Effect of Low-level Laser Therapy and Platelet-rich Fibrin on the Treatment of Intra-bony Defects
Journal of Lasers in Medical Sciences,
Vol. 11 No. 4 (2020),
3 October 2020
,
Page 456-463
Abstract
Introduction: Attempts to regenerate the periodontal osseous defect, which is lost as a result of periodontal disease, require the tapping of the innate healing potential of periodontium through appropriately designed therapeutic strategies. A multitude of grafted and non-grafted approaches have been used in the management of Intra-bony defects. However, they do not provide predictable periodontal regeneration. The aim of this study was to evaluate the combined effect of low-level laser therapy (LLLT) and platelet-rich fibrin (PRF), in site modulated intra-bony defects (decortication), which were accessed using a simplified papilla preservation flap (SPPF), on the clinical and radiographic outcomes of periodontal disease.
Methods: A total of 30 patients with intra-bony defects were recruited for the study and randomly distributed in two groups (n=15). Test group sites were accessed with SPPF and the defects received intra-marrow Penetration (IMP) following debridement and were irradiated with a low-level laser followed by PRF grafting and suturing done. The control group defects were accessed with SPPF and grafted with PRF before being secured by sutures. The plaque and bleeding score, PPD, CAL, and the position of the gingival margin with radiographic defect depth were recorded and analyzed at baseline and six months post-intervention using the student’s t-test and Wilcoxon signed-rank test.
Results: The test group showed a clinically relevant increase in mean PPD reduction, CAL gain, and radiographic bone fill (3.6 ± 1.35 mm, 3.26 ± 1.16 mm, and 2.44 ± 1.24 mm) compared to the control group (2.93 ±1.1 mm, 2.267 ± 1.33 mm and 1.26 ± 0.99 mm) six months post-intervention. However, intergroup comparison between the test and control groups did not show any statistically significant difference.
Conclusion: These results highlight that test protocol had greater amelioration of the effects of periodontal disease and all the investigated clinical and radiographic parameters showed considerable improvement from baseline to 6 months within the test and control group, but intergroup comparison between the test and control groups did not show any statistically significant difference, indicating statistical equivalence between the test and control protocol.
- Intra-bony defect; Intra-marrow penetration; Low-level laser therapy; Platelet rich fibrin; Simplified papilla preservation flap
How to Cite
References
Dabra S, Chhina K, Soni N, Bhatnagar R. Tissue engineering in periodontal regeneration: A brief review. Dent Res J (Isfahan). 2012;9(6):671-680.
Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e37-44. doi: 10.1016/j.tripleo.2005.07.008.
Schär MO, Diaz-Romero J, Kohl S, Zumstein MA, Nesic D. Platelet-rich concentrates differentially release growth factors and induce cell migration in vitro. Clin Orthop Relat Res. 2015;473(5):1635-43. doi: 10.1007/s11999-015-4192-2.
Hamajima S, Hiratsuka K, Kiyama-Kishikawa M, Tagawa T, Kawahara M, Ohta M, et al. Effect of low-level laser irradiation on osteoglycin gene expression in osteoblasts. Lasers Med Sci. 2003;18(2):78-82. doi: 10.1007/s10103-003-0255-9.
Cortellini P, Tonetti MS. Minimally invasive surgical technique and enamel matrix derivative in intra‐bony defects. I: Clinical outcomes and morbidity. J Clin Periodontol. 2007;34(12):1082-8. doi: 10.1111/j.1600-051X.2007.01144.x.
O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43(1):38-40. doi: 10.1902/jop.1972.43.1.38.
Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25:229-35.
Thorat M, Pradeep AR, Pallavi B. Clinical effect of autologous platelet‐rich fibrin in the treatment of intra‐bony defects: a controlled clinical trial. J Clin Periodontol. 2011;38(10):925-32. doi: 10.1111/j.1600-051X.2011.01760.x.
Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: A randomized controlled clinical trial. J Periodontol. 2011;82(12):1705-12. doi: 10.1902/jop.2011.110075.
Tonetti MS, Cortellini P, Suvan JE, Adriaens P, Baldi C, Dubravec D, et al. Generalizability of the added benefits of guided tissue regeneration in the treatment of deep intrabony defects. Evaluation in a multi‐center randomized controlled clinical trial. J Periodontol. 1998;69(11):1183-92. doi: 10.1902/jop.1998.69.11.1183.
Joseph VR, Raghunath A, Sharma N. Clinical effectiveness of autologous platelet rich fibrin in the management of infrabony periodontal defects. Singapore Dent J. 2012;33(1):5-12. doi: 10.1016/j.sdj.2012.10.003.
Pradeep AR, Rao NS, Agarwal E, Bajaj P, Kumari M, Naik SB. Comparative evaluation of autologous platelet-rich fibrin and platelet-rich plasma in the treatment of 3-wall intrabony defects in chronic periodontitis: a randomized controlled clinical trial. J Periodontol. 2012;83(12):1499-507. doi: 10.1902/jop.2012.110705.
Kreisler M, Christoffers AB, Willershausen B, d'Hoedt B. Effect of low‐level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: an in vitro study. J Clin Periodontol. 2003;30(4):353-8. doi: 10.1034/j.1600-051x.2003.00001.x.
Shah M, Deshpande N, Bharwani A, Nadig P, Doshi V, Dave D. Effectiveness of autologous platelet-rich fibrin in the treatment of intra-bony defects: A systematic review and meta-analysis. J Indian Soc Periodontol. 2014;18(6):698-704. doi: 10.4103/0972-124X.147400.
Ajwani H, Shetty S, Gopalakrishnan D, Kathariya R, Kulloli A, Dolas RS, et al. Comparative evaluation of platelet-rich fibrin biomaterial and open flap debridement in the treatment of two and three wall intrabony defects. J Int Oral Health. 2015;7(4):32-7.
Kiyosaki T, Mitsui N, Suzuki N, Shimizu N. Low-level laser therapy stimulates mineralization via increased Runx2 expression and ERK phosphorylation in osteoblasts. Photomed Laser Surg. 2010;28(Suppl 1):S167-72. doi: 10.1089/pho.2009.2693.
Aleksic V, Aoki A, Iwasaki K, Takasaki AA, Wang CY, Abiko Y, et al. Low-level Er: YAG laser irradiation enhances osteoblast proliferation through activation of MAPK/ERK. Lasers Med Sci. 2010;25(4):559-69. doi: 10.1007/s10103-010-0761-5.
Zhang RF, Wang Q, Zhang AA, Xu JG, Zhai LD, Yang XM, et al. Low-level laser irradiation promotes the differentiation of bone marrow stromal cells into osteoblasts through the APN/Wnt/β-catenin pathway. Eur Rev Med Pharmacol Sci. 2018;22(9):2860-8. doi: 10.26355/eurrev_201805_14988.
- Abstract Viewed: 963 times
- PDF Downloaded: 502 times