Chronic Periodontitis Clinical Trial
Official title:
Randomized Clinical Trial Assessing the Clinical Outcomes and Recolonization Patterns Following Scaling and Root Planing With and Without Using Er.YAG Laser in Chronic Periodontitis Patients
Dental bacterial plaque is the most frequent modifiable finding in patients with periodontal
(gum) diseases. Many studies have provided evidence that mechanical removal of dental plaque
is critical for improving the periodontal health. The standard initial treatment of
periodontitis (gum disease) is to remove plaque and calculus form the teeth and root
structures using sclaing and root planing (SRP). Typically hand instruments and an ultrasonic
scaler are used for SRP
While this method removes some of the bacteria that leads to periodontitis, microorganisms
are not completely eliminated through SRP. Studies have shown that after 3 months, the
bacteria initially present prior to scaling and root planing had recolonized. In order to
prevent recurrence of periodontitis, it is recommended that oral bacteria be kept at low
levels.
When used at the proper wave length, dental lasers have been shown to effectively removes
calculus, without damaging surrounding tissue. The Er:YAG laser has been FDA-approved for the
use of scaling and root planing in Dentistry. While studies on the Er:YAG laser have shown
that it is effective in removing calculus and preserving the tooth root structure, there is
no consensus of the level of calculus removal. The Er:YAG laser may also be more effective in
removing microbial bacteria than SRP with hand instruments and ultrasonic scaler.
The purpose of this study is to evaluate the effectiveness of the Er:YAG laser, as an adjunct
to scaling and root planing, in removing microbial bacteria. Participants with chronic
periodontitis will be randomized to have one quadrant undergo scaling and root planing using
hand instruments and ultrasonic scaler alone, while a second quadrant will receive the same
treatment, with the addition of the Er:YAG laser. Outcomes studies will be traditional
periodontal clinical parameters at 6 weeks and 3 months after treatment. Microbial cultures
will be performed at baseline and 3 months to compare survival and re-population by
periodontal microorganisms.
Primary Aim: The primary aim of this study is to evaluate the efficacy of Er:YAG laser as an
adjunct to mechanical scaling and root planing periodontal therapy by comparing probing depth
and clinical attachment levels.
Secondary aim: The secondary aim of this study is to evaluate the efficacy of Er:YAG laser as
an adjunct to mechanical scaling and root planing periodontal therapy by comparing gingival
bleeding index and plaque index.
Tertiary aim: The tertiary aim of this study is to compare the microbial outcomes of
mechanical periodontal therapy alone vs. mechanical therapy combined followed with Er:YAG
laser therapy at the same time.
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