IL-1β, TNF-α, Total Antioxidative Status and Microbiological Findings in Chronic Periodontitis Treated With Fluorescence-Controlled Er:YAG Laser Radiation

Background and Objective: Although some studies have attempted to elucidate the possible advantages of the use of Er:YAG laser radiation as a coadjuvant of scaling and root planing (SRP), the results have often been contradictory. A new possibility to improve the results of the laser therapy is the control of the laser radiation by a feedback system that selectively detects subgingival calculus. This study compared the effects of fluorescence-controlled Er:YAG radiation after SRP with SRP alone on the treatment of chronic periodontitis. Study Design/Materials and Methods: Thirty patients with chronic periodontitis were randomly distributed into two groups of 15 patients to receive: SRP or SRP followed by fluorescence controlled Er:YAG laser (SRP+ERL). Clinical parameters including probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI) were recorded and samples of gingival crevicular fluid (GCF) and subgingival plaque were taken at baseline, 4 and 8 weeks postoperatively. The laser therapy was performed 1 day after the SRP procedure. The GCF samples were analyzed for interleukin-1beta (IL-1 beta), tumor necrosis factor alpha (TNF-alpha) and total antioxidative status (TAS). Subgingival plaque was examined by culture for 10 bacteria. Results: During the observation periods (4 and 8 weeks postoperatively), no statistically significant differences were detected for clinical, microbiological variables and TAS of GCF between SRP and SRP+ERL groups. However, the amount of IL-1 beta and TNF-alpha in GCF was increased after SRP procedure in contrast to a slight decrease of their levels after SRP+ERL treatment, where in addition the process of recolonization seems to be more delayed. Conclusion: SRP+ERL allowed a decrease of the levels of proinflammatory cytokines and prevented a fast process of recolonization. Lasers Surg. Med. 42:24-31, 2010. (C) 2010 Wiley-Liss, Inc.