Abstract：
Background: Stage 3 grade C periodontitis (S3GCP) has always been a challenge for clinicians. However, it is proposed that the use of lasers in addition to periodontal therapy can result in a more efficient therapy outcome. Objective: The aim of this clinical study was to determine the effects of additional application of diode laser (DL, 810 nm ±5) on clinical and microbiological values during Modified Widman Flap (MWF) periodontal surgery in the S3GCP patients. Methods: A total of 18 patients were randomly assigned to the test site (MWF + activeDL) and the control site (MFW alone). Clinical parameters and microbial samples were taken preoperatively, and postoperatively at 6 weeks, 3 months, and 6 months. Visual analog scale (VAS), tissue edema (TE), tissue color (TC), and pain medication (PM) consumption, were evaluated postoperatively at 10th day. Results: All bacteria were significantly decreased at follow-up times compared with preoperative amounts in both therapy sites (p < 0.05). Bacterial amounts of Treponema denticola, Prevotella intermedia, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans at 6 weeks, Porphyromonas gingivalis and T. denticola at 3 months, T. denticola and A. actinomycetemcomitans at 6 months were statistically lower in the test site than the control site. All clinical parameters significantly improved after MWF surgery at follow-up times compared with preoperative values in intragroup comparisons, but a significant difference was not detected in the intergroup comparison. No differences were found in terms of VAS, PM, TE, and only TC was statistically more pink in the test site than the control site. Conclusions: The present study findings suggest that the use of DL together with MWF may have positive effects in the therapy of S3GCP patients by reducing the microbial load. Clinical Trial.org: NCT05108727.
摘要：
背景：3期C级牙周炎（S3GCP）一直是临床医生面临的挑战。然而,有人提出，除牙周治疗外，使用激光可以导致更有效的治疗结果。目的：这项临床研究的目的是确定额外应用二极管激光（DL，S3GCP患者改良Widman皮瓣（MWF）牙周手术中的临床和微生物学价值为810nm±5）。方法：将18例患者随机分为试验部位（MWF+activeDL）和对照部位（单纯MFW）。术前采集临床参数和微生物样本，术后6周，3个月,和6个月。视觉模拟量表(VAS),组织水肿（TE），组织颜色（TC），和止痛药(PM)消费，术后第10天进行评估。结果：在随访时间内，两组治疗部位的细菌均明显低于术前数量（p<0.05）。Denticola密螺旋体的细菌数量，中间介体普雷沃特拉，连翘坦菌,和集中放线菌在6周时，3个月时牙龈卟啉单胞菌和丁氏螺旋杆菌，在6个月时，试验部位的Denticola和放线菌在统计学上低于对照组。所有临床参数在MWF手术后的随访时间显著改善与术前相比，组内比较，但在组间比较中未检测到显著差异.在VAS方面没有发现差异，PM,TE,只有TC在测试部位比对照部位更呈粉红色。结论：本研究结果表明，DL与MWF一起使用可能通过减少微生物负荷在S3GCP患者的治疗中具有积极作用。ClinicalTrial.org：NCT05108727。
