Efectos clínicos y osteoinmunológicos de la fototerapia láseraplicada en dosis repetidas y complementaria al raspado y alisado radicular en el tratamiento de la periodontitis crónica

Abstract

The aim of this study was to evaluate the clinical, anti-inflammatory and osteoimmunological benefits of the repeated Laser Phototherapy (PT) as an adjunctive treatment of periodontal disease. Eighteen patients with chronic periodontitis were randomly divided into two groups of 9 patients each in order to undergo scaling and root planing (SRP) and SRP followed by adjunctive repeated PT five times in 2 weeks (Days 1, 2, 4, 7, 11) (SRP+ rPT). For phototherapy session, a diode laser (Lambda= 670 nm, 200 mW, 60 seconds per tooth) was applied into the sulcus. Clinical parameters, including fullmouth plaque score (FMPS), full-mouth bleeding score (FMBS) and probing pocket depth (PPD) were recorded at baseline, 4 and 8 weeks after treatment. Additionally, at the same periods of time, samples of gingival crevicular fluid (GCF) were taken. Interleukin-1beta (IL-1ß), tumour necrosis factor alpha (TNF-a), Receptor Activator of Nuclear Factor 'KB Ligand (RANKL) and osteoprotegerin (OPG) levels in the collected GCF were measured. PT used in repea-ted doses does not produce a significant reduction in the clinical parameters essayed (p>0.05). However, the levels of IL-1ß and TNF-a in the FCG and the value of the ratio RANKL / OPG were significantly reduced in the SRP+rPT group compared to SRP group (p<0,05). PT applied in repeated doses, exerts an effect of blostimulation on the periodontal tissue.