Komparativna klinička evaluacija terapijskih efekata lasera male snage i hijaluronske kiseline na kataralni gingivitis kod dece
Sažetak
Uvod/Cilj. Kataralni gingivitis je najčešće oboljenje oralne sluzokože kod dece i predstavlja inflamaciju gingive eksudativne prirode. Cilj rada je bio da se kliničkim parametrima oceni efikasnost lasera male snage i hijaluronske kiseline na kataralni gingivitis kod dece. Metode. Ispitivanjem je obuhvaćeno 100 dece sa stalnom denticijom, kojima je dijagnostikovan gingivitis catarrhalis. Isptitanici su podeljeni u dve grupe: I grupu su činili pacijenti sa inflamiranom gingivom (gingivitis catarrhalis – 50 ispitanika), kojima je nakon uklanjanja mekih i čvrstih naslaga primenjena terapija aplikovanjem hijaluronske kiseline; II grupu su činili pacijenti sa inflamiranom gingivom (gingivitis catarrhalis – 50 ispitanika), kod kojih je nakon uklanjanja mekih i čvrstih naslaga primenjena terapija laserom male snage. Klinička procena terapijskih efekata lasera male snage i hijaluronske kiseline na gingivitis catarrhalis vršena je uz pomoć odgovarajućih indeksa: plak indeks po Greene-Vermillion-u (PI), Muhlemannov indeks krvarenja (IKR) i Community Periodontal Index of Treatment Needs (CPITN). Rezultati. Studentovim t-testom zavisnih uzoraka dobijena je statistički značajna razlika (p < 0,001) između PI, IKR i CPITN indeksa pre i PI, IKR, i CPITN indeksa posle terapije u obe ispitivane grupe. Takođe CPITN indeks posle terapije ispitanika II grupe bio je statistički značajno niži (p < 0,05) u odnosu na ispitanike I grupe. Zaključak. Dobijeni rezultati pokazuju izuzetno dobar efekat hijaluronske kiseline i lasera male snage uz bazičnu terapiju u lečenju kataralnih gingivitisa kod dece. Nesto bolji rezultati dobijeni su u kombinaciji bazične terapije i lasera male snage.
Reference
Feres M, Haffajee AD, Allard K, Som S, Socransky SS. Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemically-administered amoxicillin or met-ronidazole. J Clin Periodontol 2001; 28(7): 597–609.
Rams TE, Listgarten MA, Slots J. Utility of 5 major putative periodontal pathogens and selected clinical parameters to pre-dict periodontal breakdown in patients on maintenance care. J Clin Periodontol 1996; 23(4): 346–54.
Dahiya P, Kamal R. Hyaluronic Acid: a boon in periodontal therapy. N Am J Med Sci 2013; 5(5): 309–15.
Casale M, Moffa A, Vella P, Sabatino L, Capuano F, Salvinelli B, et al. Hyaluronic acid: Perspectives in dentistry. A systematic review. Int J Immunopathol Pharmacol 2016; 29(4): 572–82.
Pozza DH, Fregapani PW, Weber JB, de Oliveira MG, Oliveira MA, Ribeiro Neto N, et al. Analgesic action of laser therapy (LLLT) in an animal model. Med Oral Patol Oral Cir Bucal 2008; 13(10): E648–52.
Obradović R, Kesić L, Jovanović G, Petrović D, Radičević G, Mihailo-vić D. Low power laser efficacy in the therapy of inflamed gin-giva in diabetics with parodontopathy. Vojnosanit Pregl 2011; 68(8): 684–9. (Serbian)
Obradović R, Kesić L, Mihailović D, Antić S, Jovanović G, Petrovic A, et al. A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus. Lasers Med Sci 2013; 28(1): 19–24.
Pamuk F, Lütfioğlu M, Aydoğdu A, Koyuncuoglu CZ, Cifcibasi E, Badur OS. The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plas-minogen activator and plasminogen activator inhibitor 1 in smoking and non-smoking chronic periodontitispatients: A split-mouth, randomized control study. J Periodontal Res 2017; 52(5): 872–82.
Demirturk-Gocgun O, Baser U, Aykol-Sahin G, Dinccag N, Issever H, Yalcin F. Role of Low-Level Laser Therapy as an Adjunct to Initial Periodontal Treatment in Type 2 Diabetic Patients: A Split-Mouth, Randomized, Controlled Clinical Trial. Pho-tomed Laser Surg 2017; 35(2): 111–5.
