Top PDF Clinical Efficacy of Soft Tissue Diode Laser as an Adjunct to Non Surgical Periodontal Therapy

Clinical Efficacy of Soft Tissue Diode Laser as an Adjunct to Non Surgical Periodontal Therapy

Clinical Efficacy of Soft Tissue Diode Laser as an Adjunct to Non Surgical Periodontal Therapy

Periodontal diseases are various group of clinical entities in which induction of an inflammatory process results in destruction of attachment apparatus, loss of supporting alveolar bone and if untreated, tooth loss (13) . The main goals of periodontal therapy are to reduce bacterial deposits and niches by removing the biofilms and to restore the biological ability of periodontally diseased root surfaces for subsequent reattachment of periodontal tissues to the treated root surface. (14) The use of Laser as an adjunct to conventional SRP is based on the fact that subgingival debridement and eradication of pathogenic microorganism could provide new sites for attachment of connective tissue attachment. The present study was undertaken to compare the efficacy of SRP with and without diode laser therapy in the management of chronic periodontitis. Fifty patients suffering from chronic periodontitis having pocket probing depth ≥ 4mm as per AAP (9)
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Clinical and Microbiological Evaluation of Photodynamic Therapy and Diode Laser (960nm) as an Adjunct to Non Surgical Periodontal Treatment: A Comparative study

Clinical and Microbiological Evaluation of Photodynamic Therapy and Diode Laser (960nm) as an Adjunct to Non Surgical Periodontal Treatment: A Comparative study

The high power carbon dioxide (CO2) and neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers are capable of excellent soft tissue ablation with a good hemostatic effect and have been generally proposed for periodontal surgery and oral surgery(Aoki A 2004 28 ). However, these lasers are not suitable for treatment of root surface or alveolar bone, due to carbonization of these tissues and major thermal side effects on the target and surrounding tissues. They are mainly indicated for gingivectomy and frenectomy. Er:YAG laser can be used for periodontal hard tissue procedures such as dental calculus removal and decontamination of the diseased root surface.
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The Effects of Diode Laser as an Adjunct to Scaling and Root Planing on Treatment of Chronic Periodontitis: A Review of the literature

The Effects of Diode Laser as an Adjunct to Scaling and Root Planing on Treatment of Chronic Periodontitis: A Review of the literature

Laser has excellent tissue ablation ability with a strong bactericidal effect. It is one of the most promising new technical modalities for non-surgical periodontal treatment. Another ad- vantage of laser treatment is the ability to access areas that are impossible to reach with conven- tional mechanical treatment. Laser irradiation has bactericidal effect while it does not create a smear layer, so that the surface of the treated root can become favorable for attachment of peri- odontal tissue. Conventionally, gingival curet- tage has been used for soft tissue debridement. Nevertheless, some studies have shown that gin- gival curettage after SRP with hand instruments has no added advantage over conventional SRP, although poor results of gingival curettage may be due to the absence of efficient instruments for soft tissue debridement. Proper removal of the epithelial lining of the pocket’s soft tissue wall with laser can improve periodontal tissue regen- eration. Part of the laser energy will turn into scattered radiation, which can irritate surround- ing tissue cells, reduce inflammation and cell proliferation, and increase the lymph flow. It can improve periodontal tissue attachment and possi- bly reduce postoperative pain. (4) Semiconductor
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A Comparative Evalutation Of Efficacy Of Surgical Stripping, Co2 Laser, Diode Laser And Electrocautry For The Treatment Of Gingival Hyper Pigmentations  A Clinical Study

A Comparative Evalutation Of Efficacy Of Surgical Stripping, Co2 Laser, Diode Laser And Electrocautry For The Treatment Of Gingival Hyper Pigmentations A Clinical Study

