CLINICAL AND RADIOGRAPHIC COMPARISONS OF TWO LOW-POWER LASER APPLICATION TECHNIQUES AS AN ADJUNCT TO BASIC PERIODONTAL THERAPY IN PATIENTS WITH PERIODONTITIS: A CONTROLLED AND RANDOMIZED CLINICAL TRIAL
periodontitis, low-power laser therapy, photobiomodulation, non-surgical periodontal treatment.
Background: Photobiomodulation has been used as an adjunct to basic periodontal therapy (BPT) due to its effects on inflammation modulation and acceleration of tissue repair. However, there isn't a standardized protocol for laser application. Aim: To evaluate and compare two techniques of low-power laser application - transgingival (LBPT) and intrasulcular (LBPI) - used in Photobiomodulation as an adjunct to BPT in patients with periodontitis. Methods: This is a randomized, split-mouth, double-blind clinical trial where, from each patient, 3 diseased sites (with interproximal attachment loss of at least 1 mm and probing depth of 4 mm or more), in different quadrants, were selected for one of three treatment groups: RAR group (control group), RAR + LBPT group (test 1), and RAR + LBPI group (test 2). Low-power laser therapy in the test groups was performed at three time points - 48 hours, 7, and 14 days after completing full-mouth RAR. Clinical parameters of probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed before treatment (T0), and at 3 months (T1) and 6 months (T2). Additionally, standardized periapical radiographs were used to measure and compare radiographic bone density 6 months after treatment completion. ANOVA for repeated measures was used for quantitative variables, and the chi-square test for the categorical variable using a significance level of p < 0.05 and confidence intervals of 95%. Results: Statistically significant reductions in PD (p < 0.001) and CAL (p < 0.001) were observed in all three treatment groups at 3 and 6 months compared to baseline, with no significant differences between the groups. No difference in radiographic bone density was found between the treatment groups at 6 months. Conclusion: With the limitations of this study, the results suggest that compared to isolated BPT, adjunct photobiomodulation does not bring additional benefits, regardless of the laser application technique used.
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