Suresh S, Merugu S, Mithradas N, Sivasankari T. Low-level laser therapy: A biostimulation therapy in periodontics. SRM J Res Dent Sci 2015; 6(1): 53–6.
Cobb CM. Lasers in periodontics: a review of the literature. J Periodontol 2006; 77(4): 54.
Dederich DN, Bushick RD. ADA Council on Scientific Affairs and Division of Science. Journal of the American Dental As-sociation. Lasers in dentistry: separating science from hype. J Am Dent Assoc 2004; 135(2): 204–12 ; quiz 22.
Teymouri F, Farhad SZ, Golestaneh H. The Effect of Photody-namic Therapy and Diode Laser as Adjunctive Periodontal Therapy on the Inflammatory Mediators Levels in Gingival Crevicular Fluid and Clinical Periodontal Status. J Dent (Shi-raz) 2016; 17(3): 226–32.
Moseley R, Waddington RJ, Embery G. Hyaluronan and its po-tential role in periodontal healing. Dent Update 2002; 29(3): 144–8.
Giannobile WV, Riviere GR, Gorski JP, Tira DE, Cobb CM. Glycosaminoglycans and periodontal disease: analysis of GCF by safranin O. J Periodontol 1993; 64(3): 186–90.
Jentsch H, Pomowski R, Kundt G, Göcke R. Treatment of gingivi-tis with hyaluronan. J Clin Periodontol 2003; 30(2): 159–64.
Mesa FL, Aneiros J, Cabrera A, Bravo M, Caballero T, Revelles F, et al. Antiproliferative effect of topic hyaluronic acid gel. Study in gingival biopsies of patients with periodontal disease. Histol Histopathol 2002; 17(3): 747–53.
Pistorius A, Rockmann P, Martin M, Willershausen B. The clinical application of hyaluronic acid in gingivitis therapy. Quintes-sence Int 2005; 36(7–8): 531–8.
Rodrigues SV, Acharya AB, Bhadbhade S, Thakur SL. Hyalu-ronan-containing mouthwash as an adjunctive plaque-control agent. Oral Health Prev Dent 2010; 8(4): 389–94.
Sahayata VN, Bhavsar NV, Brahmbhatt NA. An evaluation of 0.2% hyaluronic acid gel (Gengigel ®) in the treatment of gin-givitis: a clinical & microbiological study. Oral Health Dent Manag 2014; 13(3): 779–85.
Pagnacco O, Vangelisti R, Erra C, Poma A. Double-blind clinical trial vs. Placebo of a new sodium-hyaluronate-based gingival gel. Transl Attualita` Terapeutica Int 1997; 4: 1–12.
Vangelisti R, Pagnacco O, Erra C. Hyaluronic acid in the topical treatment of gingival inflammations: preliminary clinical trial. Transl Attualita` Terapeutica Int 1997; 3: 1–7.
Kuo T, Speyer MT, Ries WR, Reinisch L. Collagen thermal dam-age and collagen synthesis after cutaneous laser resurfacing. Lasers Surg Med 1998; 23(2): 66–71.
Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, Manzi CT. Low-level laser therapy in the management of disorders of the maxillofacial region. J Clin Laser Med Surg 1997; 15(4): 181–3.
Reddy GK, Stehno-Bittel L, Enwemeka CS. Laser photostimula-tion of collagen production in healing rabbit Achilles tendons. Lasers Surg Med 1998; 22(5): 281–7.
Gam AN, Thorsen H, Lønnberg F. The effect of low-level laser therapy on musculoskeletal pain: a meta-analysis. Pain 1993; 52(1): 63–6.
Basford JR. Low intensity laser therapy: still not an established clinical tool. Lasers Surg Med 1995; 16(4): 331–42.
Honmura A, Yanase M, Obata J, Haruki E. Therapeutic effect of Ga-Al-As diode laser irradiation on experimentally induced inflammation in rats. Lasers Surg Med 1992; 12(4): 441–9.
Albertini R, Aimbire FS, Correa FI, Ribeiro W, Cogo JC, Antunes E, et al. Effects of different protocol doses of low power gal-liumaluminum-arsenate (Ga-Al-As) laser radiation (650 nm) on carrageenan induced rat paw oedema. J Photochem Photo-biol B 2004; 74(2–3): 101–7.