Impact of Low-level Laser Therapy As an Adjunct to Non-surgical Periodontal Treatment on the Levels of Tissue Plasminogen Activator and Plasminogen Activator Inhibitor 1 in Stage 3-4, Grade C Periodontitis Patients: a Split-mouth, Randomized Control...

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2023 Sep 14

PMID 37709984

Authors

F Pamuk

M Lutfioglu

T Paksoy

C Z Koyuncuoglu

N G Polat

E Cifcibasi

S Yildirim

A Kantarci

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system.

Materials And Methods: Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA.

Results: Clinical parameters, total GCF tPA (tPA) and PAI-1 (PAI-1) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPA levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPA levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1 levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05).

Conclusion: Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels.

Clinical Relevance: LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.

References

Manresa C, Sanz-Miralles E, Twigg J, Bravo M . Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis. Cochrane Database Syst Rev. 2018; 1:CD009376. PMC: 6491071. DOI: 10.1002/14651858.CD009376.pub2. View

Sanz I, Alonso B, Carasol M, Herrera D, Sanz M . Nonsurgical treatment of periodontitis. J Evid Based Dent Pract. 2012; 12(3 Suppl):76-86. DOI: 10.1016/S1532-3382(12)70019-2. View

Umeda M, Takeuchi Y, Noguchi K, Huang Y, Koshy G, Ishikawa I . Effects of nonsurgical periodontal therapy on the microbiota. Periodontol 2000. 2004; 36:98-120. DOI: 10.1111/j.1600-0757.2004.03675.x. View

Keestra J, Grosjean I, Coucke W, Quirynen M, Teughels W . Non-surgical periodontal therapy with systemic antibiotics in patients with untreated aggressive periodontitis: a systematic review and meta-analysis. J Periodontal Res. 2014; 50(6):689-706. DOI: 10.1111/jre.12252. View

Sedghi L, DiMassa V, Harrington A, Lynch S, Kapila Y . The oral microbiome: Role of key organisms and complex networks in oral health and disease. Periodontol 2000. 2021; 87(1):107-131. PMC: 8457218. DOI: 10.1111/prd.12393. View

Joseph S, Curtis M . Microbial transitions from health to disease. Periodontol 2000. 2021; 86(1):201-209. DOI: 10.1111/prd.12377. View

Teughels W, Dhondt R, Dekeyser C, Quirynen M . Treatment of aggressive periodontitis. Periodontol 2000. 2014; 65(1):107-33. DOI: 10.1111/prd.12020. View

Darveau R, Curtis M . Oral biofilms revisited: A novel host tissue of bacteriological origin. Periodontol 2000. 2021; 86(1):8-13. DOI: 10.1111/prd.12374. View

Sgolastra F, Petrucci A, Gatto R, Monaco A . Effectiveness of systemic amoxicillin/metronidazole as an adjunctive therapy to full-mouth scaling and root planing in the treatment of aggressive periodontitis: a systematic review and meta-analysis. J Periodontol. 2011; 83(6):731-43. DOI: 10.1902/jop.2011.110432. View

10.

Rabelo C, Feres M, Goncalves C, Figueiredo L, Faveri M, Tu Y . Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis. J Clin Periodontol. 2015; 42(7):647-57. DOI: 10.1111/jcpe.12427. View

11.

Calderin S, Garcia-Nunez J, Gomez C . Short-term clinical and osteoimmunological effects of scaling and root planing complemented by simple or repeated laser phototherapy in chronic periodontitis. Lasers Med Sci. 2012; 28(1):157-66. DOI: 10.1007/s10103-012-1104-5. View

12.

Meimandi M, Talebi Ardakani M, Esmaeil Nejad A, Yousefnejad P, Saebi K, Tayeed M . The Effect of Photodynamic Therapy in the Treatment of Chronic Periodontitis: A Review of Literature. J Lasers Med Sci. 2017; 8(Suppl 1):S7-S11. PMC: 5642183. DOI: 10.15171/jlms.2017.s2. View

13.

Grzech-Lesniak K, Matys J, Dominiak M . Comparison of the clinical and microbiological effects of antibiotic therapy in periodontal pockets following laser treatment: An in vivo study. Adv Clin Exp Med. 2018; 27(9):1263-1270. DOI: 10.17219/acem/70413. View

14.

Schwarz F, Aoki A, Becker J, Sculean A . Laser application in non-surgical periodontal therapy: a systematic review. J Clin Periodontol. 2008; 35(8 Suppl):29-44. DOI: 10.1111/j.1600-051X.2008.01259.x. View

15.

Ren C, McGrath C, Jin L, Zhang C, Yang Y . The effectiveness of low-level laser therapy as an adjunct to non-surgical periodontal treatment: a meta-analysis. J Periodontal Res. 2016; 52(1):8-20. PMC: 5297978. DOI: 10.1111/jre.12361. View

16.

Qadri T, Miranda L, Tuner J, Gustafsson A . The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol. 2005; 32(7):714-9. DOI: 10.1111/j.1600-051X.2005.00749.x. View

17.

Aykol G, Baser U, Maden I, Kazak Z, Onan U, Tanrikulu-Kucuk S . The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol. 2010; 82(3):481-8. DOI: 10.1902/jop.2010.100195. View

18.

Lai S, Zee K, Lai M, Corbet E . Clinical and radiographic investigation of the adjunctive effects of a low-power He-Ne laser in the treatment of moderate to advanced periodontal disease: a pilot study. Photomed Laser Surg. 2008; 27(2):287-93. DOI: 10.1089/pho.2007.2206. View

19.

Takasaki A, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang C . Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000. 2009; 51:109-40. DOI: 10.1111/j.1600-0757.2009.00302.x. View

20.

Kurgan S, Onder C, Balci N, Fentoglu O, Eser F, Balseven M . Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy. J Periodontal Res. 2016; 52(3):574-581. DOI: 10.1111/jre.12425. View