The Effect of Argon Laser on Periodontal Disease

치주질환에 대한 Argon 레이저의 효과

  • Ahn, Hyung-Joon (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Ryu, Ji-Won (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kim, Jae-Hong (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kim, Chong-Youl (Dept. of Oral Medicine, College of Dentistry, Yonsei University)
  • 안형준 (연세대학교 치과대학 구강내과학 교실) ;
  • 유지원 (연세대학교 치과대학 구강내과학 교실) ;
  • 김재홍 (연세대학교 치과대학 구강내과학 교실) ;
  • 김종열 (연세대학교 치과대학 구강내과학 교실)
  • Published : 2005.06.30

Abstract

The purpose of this study was to evaluate photothermal effect of laser, which eliminates and reduces bacteria causing periodontal disease, on treatment of periodontal disease. This study included subjects with moderate periodontitis who visited the Department of Oral Medicine, College of dentistry, Yonsei University. The subjects were divided into experimental group, where Argon laser treatment was used, and control group, where conventional subgingival curettage was used. Gingival fluids from each subject were collected prior and after 1 week of the treatment, and changes in number of bacterial colonies cultured from aerobic as well as anaerobic bacteria responsible for the periodontal disease, and changes in clinical indices related to the periodontal disease, such as plaque index, gingival index, sulcus bleeding index, were analysed. As a result, the number of bacterial colonies of aerobic and anaerobic bacteria reduced after 1 week of the treatment in both groups, especially the bacterial colonies of anaerobic bacteria which showed statistically significant reduction(p<0.1). However, there was no significant difference between the experimental group and the control group. Clinical indices including plaque index, gingival index, sulcus bleeding index were reduced after 1 week of the treatment in both groups. In the experimental group, gingival index(p<0.1) and sulcus bleeding index(p<0.01) showed significant reduction, and, in the control group, sulcus bleeding index(p<0.01) showed significant reduction. However, there were no significant differences in each indices between the two groups. The above results suggest that Argon laser could be used as a substitute of conventional subgingival curettage, or in combination with subgingival curettage which would increase the effect of the treatment. Although the possibility of clinical application of Argon laser was observed in this study, more randomized-controlled research, including acquirement of sufficient samples as well as long-termed follow up, would be necessary before clinically effective application of Argon laser.

치주질환을 야기하는 세균을 제거하고, 세균집락을 감소시키는 레이저 에너지의 광열적 작용을 이용하여 치주질환의 치료에 대한 효과를 알아보고자, 연세대학교 치과대학병원 구강내과에 내원한 중등도의 치주질환을 가진 환자를 대상으로, 각각 Argon 레이저를 이용한 치은연하 소파술과 통상적인 치은연하 소파술을 시행하여 비교하였다. 시술 전과 시술 1주 후 각각 치은열구액을 채취하여 치주질환의 중요한 원인인 호기성 세균과 혐기성 세균에 대해 배양된 세균 군락수의 변화를 비교하고, 또한 치태지수, 치은지수, 치면열구 출혈지수와 같은 치주질환과 관련된 임상적 지표의 변화를 비교하였다. 연구 결과, 호기성 세균 및 혐기성 세균에 대한 세균 군락 수 비교 시, Argon 레이저를 이용하여 치주치료를 시행한 실험군과 치은연하 소파술을 시행한 대조군 모두 시술 전에 비해 시술 1주 후 세균의 군락 수에 있어서 감소 양상을 나타내었고, 특히 혐기성 세균의 군락 수에 있어서는 통계학적으로 유의한 감소 양상을 나타내었으며(p<0.1), 두 군 사이에 통계학적으로 유의한 차이는 없었다. 또한 치주조직의 상태를 나타내는 지표로서 이용되는 치태지수, 치은지수 및 치은열구 출혈지수의 비교 시 Argon 레이저를 이용하여 치주치료를 시행한 실험군과 치은연하 소파술을 시행한 대조군 모두 시술 전에 비해 시술 1주 후 지수의 감소양상을 나타내었고, 특히 Argon 레이저를 이용한 실험군에서는 치은지수(p<0.1)와 치은열구 출혈지수(p<0.01)가, 치은연하 소파술을 시행한 대조군에서는 치은열구 출혈지수(p<0.01)가 통계학적으로 유의한 감소 양상을 나타내었다. 그러나 두 군 사이에 각각의 지수에 있어서 모두 통계학적으로 유의한 차이는 없었다. 이상의 연구 결과, 중등도의 치주질환의 치료에 있어서 Argon 레이저는 치은연하 소파술을 대신하거나 또는 치은연하 소파술과 병용하여 치료 효과를 더욱 상승시켜주는 유의한 치료법이라고 사료되며, 본 연구 결과 임상적 적용 가능성이 있다고 보여지나, 보다 효과적으로 임상에 적용하기 위해서는 앞으로 충분한 표본의 확보 및 장기적인 예후 관찰을 포함한 더욱 정밀하게 조절된 연구가 필요하리라고 사료된다.

