Clinical Efficacy of the 940-nm Diode Laser in the Treatment of Recurrent Pockets in the Periodontal Maintenance Phase

Introduction: The basis of periodontal treatments is the mechanical removal of bacterial biofilm, which is often not sufficient. Therefore, laser therapy can be effective as an adjunct treatment. The aim of the present study was to evaluate the clinical efficacy of the 940-nm diode laser in the treatment of recurrent pockets of patients in the periodontal maintenance phase. Methods: The present clinical trial study was performed on 20 patients. Clinical indices, including bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) of the studied teeth were recorded before the test. The different quadrants were randomly divided into two experimental (scaling and root planing (SRP)+Laser) and control groups (SRP alone). Both groups were matched in terms of plaque index (PI). Clinical indices were re-recorded using therapeutic methods 30 and 90 days after the treatment, and data analysis was carried out using the t test and LSD. Results: There were no significant differences in PI, PPD, CAL, and BI in both groups before the treatment (P>0.05). However, there were significant differences in PPD, CAL, and BI in the two groups one month after the treatment (P0.05); however, there were significant improvements in the BI index in both groups (P<0.05), so that the improvement was better in the experimental group than the control group. Conclusion: Both SRP+Laser and SRP alone improved clinical indices in patients. In short-term follow-up, the effect of SRP+Laser treatment on BI, CAL, PPD was significantly superior to SRP treatment alone, but in long-term follow-up, SRP+laser was more effective than SRP alone in improving the BI index

Clinical Efficacy of the 940-nm Diode Laser in the Treatment of Recurrent Pockets in the Periodontal Maintenance Phase: 940-nm Diode Laser Effect on Recurrent Periodontal Pockets

Introduction: The basis of periodontal treatments is the mechanical removal of bacterial biofilm, which is often not sufficient. Therefore, laser therapy can be effective as an adjunct treatment. The aim of the present study was to evaluate the clinical efficacy of the 940-nm diode laser in the treatment of recurrent pockets of patients in the periodontal maintenance phase.Methods: The present clinical trial study was performed on 20 patients. Clinical indices, including bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) of the studied teeth were recorded before the test. The different quadrants were randomly divided into two experimental (scaling and root planing (SRP)+Laser) and control groups (SRP alone). Both groups were matched in terms of plaque index (PI). Clinical indices were re-recorded using therapeutic methods 30 and 90 days after the treatment and data analysis was carried out using the t-test and LSD.Results: There were no significant differences in PI, PPD, CAL, and BI in both groups before the treatment (P&gt;0.05). However, there were significant differences in PPD, CAL, and BI in the two groups one month after the treatment (P&lt;0.05); it means that improvements were more significant in the experimental group than in the control group. Comparing experimental and control groups, we found that there were no significant differences in PPD and CAL indices three months after the treatment (P&gt;0.05); however, there were significant improvements in the BI index in both groups (P&lt;0.05), so that the improvement was better in the experimental group than the control group.Conclusion: Both SRP+Laser and SRP alone improved clinical indices in patients. In short-term follow-up, the effect of SRP+Laser treatment on BI, CAL, PPD was significantly superior to SRP treatment alone, but in long-term follow-up, SRP+laser was more effective than SRP alone in improving the BI index. DOI:10.34172/jlms.2021.6

Effect of Non-Surgical Therapy on Receptor Activator Level of Salivary Nuclear Factor Kappa B Ligand and Osteoprotegerin in Chronic Periodontitis: A Prospective Cohort Study

Introduction: The receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) are molecules that play a significant role in bone resorption. The aim of this study was to evaluate the effect of periodontal therapy on the salivary levels of RANKL, OPG, and their relative ratio in patients with chronic periodontitis. Materials and Methods: This prospective cohort study was conducted and twenty-five patients with chronic periodontitis and 25 volunteers with healthy periodontium were recruited in this study. All the patients received scaling and root planing (SRP) combined with oral hygiene instructions (OHI).&nbsp; Five mL unstimulated saliva sample was collected from all individuals at baseline and four weeks after periodontal therapy. Salivary RANKL and OPG concentrations were determined by enzyme -linked immunosorbent assays (ELISA). Demographic and clinical vari¬ables were compared between the groups using Fisher’s exact test. Comparisons of indices and analyses between the test and control groups were performed by independent t-test and Mann-Whitney U test. The correlations between the salivary and periodontal parameters were evaluated by Spearman correlation coefficient test. Results: SRP improved all examined clinical parameters, and the RANKL concentration and sRANKL/OPG ratio decreased significantly in the saliva after the treatment (p=0.012 and p=0.011). However, no significant change was found for OPG (p=0.840). Conclusion: Our observations indicated that non-surgical periodontal treatment significantly reduced the RANKL and sRANKL/OPG levels. Salivary levels of RANKL and sRANKL/OPG reflected the disease response to therapy, which is suitable for monitoring the results of periodontal treatment

Visfatin expression in gingival tissues of chronic periodontitis and aggressive periodontitis patients: An immunohistochemical analysis

Background: Visfatin, also known as nicotinamide phosphoribosyltransferase, has been suggested as a pro-inflammatory and immunomodulating marker for periodontitis. The aim of this study was an immunohistochemical analysis of visfatin in gingival tissues of patients with chronic periodontitis and aggressive periodontitis. Materials and Methods: In this cross-sectional study based on clinical evaluation and inclusion and exclusion criteria. Twenty patients with generalized chronic periodontitis, 13 patients with generalized aggressive periodontitis, and 20 periodontally healthy individuals enrolled. Gingival tissue samples were obtained during periodontal flap surgery and crown lengthening surgery in periodontal patients and healthy group, respectively. Tissue samples were transferred to a pathology laboratory to determine the degree of inflammatory infiltration by hematoxylin and eosin staining and the level of visfatin expression by immunohistochemistry. The data were analyzed using SPSS version 20 statistical software and paired t-test, Mann–Whitney test, and Spearman rank correlation coefficient. P < 0.05 was considered statistically significant. Results: Inflammation grading and visfatin expression were significantly higher in periodontally diseased gingiva compared to the control group (P 0.05). Conclusion: Visfatin expression was increased in gingival tissues of chronic periodontitis and aggressive periodontitis patients. Hence, visfatin may have a role in the etiopathogenesis of chronic periodontitis and aggressive periodontitis

Treatment of a Developmental Groove and Supernumerary Root Using Guided Tissue Regeneration Technique

Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR) was carried out using decalcified freeze dried bone allograft (DFDBA) and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove