Observation Of Curative Effect Of Twinlight Laser Treatment On Chronic Periodontitis

Objective: Scraping and curing root surface under the gum(scaling and root planning,SRP)treatment is an important method of periodontal foundation treatment.Laser assisted SRP treatment can improve the clinical curative effect,but there are limitations which can not use on the periodontal hard and soft tissue at the same time and the influence of periodontal attachment using laser treatment.This experiment with application of two different wavelengths laser Er:YAG(erbium: yttrium-aluminum-garnet)laser and diode laser combined treatment of curing chronic periodontitis.By observing clinical effects index,content of inflammatory and growth factors in gingival crevicular fluid;and comparing mechanical SRP treatment and Er:YAG laser treatment curative effect,to evaluate the curative effect of twinlight laser treatment on chronic periodontitis.Methods:1 Experimental subjects : Based on the diagnostic criteria of chronic periodontitis presented by American Academy of Periodontology classification seminar in 1999,30 patients chronic periodontitis were selected randomly from Hebei Province Stomatological Hospital,aged from 30 to 58 years old and average age was 41,including 17 male and 13 female.2 Grouping:In one week after subgingival scaling,the selected patients were randomly divided into three groups: Group SRP: mechanical scaling and root planning treatment;Group ERL: Er: YAG Laser treatment under the gum scraping treatment and root planning;Group TPT: diode laser with Er: YAG treatment plus diode laser treatment.3 Experimental method: Observe and record one week(baseline)after subgingival scaling,after 6 and 12 weeks after treatment,changes of following clinical indicators: PD(probing depth),BOP(bleeding on probing)and CAL(clinical attachment level).Completing of the application of visual analogue scale method(visual analogue scale,VAS)records immediately the pain in patient after baseline treatment.Randomly select two loci(PD?5mm)from each patient and application of real-time PCR and ELISA technology to test the baseline,six weeks after treatment,12 weeks posttreatment,and detect the changes of Porphyromonas gingivalis(Pg)content relative to total bacteria in subgingival plaque and changes of Tumor Necrosis Factor-?(TNF-?)and Interleukin-1?(IL-1?)and basic fibroblast growth factor(b-FGF)and transforming growth factor,TGF-? content in each group by using real-time PCR technology and ELISA.Analyze data with repeated measures analysis of variance by using SPSS 21.0 software,compare data at different time and between different groups respectively.Results:1 Clinical indicatorsAfter treatment,gingival swelling almost disappeared,texture changed from soft to tough,the amount of bleeding decreased in three groups.Repeated measures analysis of variance showed that there were interaction at different time points and between groups(P<0.05).At the baseline,there was no statistically significant difference in PD,BOP,CAL among three groups(P>0.05).Compared with the baseline,there was statistically significant difference in PD,BOP,CAL in three groups 6 weeks and 12 weeks after treatment(P<0.05),which indicates that SRP and laser treatment both can improve periodontal clinical features obviously as very effective periodontal non-surgical treatment.At the sixth and twelfth week,there is statistical of differences between PD,CAL,BOP amang three groups(P<0.05).All indexes of PD,BOP,CAL in TPT group below the ERL and SRP group,showed that the twinlight laser treatment has a better effect comparatively as well as long lasting,meanwhile the TPT group and BOP positive points evidently less than ERL group and SRP group.VAS indicator comparison of these three groups patients gave reveals TPT group was VAS(2.84±0.32),SRP VAS(5.20±0.36),ERL VAS(3.91±0.28),these differences indicates the statistical significance(P<0.05),which means twinlight laser treatment can effectively reduce pains during treatment.2 Pg content relative to tota bacteriaRepeated measures analysis of variance showed that there were interaction at different time points and between groups(P<0.05).At baseline,there was no statistically significant difference in Pg content relative to total bacteria among three groups(P>0.05).Compared with the baseline,there was statistically significant difference in Pg content relative to total bacteria in three groups 6 weeks and 12 weeks after treatment(P<0.05).The content of Pg relative to total bacteria were lower than the baseline at 6 and 12 weeks after treatment,showed that treatment with SRP alone and laser treatment can effectively kill bacteria.After 6 and 12 weeks treatment,the difference of Pg content relative total bacteria amang three groups was statistically significant(P<0.05).Three group's periodontal pathogen Pg reduced significantly of great proportion of all bacterium.The content of Pg from TPT group were significantly lower than ERL,SRP group,and ERL below SRP group,which showed that the effect of twinlight laser treatment is better.3 IL-1?,TNF-?,b-FGF and TGF-? content in gingival crevicular fluidRepeated measures analysis of variance showed that there were interaction at different time points and between groups(P<0.05).At baseline,there was no statistically significant difference in TNF-?,IL-1?,b-FGF and TGF-? content in gingival crevicular fluid among three groups(P>0.05).Compared with the baseline,there was statistically significant difference in IL-1?,TNF-? content in gingival crevicular fluid in three groups 6 weeks and12 weeks after treatment(P<0.05).Three groups of IL-1?,TNF-? content at 6and 12 weeks after treatment were lower than the baseline.This indicates that SRP and laser treatment can both control gingiva inflammation,and reduce the quantity of IL-1?,TNF-? of gingival crevicular fluid.At 6 and 12 weeks after treatment,TPT group content of IL-1?,TNF-? group were significantly lower than ERL,SRP,and ERL below SRP group,the difference was statistically significant(P<0.05),suggesting TPT anti-inflammatory effect is more better.Compared with the baseline,there was statistically significant difference in b-FGF and TGF-? content in gingival crevicular fluid in three groups 6 weeks and 12 weeks after treatment(P<0.05).Three groups of TGF-? and b-FGF content at 6 and 12 weeks after treatment were higher than the baseline.This indicates that SRP and laser treatment can both facilitate the growth of TGF-?and b-FGF.After 6,12 weeks' treatment,TPT group of TGF-? and b-FGF content were significantly higher than that of ERL,SRP group,and ERL group is higher than the SRP,and the difference was statistically significant(P<0.05),indicating that the tiwnlight laser treatment facilitates the growth of and the effects are best.Conclusions:1 Twinlight laser treatment can effectively control periodontal inflammation,improve clinical symptoms,relieve the suffering of the patients at the same time.2 Compared to SRP treatment,twinlight laser treatment's sterilization effect is better.It can significantly both reduce the content of IL-1?,TNF-? in patients in gingival sulcus fluid,and accelertate the b-FGF and TGF-?secretion.3 Twinlight laser has a good clinical efficacy,promoting periodontal reattachment,and the operation is simple,safe,and can be widely used in the basis treatment of periodontitis.