Keywords

References

  1. Newman MG, Socransky SS, Savitt ED, Propas DA, Crawford A. Studies of the microbiology of periodontosis. J Periodontol 1976;47:373-379 https://doi.org/10.1902/jop.1976.47.7.373
  2. Haffajee AD, Dzink JL, Socransky SS. Effect of modified widman flap surgery and systemic tetracycline on the subgingival microbiota of periodontal lesions. J Clin Periodontol 1988;15:255-262 https://doi.org/10.1111/j.1600-051X.1988.tb01579.x
  3. Haffajee AD, Socransky SS, Dzink JL, Taubman MA, Ebersole JL. Clinical, microbiological and immunological features of subjects with refractory periodontal diseases. J Clin Periodontol 1988;15:390-398 https://doi.org/10.1111/j.1600-051X.1988.tb01017.x
  4. Listgarten MA, Socransky SS. Ultrastructural characteristics of a spirochete in the lesion of acute necrotizing ulcerative gingivostomatitis(Vincent's infection). Arch Oral Bio 1964;9:95-96 https://doi.org/10.1016/0003-9969(64)90050-0
  5. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy. J Clin Periodontal 1981;8:57-72 https://doi.org/10.1111/j.1600-051X.1981.tb02024.x
  6. Isidor F, Karring T. Long-term effect of surgical and nonsurgical periodontal treatment. A 5-year clinical study. J Periodontal Res 1986;21:462-472 https://doi.org/10.1111/j.1600-0765.1986.tb01482.x
  7. Isidor F, Karring T, Attstrom R. The effect of root planing as compared to that of surgical treatment. J Clin Periodontol 1984;11:669-681 https://doi.org/10.1111/j.1600-051X.1984.tb01315.x
  8. Carranza, F.A.Jr. Glickman's Clinical periodontology. 7th ed., 1990, W.B. Saunders Co
  9. Maiman TH. Stimulated optical radiation in ruby. Nature 1960;187:493 https://doi.org/10.1038/187493a0
  10. Goldman L, Hornhy P, Meyer R, Goldman B. Impact of the laser on the dental caries. Nature 1964;203:417
  11. Cobb CM, McCawley TK, Killoy WJ. A preliminary study on the effects of the Nd:YAG laser on root surfaces and subgingival microflora in vivo. J. Periodontol 1992;63:701-707 https://doi.org/10.1902/jop.1992.63.8.701
  12. Misra V, Mehrotra KK, Dixit J, Maitra SC. Effect of a carbon dioxide laser on periodontally involved root surfaces. J Periodontol 1999;70(9):1046-1052 https://doi.org/10.1902/jop.1999.70.9.1046
  13. Cheing-Meei Liu, Lein-Yuan Hou, Man-Ying Wong, Wan-Hong Lan. Comparison of Nd:YAG laser versus scaling and root planing in periodontal therapy. J Periodontol 1999;70:1276-1282 https://doi.org/10.1902/jop.1999.70.11.1276
  14. Radvar M, Creanor SL, Gilmour WH, Payne AP, McGadey J, Foye RH, Whitters CJ, Kinane DF. An evaluation of the effects of an Nd:YAG laser ono subgingival calculus, dentine and cementum. An in vitro study. J Clin Periodontol 1995;22:71-77 https://doi.org/10.1111/j.1600-051X.1995.tb01773.x
  15. Radvar M, MacFarlane TW, MacKenzie D, Whitters CJ, Payne AP, Kinane DF. An evaluation of the Nd:YAG laser in periodontal pocket therapy. Br Dent J 1996;180(2):57-62 https://doi.org/10.1038/sj.bdj.4808976
  16. Schwarz F, Sculean A, georg T, Reich E. Periodontal treatment with an Er:YAG laser compared to scaling and root planing. A controlled clinical study. J Periodontol 2001;72(3):361-367 https://doi.org/10.1902/jop.2001.72.3.361
  17. Folwaczny M, Mehl A, Haffner C, Benz C, Hickel R. Root substance removal with Er:YAG laser radiation at different parameters using a new dilivery system. J Periodontol 2000;71(2):147-155 https://doi.org/10.1902/jop.2000.71.2.147
  18. Aoki A, Ando Y, Watanabe H, Ishikawa I. In vitro studies on laser scaling of subgingival calculus with an erbium:YAG laser. J Periodontol 1994;65(12): 1097-1106 https://doi.org/10.1902/jop.1994.65.12.1097
  19. Aoki A, Miura M, Akiyama F, Nakagawa N, Tanaka J, Oda S, Watanabe H, Ishikawa I. In vitro evaluation of Er:YAG laser scaling of subgingival calculus in comparison with ultrasonic scaling. J Periodontol Res 2000;35:266-277
