Use of Lasers in Periodic Non-surgical Therapy

Useof Lasers in Periodic Non-surgical Therapy


Useof Lasers in Periodic Non-surgical Therapy

Thejournal title is Lasersin Medical Sciencewith 23 as the volume, 4 as the issue number, which was, published inJuly 2011 on pages 453 to 463 running for 11 pages.

TheArticle title is Adjunctive Nd: YAG laser application in chronicperiodontitis: clinical, immunological, and microbiological aspects.

Theauthors of this article include Clara Gómez PhD, Juan AntonioGarcía-Nuñez PhD, Arantza Domínguez AM, and Ana Isabel García-KassAM. These groups of authors collaborated and delivered this articleto Springer-Verlag on December 16 2009. The article receivedacceptance on May 18 2010, went through an online publication on June10 2010 and officially published by Lasersin Medical Science Journalin July 2011.

BothClara Gómez PhD and Arantza Domínguez AM are affiliated with LaserChemistry Department, Rocasolano Institute of Chemical Physics,National Research Council, CSIC C / Serrano 119, 2806, Madrid, Spain(Gómez etal.,2011). Additionally, Juan Antonio García-Nuñez PhD and Ana IsabelGarcía-Kass AM have a connection with the Department of EstomatologyIII, Faculty of Dentistry, UCM, Madrid, Spain. All the authors arestaff members of their affiliated organizations therefore, theyreceive some form of payment. However, there is a form of bias sincethe sample patients were recruited from the Department ofEstomatology III, UCM, Spain, meaning the organization aimed toprovide treatment to people related to it. Despite this, the staffsused to assign these patients were not in any way involved in theirtreatment and the research received approval from the Madrid locatedHospital Clinico San Carlos’s ethics committee.

Themain purpose behind this article was to determine whether the use ofSRP (scaling and root planning) alongside NDL (Nd: YAG laserradiation) can aid in the effective treatment of chronicperiodontitis compared to the traditional utilization of the SRPprocess. The authors carried out an experiment and compared theresults of both procedures to ensure that they come up with aconclusive stand regarding the matter.

Theauthors used a primary research design method where they randomlyselected thirty patients composed of fifteen men and fifteen women totake part in the experiment for two months. They then divided thisgroup into two where they received either SRP treatment or SRP andNDL treatment. At the initial stage, every patient went throughprimary periodontal treatments that included root planning, oralhygiene procedures, and scaling. The BOP (bleeding on probing), PPD(probing pocket depth), and the PI (plague index) baselinemeasurements were registered prior to the SRP procedure. Similarly,they presented microbiological samples to quantify GCF (gingivalcrevicular fluid) and periodontopathogens. Gómez etal.(2011) claim these samples then determined the Tumor Necrosis Factoralpha and Interleukin 1 beta in GCF, as well as the GCF’s TAS(total anti-oxidative status). At exactly four and eight weeks afterthe patient’s clinical examinations, treatments, and collection oftheir microbiological samples, they proceeded to take their GCFsamples similarly to those taken during both the SRP and SRPalongside NDL baseline.

Inthe results, there was a statistical difference between the mean BOP,PPD, and PI values in the two groups when comparing to informationregistered at the baseline to the post-operative information at fourand eight weeks. The majority of the reduction occurred after afour-week period (Gómez etal.,2011). The BOP mean in SRP and SRP plus NDL patients decreased from53.74 to 18.27 and 65.83 to 31.80 respectively. The PPD of the SRPand SRP plus NDL groups reduced from 4.47 to 3.58 and 5.07 to 4.25respectively, while the PI registered a drop in the SRP and SRP plusNDL volunteers from 2.11 to 0.49 and 1.66 to 0.44 correspondingly.Howbeit, no observed statistical important variations occurredbetween the given treatments researched in all of the assessedclinical parameters. When comparing the PPD values found on the deep,average, and shallow pocket sites after the two treatments, SRPregistered higher reduced PPD values on the average and shallowpockets compared to SRP plus NDL. Nevertheless, SRP and NDL recordeda higher reduction of PPD values in deep pocket sites as opposed toSRP alone.

Additionally,Interleukin 1 beta’s level experienced a substantial reduction inSRP and NDL patients four weeks after therapy but increased at eightweeks closer to the baseline figures. After the SRP treatment, thecytokine level significantly increased up to eight weeks after theprocedure. Gómez etal.(2011) registered vital distinctions associated with both therapymethodologies between the baseline values and four weeks intotreatment. Further, the Tumor Necrosis Factor alpha GCF levels afterthe SRP procedure rose substantially in the course of the studyhowbeit, the cytokine levels devaluated notably at four weeks post-SRP and NDL treatment. GCF’s total anti-oxidative capacityfollowing the SRP and NDL procedure elevated the TAS gradually,making it notable at eight weeks. On the other hand, the GCF’stotal anti-oxidative status after SRP treatment registers stability(Gómez etal.,2011). The microbiological results show a reduction of thesubgingival plague’s microbial flora although not a completeeradication in both treatment plans. The four-week period showed themost notable bacterial distribution modifications. The pathogenicspecies amounts found in every location researched altered from fourprior to treatment, one after four weeks, and two to three specieswithin eight weeks. Therefore, bacteria lost within four weeks couldnot be maintained.

Theauthors concluded that the antimicrobial laser treatment effects didnot extremely differ from the independent SPR treatment. Thecomplementary NDL treatment generally lessened periodontalinflammation owing to the diminished levels of Tumor Necrosis Factoralpha and Interleukin 1 beta in GCF. Moreover, GCF’s totalanti-oxidative status increased with no further clinical indiceseffects or subgingival plague’s microbial reduction comparative tothe independent SRP process. Due to the above observations, thecollaboration of SRP and Nd:YAG is vital in chronic periodontitistreatment.

Inmy view, the evidence presented in this article, it is apparent thatthe use of both the SRP and Nd:YAG in treating chronic periodontitisis effective. My conclusion is based the fact that the authors beyondtheir primary research, used secondary resources to substantiatetheir results. However, this paper is biased in the sense that theirprimary research involved only a sample of thirty individuals fromaround the same area. The sample does not represent the world’spopulation in establishing a very conclusive outcome regarding thetreatment of chronic periodontitis. When reading through the article,I did not notice anything of importance missing. The paper wasextensive and provides readers with all the necessary informationneeded.


Gómez,C., Domínguez, A., García-Kass, A., &amp García-Nuñez, J.(2011). Adjunctive Nd:YAG laser application in chronic periodontitis:clinical, immunological, and microbiological aspects. LasersIn Medical Science,26(4),453-463