52例鲜红斑痣颜色类别的病理图像计算机分析

目的：本文从临床激光治疗鲜红斑痣角度出发，对５２例鲜红斑痣活检标本行组织检查，将病理图像计算机分析处理。以期获得不同临床表现类别鲜红斑痣的病理形态学参数，以指导临床治疗。材料与方法：随机选取５２例鲜红斑痣病例，行常规活检，ＨＥ染色、包埋制片后，采用光学显微镜下摄片，其图像经计算机几何参数测量。结果：本组资料的病变平均血管深度为０．４５±０．２０ｍｍ，最大血管深度为０．６３±０．２２ｍｍ，平均血管面积皮肤面积比为１０．３３％，血管充盈率为１０．３０％，平均血管皮肤比在临床浅红色病变组值为４．０５±０．８９％，鲜红色组为７．５６±０．８３％，暗紫红色组为１９．１０±５．２８％。三组之间两两检验均有统计学显著差异，而其余参数在组间均无统计学差异。结论：平均血管面积皮肤面积比与临床病变的血管深浅一致，以此来区别不同的鲜红斑痣类别可以指导临床激光治疗时的不同剂量方案。     

哈尔滨地区正常青少年牙列指数测量分析

目的建立哈尔滨地区正常青少年Bolton指数和Pont指数的正常值标准,并对其临床应用价值进行评价。方法选取100名哈尔滨地区正常青少年的牙颌模型作为研究对象,进行测量分析,计算Bolton指数和Pont指数,同时进行上下颌牙量以及切牙宽度和牙弓宽度的相关性分析。结果哈尔滨地区正常青少年Bolton指数和Pont指数男女间差异均无显著性,Bolton前牙指数为(78.97±2.41)%,全牙指数为(91.48±3.14)%;Pont前磨牙指数为(83.13±4.47)%,磨牙指数为(66.08±4.83)%。结论确立了哈尔滨地区正常青少年Bolton指数和Pont指数的正常值标准;Bolton指数和Pont指数均有一定的临床应用价值。     

糖尿病患者牙周炎治疗后血清肿瘤坏死因子α和糖化血红蛋白的变化

目的　探讨牙周基础治疗对Ⅱ型糖尿病伴牙周炎患者的影响及其影响机制。方法选择 15例Ⅱ型糖尿病伴牙周炎患者 ,于牙周基础治疗前、后的 4～ 6周分别检测其体重指数、牙龈出血指数、探诊深度、糖化血红蛋白、总胆固醇、甘油三酯和血清肿瘤坏死因子α(tumornecrosisfactor alpha ,TNF α)的水平。 结果　除体重指数和总胆固醇无显著变化外 (P >0 0 5 ) ,其余各项临床及血清学指标均显著降低 ,治疗后与治疗前相比差异有显著性 (P <0 0 5 )。其中 ,龈沟出血指数由(3 6 0± 0 5 1)降至 (1 6 7± 0 6 2 ) ,探诊深度由 (5 73± 1 16 )降至 (2 6 0± 0 83)。糖化血红蛋白由(9 78± 1 4 9) %降至 (8 4 1± 0 82 ) % ,甘油三酯由 (1 78± 0 5 2 )mmol/L降至 (1 38± 0 31)mmol/L ,TNF α由 (12 74± 3 95 )ng/L降至 (9 6 8± 2 5 2 )ng/L。 结论　对于Ⅱ型糖尿病伴牙周炎患者 ,牙周基础治疗可能通过降低患者血清TNF α的含量 ,降低其糖化血红蛋白的水平     

322例成釉细胞瘤临床病理研究

目的　研究成釉细胞瘤不同类型的临床病理特点及细胞增殖活性。方法　对 32 2例成釉细胞瘤进行回顾性研究 ,并行SP法PCNA检测和AgNOR定量分析。结果　 32 2例成釉细胞瘤分为一般型 (实性型或多囊型 )和低复发型。一般型复发率为 2 3.0 8% ,低复发型为 10 .72 % ,两者间有显著性差异 (P <0 .0 5 ) ;PCNA阳性细胞指数和AgNOR计数一般型分别为 (6 .6 7± 3.35 )和 (2 .6 7± 0 .2 8) ,低复发型分别为 (2 .49± 0 .6 7)和 (1.73±0 .2 6 ) ,两者有显著性差异 (P <0 .0 1)。结论　成釉细胞瘤为多形性肿瘤 ,两型临床病理和细胞增殖活性均不同     