  20. Frentzen M, Braun A, Aniol D. Er:YAG laser scaling of diseased root surfaces. J Periodontol 2002;73:524-530 https://doi.org/10.1902/jop.2002.73.5.524
  21. Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T. Effect of galium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med 2002;30(1):60-66 https://doi.org/10.1002/lsm.10010
  22. Neumann KA, Knobler RM. Treatment of oral mucous cysts with an argon laser. Arch Dermatol 1990;126(6):829-830 https://doi.org/10.1001/archderm.126.6.829
  23. Finkbeiner RL. The results of 1328 periodontal pockets treated with the argon laser : selective pocket thermolysis J Clin Laser Med Surg 1995;13(4):273-281
  24. Ramfjord SP. The periodontal index(PDI). J. Periodontol 1967;38:602-610 https://doi.org/10.1902/jop.1967.38.6.602
  25. Muhlemann HR, Son S. Gingival sulcus bleeding-A leading symptom in initial gingivitis. Helv Odontol Acta 1971;15:107-113
  26. Bass CC. An effective method of personal oral hygiene. J La State Med Soc 1954;106(3):100-112
  27. Miserendino LJ, Levy G, Miserendino CA. Laser interaction with biologic tissues. In Miserendino LJ, Levy G, Miserendino CA(Ed). Lasers in dentistry. Chicago Illinois, 1995, Quintessence Publishing Co. Inc., pp.39-55
  28. Gold SI, Vilardi MA. Pulsed laser beam effect on gingiva. J Clin Periodontol 1994;21:391-396 https://doi.org/10.1111/j.1600-051X.1994.tb00735.x
  29. Gunsolley JC, Zambon JJ, Mellott CA, Brooks CN, Kaugars CC. Periodontal therapy in young aults with severe generalized periodontitis. J Periodontol 1994;65:268-273 https://doi.org/10.1902/jop.1994.65.3.268
  30. Mombelli A, Gmur R, Gobbi C, Lang NR. Actinobacillus actinomycetemcomitans in adult periodontitis. II. Characterization of isolated strains and effect of mechanical periodontal treatment [see comments]. J Periodontol 1994;65:827-834 https://doi.org/10.1902/jop.1994.65.9.827
  31. Sato K, Yoneyama T, Okamoto H, Dahlen G, Lindhe J. The effect of subgingival debridement on periodontal disease parameters and the subgingival microbiota. J Clin Periodontol 1993;20:359-365 https://doi.org/10.1111/j.1600-051X.1993.tb00373.x
  32. Henry C, Dyer B, Judy M. Selectivity of argon laser on phototoxicity of microbes. ISLD 3rd Int Congress 1992a;4
  33. Henry C, Dyer B, Judy M. Phototoxicity of argon laser on ptevotella and porphyromonas. ISLD 3rd Int Congress 1992b;28
  34. Lavanchy DL, Bickel M, Baehni PC. The effect of plaque control after scaling and root planing on the subgingival microflora in human periodontitis. J Clin Periodontol 1987;14:295-299 https://doi.org/10.1111/j.1600-051X.1987.tb01536.x
  35. Mousques T, Listgarten MA, Phillips RW. Effect of scaling and root planing on the composition of the human subgingival microbial flora. J Periodont Res 1980;15:144-157 https://doi.org/10.1111/j.1600-0765.1980.tb00268.x
  36. Muller HP, Hartmann J, Flores-de-Jacoby L. Clinical alterations in relation to the morphological composition of the subgingival microflora following scaling and root planing. J Clin Periodontol 1986;13:825-829 https://doi.org/10.1111/j.1600-051X.1986.tb02237.x
  37. Boucher CO. Current clinical dental terminology. A glossary of accepted terms in all disciplines of dentistry. St. Louis, 1988, Mosby
  38. Miserendino LJ, Levy G, Miserendino CA. Surgical applications of the argon laser. In Kutsch VK, Blankenau RJ(Ed). Lasers in dentistry. Chicago Illinois, 1995, Quintessence Publishing Co. Inc., pp.129-143
  39. Caffesse RG, Sweeney PL, Smith BA. Scaling and root planing with and without periodontal flap surgery. J. Clin. Periodontol 1986;13:205-210 https://doi.org/10.1111/j.1600-051X.1986.tb01461.x
  40. Lindhe J, Socransky S, Nyman S, Haffajee A, Weatfelt E. Critical probing depths in periodontal therapy. J. Clin. Periodontol 1982;9:323-336 https://doi.org/10.1111/j.1600-051X.1982.tb02099.x