cause tissue injury, and healing is eventful. Also the depth control is difficult and optimal duration of freezing is not known, thus prolonged freezing leading to increased destruction (Ozbayrak, 2000; Yeh, 1998; Gage 1998). Topical chemical therapy using harmful chemical substances such as phenol cause tissue necrosis, in addition to pain, which is the result of burning both during and after the treatment. This treatment is not acceptable to the clinician or the patient. (Tamizi Tahiri 1996). Treatment with Free gingival autografts is uncomfortable to the patient as there is involvement of a second surgical site that is the donor site, which is denuded and the final colour matching may not be predictable. (Tamizi 1996, Bouchard, Malet, Borghetti 2001). The introduction of Lasers into Dentistry, especially Periodontal surgery, have easened out many a complications of other conventional procedures, however with their own disadvantages. Lasers have been used for Gingival depigmentation from the last decade, however Comparitive Clinical trials and Reports on their efficacy are limited. The effectiveness of melanin hyperpigmentation removal with different type of lasers has been evaluated in several studies (Sharon E.et al 2000, Ozbayrak et al 2000, Atsawasuwan P et al 2000, Stuart Coleton et al 2004, Rosa Daniel SA, 2007,Emin Essen 2004, Azzeh MM 2007).The rationale for use of Lasers in the treatment of Gingival Hyperpigmentation is manifold. This is in conjunction with the studies done by Wigdor et al 1995, who described advantages of Lasers over cold steel surgical procedures as: Dry and bloodless, Instant sterilization of the surgical site, Reduced bacteraemia, Reduced mechanical trauma, Minimal post-operative swelling and scarring, Minimal post-operative pain and Minimal or no anesthesia. In the present study, carbon dioxide laser, Diode lasers and Electrocautry were compared with Surgical stripping. A Clinical evaluation was carried out. It was decided to carry out all the procedures in each patient at the same time to enable uniformity, reduce the number of patient visits and to avoid any difference in the biological variation, genetic makeup and host response of the patient. Since the patients were comparatively evaluated for Gingival wound healing, patient perspective and time interval of repigmentation, carrying out the treatments at the same visit facilitated the study.
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Comparative evaluation of efficacy of diode laser as an adjunct to open flap debridement in the treatment of chronic periodontitis – a clinical and radiographic study

Comparative evaluation of efficacy of diode laser as an adjunct to open flap debridement in the treatment of chronic periodontitis – a clinical and radiographic study

The primary goal in treating periodontitis is to remove bacterial deposits and halt the progression of disease. Complete removal of bacterial deposits and their toxins from the root surface is not always possible by conventional mechanical therapy because of limited access to areas such as furcations, concavities, developmental grooves and therefore such sites require surgical intervention. (Gokhale SR et al, 2012). Also, it does not eliminate the microorganisms in the soft tissue wall of periodontal pocket. These are sources for recolonization and reinfection. Thus, the limitations of the conventional therapy have probed us to implement the use of adjunctive antimicrobial measures.
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Clinical and Biochemical Evaluation of Efficacy of Calcium Fluoride as an Adjunct to Non-Surgical Periodontal Therapy: A Randomized Clinical Trial

Clinical and Biochemical Evaluation of Efficacy of Calcium Fluoride as an Adjunct to Non-Surgical Periodontal Therapy: A Randomized Clinical Trial

Periodontal disease is characterized by tissue inflammation and destruction of the tooth supporting structures that eventually leads to the loss of affected teeth (Kinane 2001, Page & Kornman 1997, Philstrom et al. 2005) 5,6,7 . Despite our increased understanding of the etiology and pathogenesis of periodontal infections, the diagnosis of these diseases is still based almost entirely on traditional clinical assessment ( Armitage 1995) 8 . To arrive at a periodontal diagnosis, the dentist must rely upon factors such as (a) presence and absence of signs and symptoms, including pain, ulceration and amount of observable plaque and calculus (b) patients medical and dental history (c) presence or absence of clinical signs of inflammation like bleeding on probing (d) probing depths and (e) extent and pattern of clinical attachment and bone loss. These parameters provide a measure of past destruction and are of limited use in early diagnosis (Frodge et al,2008) 1 . Because of the increasing prevalence and associated comorbidities, screening and diagnostic modalities for the early identification of periodontitis, its initiation and progression, as well as objective measures for response to therapy, are being sought. ( Beck et al 2005, Genco et al 2001, Seymour et al 2007, Mealey & Oates 2006 ) 9,10,11,12 .
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Clinical and antimicrobial effectiveness of diode laser therapy as an adjunct to non surgical periodontal treatment: A clinical microbiological study

Clinical and antimicrobial effectiveness of diode laser therapy as an adjunct to non surgical periodontal treatment: A clinical microbiological study

The study included of 8 chronic periodontitis patients (72 sites), PD ≥5mm, CAL ≥5mm, who were referred for periodontal treatment at the outpatient department of Periodontics, A.C.P.M. Dental College, Dhule. The study was carried out after the approval from the ethical committee of A.C.P.M. Medical College, Dhule. The subjects received detailed information about the proposed research & gave informed consent. The periodontal sites in each patient were randomly assigned into three groups: Group I (SRP), Group II (L) & Group III (SRP+L) by an investigator who did not collect data or perform the procedures. Exclusion criteria were periodontal treatment received for the last 1 year; systemic diseases that could influence the outcome of the therapy, pregnancy, smoking, immunosuppressive chemotherapy; and use of antibiotics and anti-inflammatory drugs for the last 6 months.
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A Comparative evaluation of clinical efficacy and patient comfort in surgical scrapping and diode laser technique for gingival depigmentation: A Clinical Trial