酸蚀剂浓度对光固化树脂加强型水门汀粘结强度的影响

目的:比较不同酸蚀浓度下光固化树脂加强型玻璃离子水门汀(RMGIC)与正畸托槽的粘结强度。方法:60颗上颌第一前磨牙,随机分成6组,每组10颗。各组采用不同酸蚀浓度的表面处理,粘结后10min,置于人工唾液室温下保存24h。干燥、固定后,测定各样本的抗剪切强度,并记录托槽脱落后牙釉质粘结界面的粘结材料残留指数(ARI)。采用SPSS11.5统计软件包对结果进行χ2检验。结果:(1)托槽的抗剪粘结强度A组为(14.786±4.940)MPa,B组未检测,C组为(7.002±3.768)MPa,D组为(7.879±3.013)MPa,E组为(7.452±2.561)MPa,F组为(7.406±2.407)MPa。C、D、E、F组托槽的抗剪粘结强度比较,差异无显著性,P>0.05。A组与其他组的剪切强度比较,差异有统计学意义,P<0.01。(2)托槽脱落后,牙釉质粘结界面的粘结材料残留指数(ARI)经χ2分析,P>0.05,ARI计分在各组之间无显著性差异。结论:不同浓度的酸蚀剂对RMGIC粘接的托槽的抗剪切强度无显著影响。用不同浓度的酸蚀剂处理牙釉质后,牙釉质表面粘结剂残留指数ARI值无显著差异。     

面部皮肤血管瘤内肥大细胞的数量特征

作者对67名上眼睑、颊、额部皮肤血管瘤的儿童进行了研究。结果表明,在30例静止期的血管瘤内有大量肥大细胞,较正常皮肤多2倍,即4.1±0.08%:1.4±0.1%。37例活动期血管瘤内的肥大细胞数量各不相同:18例的肥大细胞较正常皮肤多1倍,即2.9±0.08%;17例低于正常皮肤,即0.9±0.07%;3例接近正常,为1.2±0.2%。全组的肥大细胞平均值与正常皮肤的肥大细胞值近似,即1.6±0.1%:1.4±0.1%。     

正常开闭口时髁突运动的轨迹特征

目的　通过对正常人群下颌运动中髁突运动的测量记录 ,从而确定正常在开闭口运动中髁突的运动特征。方法　正常 38人 ,其中男女各 19人 ,平均年龄 18.7岁。应用CADIAXⅢ型 (Com puterAidedDiagnosisAxiogragh)髁突运动仪 ,记录下颌在各种边缘运动时的髁突运动情况 ,对开闭口时的髁突运动情况加以分析。结果　定性研究结果表明正常髁突运动轨迹对称 ,光滑 ,重复性好。男女性别无显著差异。在大张口时髁突相对于参考位置 (ReferencePosition)的最大位移左侧为 16 .0 2± 4 .2 7mm ,右侧为 16 .33± 5 .6 4mm ,髁突在位移 5mm时的矢状面倾斜度分别为右侧 35 .2 3± 8.18°,左侧 33.10± 8.6 6° ;在水平面内的髁突倾斜度右侧为 - 2 .0 0± 2 .6 7° ,左侧为 0 .39± 2 .18° ,大张口时绞链轴的旋转度 (GAMMA值 )为 2 6 .18± 6 .2 2°。结论　正常髁突运动轨迹有其典型的轨迹特征 ,但也存在较大的个体差异     

Docetaxel对涎腺粘液表皮样癌高转移细胞增殖及转移力的抑制作用

目的 :研究Docetaxel对涎腺粘液表皮样癌高转移细胞M3 SP4 增殖及转移力的抑制作用。方法 :用细胞计数法、克隆形成法、流式细胞术、癌细胞裸鼠尾静脉注射法、癌细胞裸鼠颌下腺原位接种法研究Docetaxel对M3 SP4 细胞增殖及转移力的抑制作用。结果 :Docetaxel对M3 SP4 细胞具有浓度及时间依赖性生长抑制作用 ,作用 72h后 ,IC3 0 和IC50 分别为 0 .34nmol/L和 0 .6 3nmol/L ;IC3 0 浓度的药物作用于M3 SP4 细胞 ,对照组及处理组细胞群体倍增时间分别为 32 .7h和 43h ;对照组及药物作用浓度分别为 0 .0 5nmol/L及 0 .1nmol/L时 ,克隆形成率为 ( 2 9.2± 1.4) %和 ( 2 0 .2± 0 .8) % ,( 2 .8± 0 .4) % ;在裸鼠体内实验中对照组及治疗组〔30mg/(kg·周 )〕肺表面的转移结节数为 11± 3.4和 0 ;裸鼠颌下腺重量 ( g)为 1.2 0± 0 .2 3和 0 .31±0 .0 5。结论 :Docetaxel可明显抑制M3 SP4 细胞的增殖及转移力。     

