Short-term (3-Month) Clinical Outcomes of WaterLase (iPlus) Laser Therapy used as an Adjunct to Non-Surgical Treatment of Chronic Periodontitis: A Randomized, Controlled, Within-Mouth Clinical Study.

摘要

Chronic periodontitis is a multifactorial, inflammatory disease that, when left untreated, results in the destruction of tooth-supporting structures including adjacent bone. Laser therapy as an adjunct to non-surgical therapy for treatment of moderate-severe chronic periodontitis has been increasingly advocated yet controversial and experimental evidence has not yet convincingly supported the use of laser treatment. Objective: The aim of this randomized, controlled clinical study was to examine the clinical efficacy of laser therapy (Er,Cr:YSGG) as an adjunct to scaling and root planing (SRP) in comparison to conventional non-surgical periodontal therapy alone 3 months after therapy in patients with chronic periodontitis. Materials & Methods: Eighteen matched and paired quadrants were evaluated in five patients and randomly treated by SRP alone (control group) or by SRP + Laser (test group). Clinical measurements (PPD, CAL, REC, BOP, PI) were recorded before treatment at baseline and at 3 months following treatment. Subgingival plaque samples of one patient were taken at baseline and 3 months after treatment and were evaluated for changes using DGGE. Results: Non-surgical treatment and subsequent healing and follow-up was uneventful in all cases. Baseline values for PD, REC, CAL, BOP and PI were not significantly different between the test and control groups (p<0.05) and baseline quadrant means for PD, REC and CAL for the test and control treated quadrants presented with similar measures of 3.7 +/- 1.7 mm and 3.6 +/- 1.5 mm, 0.3 +/- 0.9 mm and 0.3 +/- 0.6 mm, 4.1 +/- 2.0 mm and 3.8 +/- 1.7 mm, respectively. Values for PD, REC, CAL, BOP and PI improved significantly 3 months after treatment in both test and control groups. Three month analysis of laser treated quadrants revealed a mean PD reduction of 0.8 +/- 1.3 mm, a mean REC increase of 0.3 +/- 0.7 mm, and a mean gain in CAL of 0.5 +/- 1.4 mm. Evaluation of control quadrants at 3 months revealed a mean PD reduction of 0.6 +/- 1.1 mm, a mean REC increase of 0.2 +/- 0.7 mm, and a mean gain in CAL of 0.3 +/- 1.4 mm. No significant differences were detected between the laser and control treated quadrants. No significant differences in PD, REC, CAL, BOP or PI outcomes could be detected between the test and control groups (p<0.05). Sites where treatment was not indicated (non-qualifying sites) showed statistically significant improvement in PD only. Conclusions: Within the limitations of the present study, adjunctive laser therapy (Er,Cr:YSGG, RePaiR protocol) does not show significant advantages to conventional non-surgical therapy alone.