Nonsurgical periodontal therapy with/without 980 nm diode laser in patients after myocardial infarction: a randomized clinical trial

Abstract

The purpose of this study was to evaluate the possible benefits (in terms of periodontal status improvement and periodontal bacteria count reduction) of using 980 nm diode laser in the treatment of periodontitis in patients after myocardial infarction. Thirty-six patients under 65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after myocardial infarction, were recruited for the study. The control group (n = 18) received SRP (scaling, root planing and polishing) while the test group (n = 18) received SRP followed by laser therapy of the periodontal pockets with 980 nm diode laser, 1 W, continuous wave mode, 20 s per tooth side. Procedures were repeated twice at 5-7 day intervals. Microbiological and periodontal examination, including periodontal pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP) and plaque control record (PCR), were performed before treatment, 2 weeks and 3 months after treatment. The study was registered on ClinicalTrials.gov with Identifier: NCT04145557, 29.10.2019 "retrospectively registered". Additional use of laser resulted in a significant reduction in pockets with PPD ≥ 7 mm (p = 0.0151). The diode laser reduced total bacteria count (p = 0.0154) and delayed recolonisation during a 3-month observation period. A significant increase in the number of Capnocytophaga gingivalis was observed in the control group (p = 0.048). Additional use of the diode laser after SRP had no significant effect on BOP, CAL and PCR. Within the limitations of our study, we can conclude that 980 nm diode laser can be a useful tool in the treatment of periodontitis in patients after myocardial infarction.

Keywords: Diode laser; Nonsurgical periodontal debridement; Periodontal pathogens reduction; Periodontitis, myocardial infarction.

Fig. 1

CONSORT 2010 flow diagram of the study

Fig. 2

PPD in test and control group at baseline, 2 weeks and 3 months after treatment. There was a statistically significant reduction of percentage of pockets deeper than 7 mm in the test group. *p < 0.05 is statistically significant

Fig. 3

CAL in test and control group at baseline, 2 weeks and 3 months after treatment. There were no statistically significant differences between the test and control group before and after treatment in CAL. p < 0.05 is statistically significant

Fig. 4

Total bacteria count in test and control group at baseline, 2 weeks and 3 months after treatment. There was statistically significant reduction of total bacteria count in test group after 3 months after treatment. *p < 0.05 is statistically significant