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Royal Dental College of Aarhus II


Documentation — Royal Dental College of Aarhus II

N. Lioubavina, J. Jensen, T. Karring.
Royal Dental College, University of Aarhus, Denmark.

The aim of the study was to compare the effect of surgical treatment with Nd: YAG lasers versus that of conventional reverse bevelled flap (RBF) lasers in adult patients with severe Periodontitis.

Patients were subjected to a hygienic phase, including oral hygiene instructions, professional supra- and subgingival sealing.

At baseline after four weeks, 14 patients who presented at least two sites per quadrant with a pocket depth (PPD) = 6mm in two quadrants of the mouth were included in the study. At these sites the PPD, clinica1 attachment level (CAL), proportions of sites per quadrant with plaque (PL-Score), or bleeding on probing (BL-Score) were recorded by an investigator. Then, in one randomly chosen quadrant, RBF was performed at sites with PPD = 6 mm under local anaesthesia by another investigator. In the other quadrant, gingival tissue was excised at sites with PPD = 6 mm with the Nd: Y AG Genius laser (Mølsgaard Dental, Copenhagen) without local anaesthesia, except for four patients.

The laser parameters were: power — 7 W; pulse width — 250 microseconds; frequency — 50 Hz, water spray — 4 and air spray — 5. No suturing was needed after laser surgery. Following surgeries, patients performed mouth rinsing with 0.2% chlorhexidine for a week. After three and six months, PPD, CAL, PL-Scores and BL-Scores were recorded “blindly” at the treated sites.

Results revealed that both treatments showed similar (p>0.05, paired t-test) improvement of all clinical parameters at three and six months. RBF resulted in significant (p<0.001, paired t-test) reduction of the initial PPD (mean ± SD, mm) at three and six months (3.1±0.8 and 2.8±0.7, respectively). This was similar (p>0.05) to 2.6±0.7 and 2.4±0.6, observed after laser surgery at the same healing periods. At three and six months, CAL-gain (mean ± SD, mm) was 1.8±1.2 and 1.5±1.0 following RBF, while 1.6±1.0 and 1.6±0.7 following laser surgery.

At three and six months, BL-Score was significantly decreased from 0.67 to 0.27 and 0.43 after RBF, and from 0.68 to 0.31 and 0.25 after laser surgery. PL-Score was significantly (p<0.001, paired t-test) decreased only after laser surgery at six months. Postsurgical pain was found in one patient (<1%) after laser treatment, whereas it was found in seven patients (50%) after RBF. Postsurgical swelling occurred in eight patients (57%) only after RBF.

At the end of the study, all patients chose laser surgery as a preferable treatment. In conclusion, Nd: YAG laser surgery resulted in improvements of all clinical parameters in deep periodontal pockets. similar to conventional periodontal surgery. However, there were fewer postsurgical complications following laser surgery.