127名汉族青年口腔唾液一氧化氮含量检测

目的 :研究健康汉族青年唾液中一氧化氮 (NO)含量正常参考值限 ,及其与口腔龋病、龈炎的关系。方法 :分别采集口腔正常 (42名 )、有龋病 (49名 )或龈炎 (36名 )的健康汉族青年学生口腔唾液 ,由专业人员用NO检测试剂盒 ,比色并计算出唾液中NO含量。结果 :男性唾液中NO含量值限为 0～ 2 40mol/L ,均值为(6 7.0 2 5± 39.0 6 5 ) μmol/L ;女性唾液中NO含量值限为 0～ 2 39μmol/L ,均值为 (76 .397± 34 .85 6 ) μmol/L。口腔正常组、龋病组、龈炎组唾液NO含量均值 ,分别为 (6 8.2 86± 37.432 ) μmol/L ,(6 8.6 82± 34 .6 2 7) μmol/L和 (79.70 0±40 .0 0 7) μmol/L ,经统计学检验 ,3组间唾液NO含量无显著差异 (P >0 .0 5 )。 结论 :汉族青年唾液NO含量正常参考值在 11～ 140 μmol/L ,唾液中NO含量在浅、中度龋和轻度龈炎者中 ,未见明显增高 (P >0 .0 5 )。     

氨来呫诺糊剂治疗复发性阿弗他溃疡的临床研究

目的研究50g/L的氨来呫诺糊剂治疗复发性阿弗他溃疡的有效性和安全性.方法应用随机、双盲、平行对照的临床试验方法,试验组和对照组各纳入120例轻型复发性阿弗他受试者,分别应用50g/L氨来呫诺糊剂和空白基质糊剂,4次/d;应用5 d.于初诊后第4天和第6天进行随访,采用视觉类比量表获取的疼痛指数评估其镇痛效果,并比较2组受试者的溃疡愈合时间,用药前、后进行血常规、血生化和心电图检查.结果试验组和对照组完成病例分别为115例和113例(P＞0.05).初诊时2组的总体疼痛指数分别为18.12±7.18和18.09±7.15(P＞0.05);第4天分别为7.56±6.87和10.00±7.07(P＜0.01);第6天分别为2.14±4.70和3.84±5.75(P＜0.01).50%受试者溃疡愈合在试验组为5 d,空白基质组为6 d.与研究药物有关的不良事件在氨来呫诺组有10例(8.40%),在空白基质组中有9例(7.5%)(P＞0.05).全部不良事件均为轻度,未经处理即好转.2组受试者在治疗结束时血常规、血生化和心电图检查结果均为正常或异常但无临床意义.结论50g/L氨来呫诺糊剂治疗复发性阿弗他溃疡是安全有效的.     

氪激光光动力治疗鲜红斑痣的初步临床观察

目的为探索真正消除鲜红斑痣病灶而不留瘢痕的治疗方法，采用氪激光光动力治疗鲜红斑痣进行临床观察。方法测定光敏剂ＰｓＤ－００７在３００－７００ｎｍ范围内的吸收曲线。随机选择２０例工斑痣患者，采用自身对照方法，应用氪激光４１３ｎｍ波长进行光动力治疗。观察照射即刻，１周至２个月的临床变化。着重观察疗效与皮肤不良反应。志愿者激光治疗前后病理活检对比观察。结果光敏剂ＰｓＤ－００７在４０８ｎｍ有最大吸收峰。临床     

The effects of argon laser irradiation on enamel decalcification: An in vivo study.