A Comparative evaluation of clinical efficacy and patient comfort in surgical scrapping and diode laser technique for gingival depigmentation: A Clinical Trial

The diode laser treatment showed lesser bleeding because of the photocoagulation of the blood vessels, due to the absorption of light in its blood column, which heats hemoglobin to a temperature high enough to produce thrombus formation and collagen shrinkage in the wall of the blood vessel and its surrounding connective tissues. Light absorption by hemoglobin varies according to the wavelength and oxygen saturation. Ideally, photon penetration depth for a laser wavelength used in vessel closure should be roughly equal to the vessel diameter so that there is effective bulk heating of the blood column without superficial damage of perforation of the vessel wall at the treatment site. [43] The laser seals the blood vessels in the surrounding tissue up to a diameter of 0.5 mm thus; the primary advantage is hemostasis and a relatively dry field. 3
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Comparison of Scalpel versus Soft Tissue Diode Laser for
Biopsy of Oral Lesions

Comparison of Scalpel versus Soft Tissue Diode Laser for Biopsy of Oral Lesions

Histological analysis of the epithelium, connective tissue, charring, and presence of artifacts was under- taken. It is critical that the right type of laser setting be prudently employed owing to the fact that distinctive thermal effects are seen in biological tissue. This is the only way to ensure optimal clinical effectiveness, while ensuring that there is no destruction to the irradiated tissue. Dark substances such as hemoglobin show a greater degree of absorption and the depth of propaga- tion is also correlated to the wavelength and the absorp- tion coefficient of the irradiated tissue. The action of most dental lasers occurs through photonic absorption which results in increased temperature (often by more than 100°C) within the tissue being focused on by the laser beam. This is the reason for irreversible or perma- nent damage in the surrounding tissues if the laser is not used judiciously. With this aim in mind, an effort was made to analyze the thermal effects, particularly at the marginal areas of the excised specimen in our study. [14]
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Clinical Evaluation of Papilla Reconstruction Using Subepithelial Connective Tissue Graft

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“Black triangles” or the interproximal spaces are one of the most troubling dilemmas in dentistry, can cause aesthetic concerns, phonetic difficulties, and food impaction. Several reasons contribute to the loss or absence of interdental papilla and establishment of ‘Black Triangle’, including gingival inflammation, attachment loss, and interproximal bone resorption. The most common reason for black triangle in the adult population is plaque associated loss of periodontal support as well abnormal tooth shape or traumatic oral hygiene [4]. While Kandaswamy et al., reported that black holes (dark triangles) are more likely to develop following labial movement of overlapping or palatally placed incisors and diastema closure [5]. An interproximal contact point and an adequate level of bone support are essential for maintenance of a healthy papilla that completely fills the interproximal space [6]. From a biological point of view, the presence or absence of the papilla primarily depends on the distance between the interdental contact point and the interproximal crest of bone. Tarnow et al., stated that the distance of 5 mm is critical for
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Reduced platelet hyper-reactivity and platelet-leukocyte aggregation after periodontal therapy

Reduced platelet hyper-reactivity and platelet-leukocyte aggregation after periodontal therapy

One limitation of the current study is the absence of an untreated (control) group. This would consist of peri- odontitis patients left untreated for the whole duration of the study. However, the inclusion of such a group is unethical, and would be met with strong opposition by the University Ethical Board. Furthermore, such a control group has been shown to be susceptible to a high dropout rate by patients who seek periodontal therapy elsewhere [45]. Nevertheless, on the basis of the current study it is not possible to establish whether the improvement in platelet reactivity is solely related to the professionally- applied periodontal therapy. It cannot be excluded that some patients have changed their lifestyle after receiving information about the negative effects of smoking, over- weight, lack of physical activity or unhealthy diet. The study protocol did not include the assessment of changes in physical activity or diet, which might have been of influ- ence on the measured platelet functions. The LDL levels were lower post-treatment and, by the time of the recall (3 months post-periodontal therapy), six out of the 14 smokers in the current study had quitted smoking. As both LDL and smoking could influence platelet function [46–48], we sought of estimating their effect on the mea- sured platelet parameters by regression analysis. When ex- ploring the predictive value of smoking or the changes in LDL, systolic blood pressure, waist circumference for the measured platelet parameters, no significant effect of these variables was found. However, the study cohort is rather limited, so this conclusion might be underpowered.
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Diode Laser – A Boon in the Treatment of Mucocele – A Case Report

