背景:为了比较Er:YAG激光(ERL)和低强度激光治疗(LLLT)的联合治疗与单激光应用的疗效,和牙周非手术治疗的刮削和根面平整(SRP)。
方法:在一项随机对照试验中,招募了25名非吸烟II期或III期牙周炎患者。将四个口内象限随机分配到四种不同的治疗方法:(1)与ERL加SRP加LLLT联合应用;(2)ERL加SRP;(3)SRP加LLLT;(4)SRP。我们评估了牙周指数,包括探测深度(PD),临床依恋水平(CAL),出血指数(BI),和菌斑指数(PLI),连同三种细胞因子(IL-1β,TNF-α,基线时,来自龈沟液的IL-10)和来自龈下牙菌斑的红色复合病原体,3个月,和6个月。
结果:对于初始的中等口袋(4mm≤PD≤6mm),用ERL+SRP+LLLT处理的象限,ERL+SRP,在3个月的随访中,与对照(SRP)象限相比,SRPLLLT显示出更大的PD改善(1.25±1.06,1.23±1.12,1.00±1.21vs.0.98±1.21mm)和6个月的随访(1.35±1.06,1.23±1.17,1.35±0.98vs.0.98±1.23mm)(p=0.002)。在3个月的随访中,用ERLSRPLLLT和SRPLLLT治疗的象限比对照象限显示出更多的CAL增益均值(0.96±1.42,0.61±1.39vs.0.55±1.57mm)和6个月的随访(0.84±1.54,0.89±1.49vs.0.48±1.68mm)(p=0.008)。对于初始深袋(PD≥7mm),在随访中,与对照象限相比,ERLSRPLLLT象限具有更多的PD改善和CAL增益。BI没有显著差异,PLI,炎性细胞因子,和牙周病原体在四组中。
结论:ERL和LLLT的联合应用在减少PD方面显示出潜在的疗效,特别是对于深口袋。
结论:为了比较联合使用Er:YAG激光(ERL)和低水平激光治疗(LLLT)与单激光的治疗效果,和传统牙周治疗(SRP)。共纳入25例非吸烟牙周炎患者,他们的嘴被分成四个部分,每个人接受不同的治疗:ERL+SRP+LLLT,ERL+SRP,SRP+LLLT,SRP。在基线时评估临床指标和实验室指标。3个月,和6个月。六个月后,对于最初适度的口袋,联合激光组和单激光组在减少牙周袋深度和增加附着水平方面比传统组表现出更好的改善。但是对于最初的财大气粗,仅联合激光组比传统组表现出更好的改善。出血没有显著差异,牌匾,炎症,或群体中有害的细菌水平。这些发现表明,将Er:YAG激光和低水平激光治疗整合到标准牙周治疗中可能会增强治疗在减少口袋深度方面的益处。特别是在恶劣的条件下。
BACKGROUND: To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment.
METHODS: In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months.
RESULTS: For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups.
CONCLUSIONS: The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets.
CONCLUSIONS: To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low level laser therapy into standard periodontal treatment may enhance the treatment\'s benefits in reducing pocket depth, especially for severe conditions.