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      Minimally Invasive Treatment of Infrabony Periodontal Defects Using Dual-Wavelength Laser Therapy

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          Abstract

          Introduction. Surgical management of infrabony defects is an invasive procedure, frequently requiring the use of adjunctive material such as grafts or biologics, which is time-consuming and associated with expense and morbidity to the patient. Lasers in periodontal regeneration have been reported in the literature, with each wavelength having potential benefits through different laser-tissue interactions. The purpose of this case series was to assess the efficacy of a new dual-wavelength protocol in the management of infrabony defects. Materials and Methods. 32 defects (one in each patient) were treated using ultrasonic debridement, followed by flapless application of Erbium, Chromium:Yttrium, Scandium, Gallium, Garnet (Er,Cr:YSGG) laser (wavelength 2780 nm), and final application of diode laser (wavelength 940 nm). Pocket depths (PD) were measured after 6 months and repeat radiographs taken after one year. Results. The mean baseline PD was 8.8 mm (range 6–15 mm) and 6 months later was 2.4 mm (range 2–4 mm), with mean PD reduction being 6.4 ± 1.7 mm (range 3–12 mm). There was a significant gain in relative linear bone height (apical extent of bone), with mean percentage bone fill of 39.7 ± 41.2% and 53% of sites showing at least 40% infill of bone. Conclusion. The results compare favourably with traditional surgery and require further validation through randomised clinical controlled trials.

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          Most cited references44

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          Periodontal and peri-implant wound healing following laser therapy.

          Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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            Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts.

            Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts.
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              Periodontal regeneration - intrabony defects: a consensus report from the AAP Regeneration Workshop.

              Treatment of intrabony defects is an important therapeutic goal of periodontal therapy. The goal of this consensus report was to critically appraise the evidence for the available approaches for promoting periodontal regeneration in intrabony defects. In addition to evaluating the effectiveness of new regenerative approaches for intrabony defects, recommendations for future research were defined for this area.

                Author and article information

                Journal
                Int Sch Res Notices
                Int Sch Res Notices
                ISRN
                International Scholarly Research Notices
                Hindawi Publishing Corporation
                2356-7872
                2016
                2 June 2016
                : 2016
                : 7175919
                Affiliations
                1Al-FaPerio Clinic, 48A Queens Road, Buckhurst Hill, Essex IG9 5BY, UK
                2Department of Periodontology, King's College London Dental Institute, Floor 21, Tower Wing Guys Hospital, London SE 1 9RT, UK
                Author notes

                Academic Editor: Jiiang H. Jeng

                Author information
                http://orcid.org/0000-0002-1757-4970
                Article
                10.1155/2016/7175919
                4912985
                27366790
                f12b64fe-414c-49d5-9156-928ab8f83fac
                Copyright © 2016 Rana Al-Falaki et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 January 2016
                : 15 April 2016
                : 26 April 2016
                Categories
                Clinical Study

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