Diode Laser – A Boon in the Treatment of Mucocele – A Case Report Shakti Agarwal 1* , Shailesh Kumar 2, Haider Iqbal1 , Kamini Kiran 3 Abhishek Sinha 1and Rameshwar Singh4

one side so as to allow for undermining of the tissue as excisional biopsy was being attempted, this undermining procedure should be done carefully with the tissue retracted to one side and the laser beam kept parallel to the long axis of the tissue so that the beam does not damage the adjacent tissues. Histologically, it was found in the scanner view epithelium overlying the connective tissue is seen. On higher magnification parakeratinised stratified squamous epithelium can be seen, connective tissue stroma shows mucous acini with pooling of mucous (marked by arrow in the Fig. 5), inflammatory cells and extravasated RBCs of mucocele which was suggestive of mucocele. Routine postoperative instruction was given.
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Effectiveness of Soft Tissue Mobilisation as an adjunct to the Conventional Therapy in patients with Ankylosing Spondylitis

Effectiveness of Soft Tissue Mobilisation as an adjunct to the Conventional Therapy in patients with Ankylosing Spondylitis

EULAR) working groups, combination of non-pharmacological and pharmacological treatment came under main stream [7]. The only available non-pharmacological measure in AS management is physiotherapy aiming to prevent and/or retard restriction of spinal mobility, improving pain and stiffness as long as possible [8]. To avoid stiffening in a lexed posture and to maintain/improve functional capacity and QOL, patient education and regular exercise is effective in patient under TNF inhibitors [9]. In order to learn speci ic exercise to continue, at the initial phase i.e. irst years of the disease multidisciplinary in-patient rehabilitation program is needed that had a positive effect on disease activity, pain, function and well-being [10].
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Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review

Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review

Polytetrafluoroethylene (PTFE) is a non-porous inert and biocompatible fluorocarbon polymer [172]. Two non-resorbable PTFE based barrier membranes that are commonly used are the expanded-polytetrafluoroethylene (e-PTFE) and the titanium-reinforced high density polytetrafluoroethylene (Ti-d-PTFE). The e-PTFE has been commonly used in vascular surgeries [173] and is fabricated by exposing PTFE to high tensile stresses which results in expansion and the formation of a porous micro- structure [174]. The e-PTFE membranes are stable in bio- logical systems and their clinical effectiveness has been studied [175] with evidence of periodontal regeneration with their use [156]. When there is a clinical requirement that requires larger areas of space maintenance, Ti-d- PTFE can be used as it is stiffer due to the central portion of the membrane reinforced with titanium to prevent col- lapse [176]. The Ti-d-PTFE has also smaller pore size that does not allow bacterial ingrowth into the graft material if left exposed [177], (Fig. 4). An alternative approach is using a double layer of PTFE membrane with a titanium framework interposed (Cytoplast® Ti-250) which has shown to be successful for ridge augmentation and treat- ment of large defects in the alveolar process [178].
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Influence of smoking in clinical presentation of periodontal disease in patients with other cardiovascular risk factors

Influence of smoking in clinical presentation of periodontal disease in patients with other cardiovascular risk factors

The clinical examination of smokers and non-smokers with periodontal disease demonstrates that clinical characteristics, such as the presence of tartar, epithelium and conjunctive tissue alterations, gingival coloration, tooth mobility and bone loss, are more frequent among smokers. Thus, the influence of smoking over periodontal disease should be considered by clinicians and patients during active periodontal treatment and the maintenance of oral health. Regarding other cardiovascular risk factors, the main conditions found in smokers with PD were systemic arterial hypertension, alcoholism, and stress. These results are in agreement with the literature. Individuals with PD present inflammatory process that undertake gingival tissue (gingivitis) and/or destroy dental bone support (periodontitis) (Hart and Kornman, 1997), increasing the C- Table 1. Number of associated cardiovascular risk factors
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The effect of adjunctive use of azithromycin with non surgical periodontal therapy