Enamel decalcification is a significant problem in orthodontic patients. The argon laser has been shown to reduce decalcification during an acidic challenge in vitro. The purpose of this study was to investigate the in vivo effects of argon laser irradiation on enamel decalcification during orthodontic treatment. Nine volunteers whose treatment plans included 4 first premolar extractions were enrolled in the study. The 36 extracted premolars were assigned to 1 of the following 4 groups: group 1, control group with no treatment; group 2 (pumice-laser), teeth were pumiced for 3 seconds and treated with a 325 mW, 5-mm diameter laser beam for 60 seconds; group 3 (pumice-etch-laser), teeth were pumiced for 3 seconds, acid-etched with 30% phosphoric acid for 30 seconds, and treated for 60 seconds with laser; and group 4 (laser only), teeth were treated for 60 seconds with laser. A specially designed (oversized) orthodontic band was fitted on each of the premolars to create a pocket for decalcification. The bands were cemented in place for 5 weeks. After extraction, the teeth were sectioned and examined under polarized light microscopy. Images of lesions were digitally analyzed and measured. Average lesion depths were calculated from 3 depth measurements recorded 10 microm apart. Average lesion area was calculated with the aid of imaging analysis software. Data were analyzed with analysis of variance (P <.05) and Student t tests. Significant differences were found in lesion depth (P <.001) and lesion area (P <.01) among the 4 test groups. The average lesion depths were 15.93 +/- 9.31 microm (control), 6.45 +/- 8.70 microm (pumice-laser), 1.71 +/- 4.82 microm (pumice-etch-laser), and 1.34 +/- 3.80 microm (laser only). The average lesion areas were 1028.67 +/- 725.68 microm (2) (control), 555.49 +/- 948.20 microm (2) (pumice-laser), 79.91 +/- 226.03 microm (2) (pumice-etch-laser), and 55.71 +/- 157.59 microm (2) (laser only). The average lesion depth in the laser-only group was reduced by 94.1% and the average lesion area was reduced by 94.4% when compared with the control group. In the pumice-etch-laser group, the average lesion depth was reduced by 89.1% and the average lesion area was reduced by 92.2% when compared with the control group. There were no significant differences in lesion depth and lesion area between maxillary and mandibular teeth (P <.06 and P <.08, respectively) and between the teeth on the right and left sides (P <.68 and P <.55, respectively). These results show that argon laser irradiation is effective in reducing enamel decalcification during orthodontic treatment. Pumicing and etching do not appear to reduce the effect of laser on enamel solubility.     

Argon laser irradiation and fluoride treatment effects on caries-like enamel lesion formation in primary teeth: an in vitro study

PURPOSE: To evaluate topical acidulated phosphate fluoride (APF) and low fluence argon laser (Ar) treatment effects on in vitro caries formation in primary tooth enamel. METHODS: 20 extracted or exfoliated primary teeth with sound buccal and lingual surfaces underwent soft tissue debridement and a fluoride-free prophylaxis. Treatment groups were: (1) Control [n=5]; (2) Ar [231mW, 10 seconds, 11.5J/cm2; n=5], (3) 1.23% APF for 4 minutes before Ar [n=5]; (4) Ar before APF [n=5]. Buccal and lingual enamel surfaces were treated, and then rinsed in deionized,distilled water (24 hours). An acid-resistant coating was applied leaving buccal and lingual sound enamel windows exposed. In vitro enamel caries was created (2.2 mM calcium, 2.2 mM phosphate, 5.0 mM fluoride, pH 3.90, 10 days). Following longitudinal sectioning, two lesions per primary tooth (10 lesions total) with each group were evaluated for lesion depth (polarized light, water imbibition) and compared (ANOVA, Duncan's Multiple Range). RESULTS: Argon laser irradiation alone provided a 41% reduction in lesion depth (176 +/- 21 microm, P< 0.05) when compared with that for the no treatment controls (297 +/- 31 microm). The combination of argon laser irradiation with APF treatment resulted in lesion depth decreases of slightly over 50% (140 +/- 23 microm for APF before ArTx; 124 +/- 17 microm for ArTx before APF, P< 0.05) compared with control lesion depths, and 20 to 30% over that for argon laser treatment alone (P< 0.05). There was no statistical difference in lesion depth regardless of whether fluoride treatment occurred before or after laser irradiation (P> 0.05).     

In vivo caries formation in enamel following argon laser irradiation and combined fluoride and argon laser treatment: a clinical pilot study.

