Bacterial reduction in class II furcation after root debridment with or without Nd:YAG laser irradiation

Abstract

The use of Nd:Yag laser for bacterial reduction as an adjuvant to nonsurgical periodontal treatment has been approached in several studies. Furcation complex anatomy is responsible for comprised treatment results in this areas due to the lack of proper access for instrumentation showing the persistence of a pathogenic microbial flora. The purpose of this clinical trial, randomized, double-blinded was to evaluated the bacterial reduction achieved with the Nd:YAG associated to conventional treatment on furcation sites of patients with chronic periodontitis. In a split mouth design study, 34 class II furcations that were selected from 17 patients with chronic periodontitis. They received previous full mouth periodontal treatment, except for the experimental sites. The 17 furcations of the Control group underwent twice manual and ultrasonic root debridment in weekly intervals. The Test group received the same treatment as the Control group followed by the Nd:YAG laser application (100mJ/pulse; 1.5W; 15Hz; 60sec). The microbiological parameters total numbers of anaerobic Colony Forming Units(CFU); Black pigmented CFU and the level of Actinobacillus actinomycetemcomitans(Aa), Porphyromonas gingivalis (Pg) and Prevotella intermedia(Pi) were determined at baseline, immediatly and one month after the treatment. The results showed a significant reduction of total CFU for both groups immediately after the treatment, but it was better for the Test group. After one month the total CFU average increased but was still below pretreatment levels for both groups. The black pigmented CFU and the level of Aa, Pg e Pi decreased significantly after the treatment but 30 days after there was an increase almost equal to baseline levels for both groups. The Nd:Yag laser associated with convencional treatment promoted bacterial reduction on class II furcation immediately after its application.