The effect of adjunctive use of azithromycin with non surgical periodontal therapy

records plus 3, 6, 9, 12 months (3/12) follow up records. Forty- seven patients were selected and prescribed azithromycin for periodontal disease. All the notes for the 47 patients were reviewed. Eighteen patients out of 47, did not attend the three- month assessment treatment. Five patients had systemic disease like un-controlled diabetes, which were excluded. So at the end the total number of patient was 24 for which the data was collected at base-line and 3/12 months’ re-assessment. The group of 24 patients, who received RSD plus Azithromycin 500mg OD for 3 days on the completion of the treatment. The records of probing depths at base-line and 3/12 re–assessment of 6 sites (Mesiobuccal, midbuccal, distobuccal, distolingual, midlingual, and mesiolingual) were collected for all the teeth present, excluding 3rd molars. The pocket depths were divided into 3 categories, shallow, moderate and deep. Shallow pockets were < 3mm moderate pockets were 4-6mm and deep pockets were > 7mm. All the data was entered into an excel spread sheet which included, the age of the patients, number of teeth, number of sites, pocket depth number and percentage at both baseline and reassessment. The different between baselines and 3/12 re-assessment values were computed and average, median and standard deviation and range values were calculated. The statistic were mainly descriptive statistics and not analytical and the difference in the change of pocket depth between baseline 3/12 re-assessment was the main outcome of interest. Thus the primary outcome variable which was evaluated included change in number and percentage of pocket depth at sites with > 3mm at base-line compared with the 3/12 re- assessment.
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Efficacy of Diode Laser Therapy in Acceleration of Orthodontic Space Closure: A Split-Mouth Randomized Clinical Trial

Efficacy of Diode Laser Therapy in Acceleration of Orthodontic Space Closure: A Split-Mouth Randomized Clinical Trial

In this study, we used the semiconductor with a wavelength of 940 nm, a pulsed wave mode, an output power of 1mW, and an exposure time of 10 seconds. Results of Bradley et al. [27] had indicated significant bio- stimulatory effects on bone metabolism around this dosage, whereas higher dosages had bio-inhibitory effects, and lower dosage showed non significant results. A 15-day regimen was used, coinciding with normal recall visits for hygienist control in clinical service. Kavaliauskiene et al. [28] proved that after an orthodontic procedure, pain and soreness occur after 24 to 48 hours. Thus, the first follow-up score after low-intensity laser therapy was recorded on day 7.
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Evaluation of Low-Level Laser Therapy with Diode Laser for the Enhancement of the Orthodontic Tooth Movement: a Split-Mouth Study

Evaluation of Low-Level Laser Therapy with Diode Laser for the Enhancement of the Orthodontic Tooth Movement: a Split-Mouth Study

Tissue-penetrating light can be generated by numerous types of currently available lasers, including He-Ne, Nd: YAG, and diode lasers, which are often used in the dental field. Surface absorption-type CO2 and Er: YAG laser light is also widely used. Diode laser light is highly penetrant and minimally absorbed by water [17,18]. In addition, diode lasers are inexpensive devices and easy to miniaturize, which has led to the development of a wide range of clinical applications. Laser therapy can aid in repairing the mucosa, controlling pain, and accelerating wound healing through low mechanical stress on the root surfaces and bactericidal and detoxifying effects [15,19].
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Management of Oral Leukoplakia Using Diode Laser: A Pilot Study

Management of Oral Leukoplakia Using Diode Laser: A Pilot Study

A study was conducted in 2005 by Mona et al. on patients with oral lichen planus using diode laser (980 nm). The patients were followed up for 9 months. At the follow up sessions, lesions were examined to detect any residual lesion. Lesions were exactly measured and digital photographs were taken at follow up session. Response rates were assessed clinically by amount of reduction in surface area of lesions. Complete healing of surgical site occurred after the second week, with recurrence occurred only in three patients by the end of six months follow-up [9].
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The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=

The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=

This review has various limitations. Drug dosage, plaque control trial design, length of follow-up, disease severity and activity of the patient populations under investiga- tion differ among studies and are important factors that should be taken in consideration [3]. Furthermore the heterogeneity regarding the antibiotics, daily dosage and length of drug regimens makes terminating conclusions about use in clinical practice difficult [40]. The possible impact of a publication bias on exaggerating the size of the test treatment effect should also be considered when interpreting the results. This systematic review narrowed down on a specific combination of two antibiotics and comprehensively evaluated the available evidence. In 3 recent systematic reviews [53–55] that evaluated sys- temic antibiotics in the treatment of periodontitis in a more broader sense come to the conclusion that out of all available antibiotics this combination is a most potent antibiotic combination and resulted in clinical improve- ments that were more pronounced. Limitations are fur- ther discussed in detail in Additional file 1: S60.
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