OBJECTIVE: This in vivo pilot study investigated the role of argon laser irradiation and combined fluoride and argon laser treatment in accelerated natural caries development in sound enamel surfaces beneath plaque-retentive orthodontic bands. METHOD AND MATERIALS: Five patients (3 female, 2 male, ages 19 to 28 years) requiring tooth extraction prior to orthodontic treatment, participated in the study. Buccal surfaces were treated with either: (1) argon laser (250 mW for 10 seconds, ARGO-MOD); (2) topical fluoride (0.5% fluoride ion, Thera-Flur-N) followed by argon lasing; or (3) no treatment (control). Orthodontic bands with plaque-retentive slots on buccal surfaces were placed on the teeth slated for extraction (n = 14). Following a minimum of 5 weeks of intraoral exposure, the teeth were extracted for laboratory analysis. The teeth underwent serial longitudinal sectioning (12 sections per tooth). The sections were imbibed in water, and lesion depths were determined with each section, using polarized light microscopy. Comparisons were made among treatment groups (analysis of variance, Duncan's multiple range test for paired samples). RESULTS: Mean lesion depths were: 261 +/- 24 microm for the no treatment control group (n = 84 sections); 147 +/- 18 microm for the argon laser group (n = 24 sections); and 99 +/- 12 microm for the fluoride and argon laser group (n = 60 sections). Both the argon laser (44%) and the fluoride and argon laser groups (62%) had significant lesion depth reductions compared to controls. The addition of fluoride treatment prior to argon lasing resulted in a 32% reduction in lesion depth compared to argon laser treatment alone. CONCLUSIONS: Within this clinical pilot study, in vivo natural caries formation was affected significantly by a single exposure to low fluence argon laser irradiation. Topical fluoride treatment in combination with argon lasing provided an even greater degree of resistance against in vivo enamel caries development. A simple technique for reducing the caries susceptibility of enamel may be a clinical reality.     

Laser treatment of vascular birthmarks

Laser treatment of vascular birthmarks remains one of the more common applications of dermatologic lasers and is the treatment of choice for port-wine stains (PWS) and superficial capillary hemangiomas. Before the development of laser technology, these lesions were treated with radiation, surgical excision and grafting, cryosurgery, and camouflage with cosmetics or tattoos. All of these techniques produced unsatisfactory results or poor aesthetic outcomes. The development of the pulsed dye laser in the 1980s permitted selective photocoagulation and destruction of lesional blood vessels without damage to the surrounding normal skin, thereby producing dramatic clearing of PWS and hemangiomas with minimal risk of scarring.     

Periodontal treatment with an Er:YAG laser or scaling and root planing. A 2-year follow-up split-mouth study

BACKGROUND: Non-surgical periodontal treatment with an Er:YAG laser has been shown to result in significant clinical attachment level gain; however, clinical results have not been established on a long-term basis following Er:YAG laser treatment. Therefore, the aim of the present study was to present the 2-year results following non-surgical periodontal treatment with an Er:YAG laser or scaling and root planing. METHODS: Twenty patients with moderate to advanced periodontal destruction were treated under local anesthesia, and the quadrants were randomly allocated in a split-mouth design to either 1) Er:YAG laser (ERL) using an energy level of 160 mJ/pulse and 10 Hz, or 2) scaling and root planing (SRP) using hand instruments. The following clinical parameters were evaluated at baseline and at 1 and 2 years after treatment: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). Subgingival plaque samples were taken at each appointment and analyzed using dark-field microscopy for the presence of cocci, non-motile rods, motile rods, and spirochetes. The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. Power analysis to determine superiority of ERL treatment showed that the available sample size would yield 99% power to detect a 1 mm difference. RESULTS: The sites treated with ERL demonstrated mean CAL change from 6.3 +/- 1.1 mm to 4.5 +/- 0.4 mm (P < 0.001) and to 4.9 +/- 0.4 mm (P < 0.001) at 1 and 2 years, respectively. No statistically significant differences were found between the CAL mean at 1 and 2 years postoperatively. The sites treated with SRP showed a mean CAL change from 6.5 +/- 1.0 mm to 5.6 +/- 0.4 mm (P < 0.001) and to 5.8 +/- 0.4 mm (P < 0.001) at 1 and 2 years, respectively. The CAL change between 1 and 2 years did not present statistically significant differences. Both groups showed a significant increase of cocci and non-motile rods and a decrease in the amount of spirochetes. However, at the 1- and 2-year examination, the statistical analysis showed a significant difference for the CAL (P < 0.001, respectively) between the 2 treatment groups. CONCLUSION: It was concluded that the CAL gain obtained following non-surgical periodontal treatment with ERL or SRP can be maintained over a 2-year period.     

Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: a pilot study

The aim of this controlled, parallel design clinical study was to compare the effectiveness of an Er:YAG laser (ERL) to that of mechanical debridement using plastic curettes and antiseptic therapy for nonsurgical treatment of peri-implantitis. Twenty patients with moderate to advanced peri-implantitis lesions were randomly treated with either (1) an ERL using a cone-shaped glass fiber tip at an energy setting of 100 mJ/pulse and 10 pps (ERL), or (2) mechanical debridement using plastic curettes and antiseptic therapy with chlorhexidine digluconate (0.2%) (C). The following clinical parameters were measured at baseline, 3 and 6 months after treatment by one blinded and calibrated examiner: Plaque index (PI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). At the baseline examination, there were no statistically significant differences in any of the investigated parameters. Mean value of BOP decreased in the ERL group from 83% at baseline to 31% after 6 months (P < 0.001) and in the C group from 80% at baseline to 58% after 6 months (P < 0.001). The difference between the two groups was statistically significant (P < 0.001, respectively). The sites treated with ERL demonstrated a mean CAL change from 5.8 +/- 1 mm at baseline to 5.1 +/- 1.1 mm (P < 0.01) after 6 months. The C sites demonstrated a mean CAL change from 6.2 +/- 1.5 mm at baseline to 5.6 +/- 1.6 mm (P < 0.001) after 6 months. After 6 months, the difference between the two groups was statistically not significant (P > 0.05). Within the limits of the present study, it was concluded that (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) ERL resulted in a statistically significant higher reduction of BOP than C.     

Periodontal treatment with an Er:YAG laser compared to ultrasonic instrumentation: a pilot study

BACKGROUND: The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of ultrasonic scaling for non-surgical periodontal treatment. METHODS: Twenty patients with moderate to advanced periodontal disease were randomly treated in a split-mouth design with a single episode of subgingival debridement using either an Er:YAG laser device (160 mJ/pulse, 10 Hz) combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP diode laser radiation (ERL), or an ultrasonic instrument (UI). Clinical assessments of full-mouth plaque score (FMPS), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made at baseline and at 3 and 6 months following therapy. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the ERL group from 40% at baseline to 17% after 6 months (P<0.0001) and in the UI group from 46% at baseline to 15% after 6 months (P<0.0001). The sites treated with ERL demonstrated mean CAL gain of 1.48 +/- 0.73 mm (P<0.001) and of 1.11 +/- 0.59 mm (P<0.001) at 3 and 6 months, respectively. The sites treated with UI demonstrated mean CAL gain of 1.53 +/- 0.67 mm (P<0.001) and of 1.11 +/- 0.46 mm (P<0.001) at 3 and 6 months, respectively. No statistically significant differences were observed between the groups (P>0.05). CONCLUSION: Within the limits of the present study, it can be concluded that both therapies led to significant improvements of the investigated clinical parameters.     

Periodontal treatment with an Er: YAG laser compared to scaling and root planing. A controlled clinical study

BACKGROUND: The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of scaling and root planing for non-surgical periodontal treatment. METHODS: Twenty patients with moderate to advanced periodontal destruction were treated under local anesthesia and the quadrants were randomly allocated in a split-mouth design to either Er:YAG laser using an energy level of 160 mJ/pulse and 10 Hz or scaling and root planing (SRP) using hand instruments. Clinical assessments of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 3 and 6 months after treatment. Subgingival plaque samples were taken at each appointment and analyzed using darkfield microscopy for the presence of cocci, non-motile rods, motile rods, and spirochetes. Differences in clinical parameters and prevalence of bacterial species were analyzed using the paired t-test. RESULTS: The PI remained nearly unchanged while a significant reduction of the GI occurred in both groups after 6 months (P < or =0.001, P< or =0.001, respectively). The mean value of BOP decreased in the laser group from 56% at baseline to 13% after 6 months (P < or =0.001) and in the SRP group from 52% at baseline to 23% after 6 months (P < or =0.001). The mean value of the PD decreased in the laser group from 4.9+/-0.7 mm at baseline to 2.9+/-0.6 mm after 6 months (P< or =0.001) and in the SRP group from 5.0+/-0.6 mm at baseline to 3.4+/-0.7 mm after 6 months (P < or =0.001). The mean value of the CAL decreased in the laser group from 6.3+/-1.1 mm at baseline to 4.4+/-1.0 mm after 6 months (P < or =0.001) and in the SRP group from 6.5+/-1.0 mm at baseline to 5.5+/-1.0 after 6 months (P < or =0.001). The reduction of the BOP score and the CAL improvement was significantly higher in the laser group than in the SRP group (P < or =0.05, P < or =0.001, respectively). Both groups showed a significant increase of cocci and non-motile rods and a decrease in the amount of motile rods and spirochetes. CONCLUSIONS: An Er:YAG laser may represent a suitable alternative for non-surgical periodontal treatment.