Effect of Low Level Laser Therapy on Gingival Inflammation in Patients undergoing Fixed Orthodontic Treatment: A Randomized Clinical Trial
DOI:
https://doi.org/10.3889/oamjms.2020.4201Keywords:
low level laser, gingival inflammation, gingivitis, fixed Orthodontic treatmentAbstract
AIM: The aim of this study was to compare the effect of low level laser therapy (LLLT) with non-LLLT as an adjunct to mechanical debridement in patients who develop gingival inflammation during fixed orthodontic treatment.
MATERIALS AND METHODS: Thirty subjects undergoing comprehensive fixed orthodontic treatment were randomly allocated. Split mouth design was applied for each patient, where the four quadrants were randomly allocated to receive full mouth debridement. The test group (quadrant) received three laser sessions (days 1, 3, and 5) besides debridement while the control group (quadrant) received debridement only. Both bleeding index (BI) and plaque index (PI) were measured after 1 and 3 months, while the total colony forming units (CFU) were measured after 2 and 6 weeks.
RESULTS: Clinical assessments (BI and PI) showed a statistically significant decrease at the first follow-up (after 1 month) and a slight increase in the second (after 3 months) that did not reach the base line. While, the total CFU showed a significant decrease in both follow-ups.
CONCLUSION: Laser showed superior results in the treatment of gingival inflammation induced by fixed orthodontic appliances other than debridement only.
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Al-Jewair TS, Suri S, Tompson BD. Predictors of adolescent compliance with oral hygiene instructions during two-arch multibracket fixed orthodontic treatment. Angle Orthod. 2011;81(3):525-31. https://doi.org/10.2319/092010-547.1 PMid:21306222
Beckwith FR, Ackerman RJ, Cobband CM, Tira DE. An evaluation of factors affecting duration of orthodontic treatment. Am J Orthod Dentofacial Orthop. 1999;115:439-47. PMid:10194290
Verrusio C, Iorio-Siciliano V, Blasi A, Leuci S, Adamo D, Nicolo M. The effect of orthodontic treatment on periodontal tissue inflammation: A systematic review. Quintessence Int. 2018;49(1):69-77. PMid:29114647
Wang SY, Yang YH, Chang HP. The effect of an oral hygiene instruction intervention on plaque control by orthodontic patients. J Dent Sci. 2007;2(1):45-51.
Martha K, Mezei T, Janos K. A histological analysis of gingival condition associated with orthodontic treatment. Rom J Morphol Embryol. 2013;54(3 Suppl):823-7. PMid:24322034
Su Y, Chen C, Guo L, Du J, Li X, Liu Y. Ecological balance of oral microbiota is required to maintain oral mesenchymal stem cell homeostasis. Stem Cell. 2017;36(4):551-61. https://doi. org/10.1002/stem.2762 PMid:29266799
Torlakovic L, Paster BJ, Ogaard B, Olsen I. Changes in the supragingival microbiota surrounding brackets of upper central incisors during orthodontic treatment. Acta Odontol Scand. 2013;71(6):1547-54. https://doi.org/10.3109/00016357.2013.77 6107 PMid:24180590
Babacan H, Sokucu O, Marakoglu I, Ozdemir H, Nalcaci R. Effect of fixed appliances on oral malodor. Am J Orthod Dentofacial Orthop. 2011;139(3):351-5. https://doi.org/10.1016/j. ajodo.2009.03.055
Liu H, Sun J, Dong Y, Lu H, Zhou H, Hansen BF, Song X. Periodontal health and relative quantity of subgingival Porphyromonas gingivalis during orthodontic treatment. Angle Orthod. 2011;81:609-15. https://doi.org/10.2319/082310-352.1 PMid:21306224
Folco AA, Benı´tez-Roge´ SC, Iglesias M, Calabrese D, Pelizardi C, Rosa A, Brusca MI, et al. Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets. Acta Odontol Latinoam. 2014;27(3):120-4. PMid:25560690
Arneberg P, Ogaard B, Scheie AA, Rølla G. Selection of Streptococcus mutans and lactobacilli in an intra-oral human caries model. J Dent Res. 1984;63(10):1197-2000. https://doi. org/10.1177/00220345840630100501 PMid:6384298
Petti S, Barbato E, Simonetti D’Arca A. Effect of orthodontic therapy with fixed and removable appliances on oral microbiota: A six-month longitudinal study. New Microbiol. 1997;20(1):55-62. PMid:9037669
Dale BA. Periodontal epithelium: A newly recognized role in health and disease. Periodontol 2000. 2002;30:70-8. https://doi. org/10.1034/j.1600-0757.2002.03007.x PMid:12236897
Bosshardt DD, Lang NP. The junctional epithelium: From health to disease. J Dent Res. 2005;84(1):9-20. https://doi. org/10.1177/154405910508400102 PMid:15615869
Pejcic A, Kojovic D, Kesic L, Obradovic R. The effects of low level laser irradiation on gingival inflammation. Photomed Laser Surg. 2010;28(1):69-74. https://doi.org/10.1089/pho.2008.2301 PMid:19929224
Zare D, Haerian A, Molla R, Vaziri F. Evaluation of the effects of diode (980 Nm) laser on gingival inflammation after nonsurgical periodontal therapy. J Lasers Med Sci. 2014;5(1):28-31. PMid:25606336
Goldstep F, Freedman G. Diode lasers for periodontal treatment: The story so far. J Oral Health. 2009;45-6.
Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T. Effect of gallium arsenide diode laser on human periodontal disease: A microbiological and clinical study. Lasers Surg Med. 2002;30(1):606. https://doi.org/10.1002/lsm.10010 PMid:11857606
Gokhale SR, Padhye AM, Byakod G, Jain SA, Padbidri V, Shivaswamy S. A comparative evaluation of the efficacy of diode laser as an adjunct to mechanical debridement versus conventional mechanical debridement in periodontal flap surgery: A clinical and microbiological study. Photomed Laser Surg. 2012;30(10):598-603. https://doi.org/10.1089/ pho.2012.3252 PMid:22889285
Güncü GN, Tözüm TF, Cağlayan F. Effects of endogenous sex hormones on the periodontium review of literature. Aust Dent J. 2005;50(3):138-45. https://doi.org/10.1111/j.1834-7819.2005. tb00352.x PMid:16238210
Claffey N, Egelberg J. Clinical indicators of probing attachment loss following initial periodontal treatment in advanced periodontitis patients. J Clin Periodontal. 1995;22(9):690-6. https://doi.org/10.1111/j.1600-051x.1995.tb00828.x PMid:7593699
Checchi L, Montevecchi M, Checchi V, Zappulla F. The Relationship between bleeding on probing and subgingival deposits. An endoscopical evaluation. Open Dent J. 2009;3:154- 60. https://doi.org/10.2174/1874210600903010154 PMid:19672332
Kurgan Ş, Fentoğlu Ö, Önder C, Serdar M, Eser F, Tatakis DN, et al. The effects of periodontal therapy on gingival crevicular fluid matrix metalloproteinase-8, interleukin-6 and prostaglandin E2 levels in patients with rheumatoid arthritis. J Periodont Res. 2016;51(5):586-95. https://doi.org/10.1111/jre.12337 PMid:26575440
Slots J. Rapid identification of important periodontal microorganisms by cultivation, 1986. Oral Microbiol Immunol. 1986;1(1):48-57. https://doi.org/10.1111/j.1399-302x.1986. tb00318.x PMid:3295680
Wilkins TD, Chalgren S. Antimicrobial. Agent Chemother 1976;10:926.
Mahon C, Manuselis JR. Diagnostic Microbiology. Philadelphia: WB Saunders Company; 2000. p. 1165.
Collee JG, Miles RS, Watt B. Mackie and McCartney Practical Medical Microbiology. 14th ed. New York: Churchill Livingstone; 1996.
