The Efficacy of Diode Laser (810-980 nm) as an Adjunct to Non-Surgical Treatment of Periodontitis on Porphyromonas gingivalis: A Randomized Split-Mouth Study

Abstract

Abstract: Periodontitis is a chronic, complex inflammatory condition linked to dysbiotic plaque biofilms and marked by the progressive deterioration of the tooth-supporting structures. Porphyromonas gingivalis, a critical periodontal infection, is known to significantly contribute to the onset and advancement of periodontal illnesses by inducing a dysbiotic alteration in the overall, particularly sub-gingival, gram-positive and gram-negative periodontal microbiota. Conventional therapies, including scaling and root planing (SRP), seek to eliminate plaque and tartar from the surfaces of teeth and subgingival areas. Nonetheless, these treatments are accompanied by certain limitations.The advent of diode lasers has demonstrated potential as an adjuvant therapy, possibly improving the results of traditional treatments.
Aim of the study: This study aimed to compare the effectiveness of the diode laser as an adjunctive treatment modality for nonsurgical treatment versus SRP only on the colony-forming unit (CFU) of the Porphyromonas gingivalis in patients with periodontitis.
Material and methods: This research was structured as a singular, randomized controlled, split-mouth clinical experiment. Twenty-five persons (11 females and 14 men aged 20 to 56 years) diagnosed with periodontitis, participated in this research. Following primary periodontal treatment, which included dental hygiene guidelines and scaling procedures, each patient underwent two separate treatments on opposing sides of the mouth. The left side was designated as the test group, while the right side was allocated to the control group. Randomization was accomplished by a coin toss to guarantee impartial allocation.In the test group(left side) patients underwent scaling and root planing (SRP) in conjunction with diode laser therapy; in the opposing control group (right side) they received scaling and root planing (SRP) treatment exclusively. The laser was set at a 1.5 W, continuous wave, 400 μm tip, contact, and sweeping technique. 50 Subgingival plaque samples were taken after recording periodontal parameters, plaque index(PI), bleeding on probing(BOP), periodontal pocket depth(PPD), and clinical attachment loss (CAL) at baseline before, immediately after 3 days, 1 week, and 12 weeks post-treatment. Microbiological assessments focused on the colony-forming unit of Porphyromonas gingivalis (P.G). Colony-forming units (CFU) were enumerated for each group for 48-72 hours on a suitable culture medium following serial dilution. Clinically isolated bacteria were confirmed by using the biochemical test, microscopic examination,viteck II system, and finally by PCR technique (16S rRNA).
Result: Colony-forming units (CFU) reduced with both forms of treatment and did not return to the initial concentrations three months after therapy. The SRP plus the diode laser group exhibited significantly higher reductions in bacterial levels of P. gingivalis at 3 days, 1 week, and 3 months after treatment in comparison to SRP treatments alone.