RESUMEN
OBJECTIVE: To assess clinical and microbiological outcomes of an Er:YAG laser in comparison with sonic debridement in the treatment of persistent periodontal pockets in a prospective randomized controlled multicentre study design. MATERIAL AND METHODS: A total of 78 patients in supportive periodontal therapy with two residual pockets were included, 58 were available for the whole follow-up period. Root surfaces were instrumented either with a sonic scaler (Sonicflex(®) 2003 L) or with an Er:YAG laser (KEY Laser(®) 3). Clinical attachment levels (CAL), Probing depths (PD), Plaque control record (PCR) and Bleeding on probing (BOP) were assessed at baseline, 13 and 26 weeks after treatment. In addition, microbiological analysis was performed employing a DNA diagnostic test kit (micro-IDent(®) Plus). RESULTS: Probing depths and CAL were significantly reduced in both groups over time (p < 0.05), without significant differences between the groups (p > 0.05). BOP frequency values decreased significantly within both groups (p < 0.05), with no difference between the laser and the sonic treatment (p > 0.05). PCR frequency values did not change during the observation period (p > 0.05). Microbiological analysis failed to expose any significant difference based on treatment group or period. CONCLUSION: Employing both sonic and laser treatment procedures during supportive periodontal care, similar clinical and microbiological outcomes can be expected.
Asunto(s)
Láseres de Estado Sólido/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Desbridamiento Periodontal/métodos , Bolsa Periodontal/radioterapia , Carga Bacteriana/efectos de la radiación , Periodontitis Crónica/microbiología , Periodontitis Crónica/radioterapia , Periodontitis Crónica/terapia , Placa Dental/microbiología , Placa Dental/prevención & control , Femenino , Estudios de Seguimiento , Hemorragia Gingival/clasificación , Hemorragia Gingival/microbiología , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/efectos de la radiación , Ondas de Choque de Alta Energía/uso terapéutico , Humanos , Terapia por Luz de Baja Intensidad/instrumentación , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/microbiología , Pérdida de la Inserción Periodontal/radioterapia , Pérdida de la Inserción Periodontal/terapia , Desbridamiento Periodontal/instrumentación , Bolsa Periodontal/microbiología , Bolsa Periodontal/terapia , Estudios Prospectivos , Sonicación/instrumentación , Raíz del Diente/microbiología , Raíz del Diente/patología , Raíz del Diente/efectos de la radiación , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess the subjective intensities of pain during supportive periodontal treatment using a sonic scaler or an Er:YAG laser. MATERIAL AND METHODS: Forty patients with two residual periodontal pockets following conventional periodontal therapy were treated using a sonic scaler and an Er:YAG laser in a split-mouth design. A visual analogue scale was used for pain assessment directly after each treatment procedure. Additionally, pain was recorded during the treatment of 11 patients at intervals of 0.5 s using an inter-modal intensity comparison. RESULTS: Pain assessment during treatment showed that laser treatment (median pain score: 0.71 U, maximum: 9.94 U, minimum: 0 U) caused less pain than the sonic device (median pain score: 2.17 U, maximum: 11.26 U, minimum: 0 U) (p<0.05) with no difference in the treatment time (p>0.05). These results could be confirmed by the visual analogue scale: pain scores assessed after laser treatment (median: 1 U, maximum: 7 U, minimum: 0 U) were lower than those after sonic instrumentation (median: 3.5 U, maximum: 7.5 U, minimum: 0 U) (p<0.05). CONCLUSIONS: Using an Er:YAG laser during supportive periodontal treatment, painful sensations can be reduced compared with sonic scaler instrumentation.