Feres M, Haffajee AD, Allard K, Socransky SS. Change in subgingival microbial profiles in adult periodontitis subjects. J Clin Periodontol. 2001;28(7):597-609. https://doi. org/10.1034/j.1600-051x.2001.028007597.x PMid:11422580
Wilson TG Jr., Carnio J, Schenk R, Myers G. Absence of histologic signs of chronic inflammation following closed subgingival scaling and root planing using the dental endoscope: Human biopsies a pilot study. J Periodontol. 2008;79(11):2036- 41. https://doi.org/10.1902/jop.2008.080190 PMid:18980510
Kreisler M, Christoffers AB, Willershausen B, d’Hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: An in vitro study. J Clin Periodontol. 2003;30(4):353-8. https://doi. org/10.1034/j.1600-051x.2003.00001.x PMid:12694435
Sasaki Y, Hayashi JI, Fujimura T, Nishida YI, Ohno T, Okada K, et al. New irradiation method with indocyanine green-loaded nanospheres for Inactivating periodontal pathogens. Int J Mol Sci. 2017;18(1):154. https://doi.org/10.3390/ijms18010154
Qadri T, Miranda L, Tuner J, Gustafsson A. The short term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol. 2005;32(7):714-9. https://doi.org/10.1111/j.1600-051x.2005.00749.x PMid:15966876
Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. A review. J Clin Periodontol. 1996;23(5):492-6. https://doi.org/10.1111/j.1600- 051x.1996.tb00580. PMid:8783057
Goteiner D, Vogel R, Deasy M, Goteiner C. Periodontal and caries experience in children with insulin-dependent diabetes mellitus. J Am Dent Assoc. 1986;113(2):277-9. https://doi. org/10.14219/jada.archive.1986.0166 PMid:3462234
Coleton S. Sensitivity and laser treatment. J Am Dent Assoc. 1998;129(9):1200-4. PMid:9786741
Aykol G, Baser U, Maden I. The effect of low- level laser therapy as an adjunct to non- surgical periodontal treatment. J Periodontol. 2011;82(3):481-8. https://doi.org/10.1902/ jop.2010.100195 PMid:20932157
Basford JR. Low-energy laser therapy: Controversies and new research findings. Lasers Surg Med. 1989;9(1):1-5. PMid:2648091
Kageyama S, Takeshita T, Asakawa M, Shibata Y, Takeuchi K, Yamanaka W, et al. Relative abundance of total subgingival plaque-specific bacteria in salivary microbiota reflects the overall periodontal condition in patients with periodontitis. PLoS One. 2017;12(4):e0174782. https://doi.org/10.1371/journal. pone.0174782 PMid:28369125
Petrović MS, Kannosh IY, Milašin JM, Mihailović DS, Obradović RR, Bubanj SR, et al. Clinical, microbiological and cytomorphometric evaluation of low-level laser therapy as an adjunct to periodontal therapy in patients with chronic periodontitis. Int J Dent Hyg. 2018;16(2):e120-7. https://doi. org/10.1111/idh.12328 PMid:29327449
Birang R, Shahaboui M, Kiani S, Shadmehr E, Naghsh N. Effect of nonsurgical periodontal treatment combined with diode laser or photodynamic therapy on chronic periodontitis: A randomized controlled split-mouth clinical trial. J Lasers Med Sci. 2015;6(3):112-9. https://doi.org/10.15171/jlms.2015.04 PMid:26464778
Gupta S, Sawhney A, Jain G, Dhar S, Gupta B, et al. An evaluation of diode laser as an adjunct to scaling and root planning in the nonsurgical treatment of chronic periodontitis: A clinico-microbiological study. Dent Med Res. 2016;4(2):44-9. https://doi.org/10.4103/2348-1471.184733
Lai SM, Zee KY, Lai MK, Corbet EF. Clinical and radiographic investigation of the adjunctive effects of a low- power HeNe laser in the treatment of moderate to advanced periodontal disease: A pilot study. Photomed Laser Surg. 2009;27:287-93. https://doi.org/10.1089/pho.2007.2206 PMid:18785848
Angelov N, Pesevska S, Nakova M, Gjorgoski I, Ivanovski K, Angelova D, et al. Periodontal treatment with a low- level diode laser: Clinical findings. Gen Dent. 2009;57(5):510-3. PMid:19903643
Pesevska S, Nakova M, Gjorgoski I, Angelov N, Ivanovski K, Nares S, et al. Effect of laser on TNF- alpha expression in inflamed human gingival tissue. Lasers Med Sci. 2012;27(2):377-81. https://doi.org/10.1007/s10103-011-0898-x PMid:21380536
Calderın S, Garcıa-Nunez JA, Gomez C. Short term clinical and osteoimmunological effects of scaling and root planing complemented by simple or repeated laser phototherapy in chronic periodontitis. Lasers Med Sci. 2013;28(1):157-66. https://doi.org/10.1007/s10103-012-1104-5 PMid:22546942
Makhlouf M, Dahaba MM, Tuner J, Eissa SA, Harhash TA. Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis. Photomed Laser Surg. 2012;30(3):160-6. https://doi.org/10.1089/pho.2011.3069 PMid:22233558
Ribeiro IW, Sbrana MC, Esper LA, Almeida AL. Evaluation of the effect of the GaAlAs laser on subgingival scaling and root planing. Photomed Laser Surg. 2008;26(4):387-91. https://doi. org/10.1089/pho.2007.2152 PMid:18647095
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Copyright (c) 2020 Eman Aly, Hend Salah Hafez, Amr Hussein Labib, Tarek Abdel Hamid Harhash, Mohamed Abou El-Yazeed, Sylvana Gaber, Shaimaa Nasr (Author)
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