39(1):10–22CrossRef
29.
Zurück zum Zitat Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P et al (1997) Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study. J Clin Laser Med Surg 15(1):33–37CrossRef Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P et al (1997) Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study. J Clin Laser Med Surg 15(1):33–37CrossRef
30.
Zurück zum Zitat Aena PJ, Parul A, Siddharth P, Pravesh G, Vikas D, Vandita A (2015) The clinical efficacy of laser assisted modified Widman flap: a randomized split mouth clinical trial. Indian J Dent Res 26(4):384–389CrossRef Aena PJ, Parul A, Siddharth P, Pravesh G, Vikas D, Vandita A (2015) The clinical efficacy of laser assisted modified Widman flap: a randomized split mouth clinical trial. Indian J Dent Res 26(4):384–389CrossRef
31.
Zurück zum Zitat Karthikeyan J, Vijayalakshmi R, Mahendra J, Kanakamedala AK, Chellathurai BNK, Selvarajan S et al (2019) Diode laser as an adjunct to Kirkland flap surgery-a randomized split-mouth clinical and microbiological study. Photobiomodul Photomed Laser Surg 37(2):99–109CrossRef Karthikeyan J, Vijayalakshmi R, Mahendra J, Kanakamedala AK, Chellathurai BNK, Selvarajan S et al (2019) Diode laser as an adjunct to Kirkland flap surgery-a randomized split-mouth clinical and microbiological study. Photobiomodul Photomed Laser Surg 37(2):99–109CrossRef
32.
Zurück zum Zitat Agarwal A, Saxena A, Gummaluri SS, Chaudhary B, Subramanyam SSK, Kumar G (2021) Clinical and microbiological evaluation of 940-nm diode laser as an adjunct to modified Widman flap for the management of chronic periodontitis: a 6-month randomized split-mouth clinical trial. J Dent Res Dent Clin Dent Prospects 15(2):133–139CrossRef Agarwal A, Saxena A, Gummaluri SS, Chaudhary B, Subramanyam SSK, Kumar G (2021) Clinical and microbiological evaluation of 940-nm diode laser as an adjunct to modified Widman flap for the management of chronic periodontitis: a 6-month randomized split-mouth clinical trial. J Dent Res Dent Clin Dent Prospects 15(2):133–139CrossRef
33.
Zurück zum Zitat Castro GL, Gallas M, Nunez IR, Borrajo JL, Varela LG (2006) Histological evaluation of the use of diode laser as an adjunct to traditional periodontal treatment. Photomed Laser Surg 24(1):64–68CrossRef Castro GL, Gallas M, Nunez IR, Borrajo JL, Varela LG (2006) Histological evaluation of the use of diode laser as an adjunct to traditional periodontal treatment. Photomed Laser Surg 24(1):64–68CrossRef
34.
Zurück zum Zitat Romanos G (2015) Current concepts in the use of lasers in periodontal and implant dentistry. J Indian Soc Periodontol 19(5):490–494CrossRef Romanos G (2015) Current concepts in the use of lasers in periodontal and implant dentistry. J Indian Soc Periodontol 19(5):490–494CrossRef
35.
Zurück zum Zitat Gokhale SR, Padhye AM, Byakod G, Jain SA, Padbidri V, Shivaswamy S (2012) A comparative evaluation of the efficacy of diode laser as an adjunct to mechanical debridement versus conventional mechanical debridement in periodontal flap surgery: a clinical and microbiological study. Photomed Laser Surg 30(10):598–603CrossRef Gokhale SR, Padhye AM, Byakod G, Jain SA, Padbidri V, Shivaswamy S (2012) A comparative evaluation of the efficacy of diode laser as an adjunct to mechanical debridement versus conventional mechanical debridement in periodontal flap surgery: a clinical and microbiological study. Photomed Laser Surg 30(10):598–603CrossRef
36.
Zurück zum Zitat AboElsaad NS, Soory M, Gadalla LM, Ragab LI, Dunne S, Zalata KR et al (2009) Effect of soft laser and bioactive glass on bone regeneration in the treatment of bone defects (an experimental study). Lasers Med Sci 24(4):527–533CrossRef AboElsaad NS, Soory M, Gadalla LM, Ragab LI, Dunne S, Zalata KR et al (2009) Effect of soft laser and bioactive glass on bone regeneration in the treatment of bone defects (an experimental study). Lasers Med Sci 24(4):527–533CrossRef
37.
Zurück zum Zitat Huang YY, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy - an update. Dose Response 9(4):602–618CrossRef Huang YY, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy - an update. Dose Response 9(4):602–618CrossRef
38.
Zurück zum Zitat Raut CP, Sethi KS, Kohale B, Mamajiwala A, Warang A (2018) Evaluation of diode laser and stannous fluoride in the treatment of root sensitivity after access flap surgery: randomized controlled clinical trial. J Indian Soc Periodontol 22(2):158–163CrossRef Raut CP, Sethi KS, Kohale B, Mamajiwala A, Warang A (2018) Evaluation of diode laser and stannous fluoride in the treatment of root sensitivity after access flap surgery: randomized controlled clinical trial. J Indian Soc Periodontol 22(2):158–163CrossRef
39.
Zurück zum Zitat Bhardwaj A, Jafri Z, Sultan N, Sawai M, Daing A (2018) Periodontal flap surgery along with vestibular deepening with diode laser to increase attached gingiva in lower anterior teeth: a prospective clinical study. J Nat Sci Biol Med 9(1):72–76CrossRef Bhardwaj A, Jafri Z, Sultan N, Sawai M, Daing A (2018) Periodontal flap surgery along with vestibular deepening with diode laser to increase attached gingiva in lower anterior teeth: a prospective clinical study. J Nat Sci Biol Med 9(1):72–76CrossRef
40.
Zurück zum Zitat Laky M, Laky B, Arslan M, Lettner S, Muller M, Haririan H et al (2021) Effectiveness of a 655-nm InGaAsP diode laser to detect subgingival calculus in patients with periodontal disease. J Periodontol 92(4):547–552CrossRef Laky M, Laky B, Arslan M, Lettner S, Muller M, Haririan H et al (2021) Effectiveness of a 655-nm InGaAsP diode laser to detect subgingival calculus in patients with periodontal disease. J Periodontol 92(4):547–552CrossRef
Metadaten
Titel
Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure—a randomised controlled split-mouth clinical trial
verfasst von
Thaneshwar Patila
Sunaina Shetty Y
Gopinath Vivekanandan
Raghavendra M. Shetty
Betul Rahman
Saaid Al Shehadat
Shishir Ram Shetty
Publikationsdatum
22.07.2022
Verlag
Springer London
Erschienen in
Lasers in Medical Science / Ausgabe 8/2022
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-022-03605-0

Weitere Artikel der Ausgabe 8/2022

Lasers in Medical Science 8/2022 Zur Ausgabe