BackgroundTo compare the efficacy of combined treatment of Er:YAG laser (ERL) and low‐level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non‐surgical periodontal treatment.MethodsIn a randomized controlled trial, 25 non‐smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL‐1β, TNF‐α, IL‐10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months.ResultsFor initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3‐month follow‐up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6‐month follow‐up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3‐month follow‐up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6‐month follow‐up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow‐up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups.ConclusionThe combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets.Plain Language SummaryTo compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low level laser therapy into standard periodontal treatment may enhance the treatment's benefits in reducing pocket depth, especially for severe conditions.

中文翻译：

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Er:YAG激光与低强度激光联合应用非手术治疗牙周炎


背景比较 Er:YAG 激光 (ERL) 和低强度激光治疗 (LLLT) 联合治疗与单激光应用以及洗牙和根面平整 (SRP) 用于非手术牙周治疗的疗效。方法在一项随机对照试验中，招募了 25 名不吸烟的 II 期或 III 期牙周炎患者。口腔内的四个象限被随机分配为四种不同的治疗方法：（1）ERL+SRP+LLLT联合应用； (2) ERL 加 SRP； (3) SRP加LLLT； (4) 建议零售价。我们评估了牙周指数，包括探诊深度 (PD)、临床附着水平 (CAL)、出血指数 (BI) 和菌斑指数 (PLI)，以及三种细胞因子（IL-1β、TNF-α、IL-10）基线、3 个月和 6 个月时龈沟液和龈下牙菌斑中的红色复合病原体。结果对于初始中等牙周袋 (4 mm ≤ PD ≤ 6 mm)，采用 ERL+SRP+LLLT、ERL+SRP 和 SRP 治疗的象限在 3 个月的随访（1.25 ± 1.06、1.23 ± 1.12、1.00 ± 1.21 与 0.98 ± 1.21 mm）和 6 个月的随访（ 1.35 ± 1.06、1.23 ± 1.17、1.35 ± 0.98 与 0.98 ± 1.23 毫米）（p = 0.002）。在 3 个月的随访中（0.96 ± 1.42、0.61 ± 1.39 与 0.55 ± 1.57 mm）和 6 个月的随访中，使用 ERL+SRP+LLLT 和 SRP+LLLT 治疗的象限显示出比对照象限更多的 CAL 增益平均值‐向上（0.84 ± 1.54、0.89 ± 1.49 与 0.48 ± 1.68 毫米）（p = 0.008）。对于初始深袋（PD ≥ 7 mm），与随访时的对照象限相比，ERL+SRP+LLLT 象限有更多的 PD 改善和 CAL 增益。四组间BI、PLI、炎性细胞因子和牙周病原菌均无显着差异。结论 ERL 和 LLLT 的联合应用显示出减少 PD 的潜在功效，特别是对于深部口袋。 通俗总结比较 Er:YAG 激光 (ERL) 和低强度激光治疗 (LLLT) 联合使用与单激光应用的治疗效果，和传统的牙周治疗（SRP）。共有25名非吸烟牙周炎患者参与研究，他们的口腔被分为四个部分，每个部分接受不同的治疗：ERL+SRP+LLLT、ERL+SRP、SRP+LLLT和SRP。在基线、3个月和6个月时评估临床指标和实验室指标。六个月后，对于初始中度牙周袋，联合激光组和单一激光组在减少牙周袋深度和增加附着水平方面比传统组表现出更好的改善。但对于初始资金雄厚的情况，只有组合激光组比传统组表现出更好的改善。各组之间的出血、斑块、炎症或有害细菌水平没有显着差异。这些发现表明，将 Er:YAG 激光和低强度激光治疗整合到标准牙周治疗中可能会增强治疗在减少牙周袋深度方面的益处，特别是对于严重的情况。