Long-term efficacy of microbiology-driven periodontal laser-assisted therapy
Long-term efficacy of microbiology-driven periodontal laser-assisted therapy
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DOI：
10.1007/s10096-015-2555-y
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发表时间：
2016-03-01
影响因子：
4.5
通讯作者：
Medico, E.
中科院分区：
文献类型：
--
作者：
Martelli, F. S.;Fanti, E.;Medico, E.
牙周炎是一种非常普遍的健康问题，会导致严重的功能障碍、生活质量下降以及全身性疾病的风险增加，包括呼吸系统疾病、心血管疾病和骨关节疾病、糖尿病和生育问题。这是多因素疾病的典型例子，环境因素、生活方式和遗传背景有利于多种微生物感染诱发牙周组织慢性炎症。由于牙周病原体可以在血管化不良的龛位中定植，因此通常需要使用防腐剂和抗生素来进行局部治疗来控制缺陷，但结果不稳定，尤其是在早发病例中。在此，报告了一项回顾性研究的结果，评估了一种方案（牙周生物激光辅助治疗，Perioblast (TM)）的功效，通过该方案，牙周袋的微生物分析用于确定局部掺钕钇铝石榴石（Nd：YAG）激光照射加常规治疗的范围和持续时间。该方案对 2683 名患者进行了多中心应用，发现即使在侵袭性病例中，所有临床和细菌学参数也能产生显着且持久的改善。对选定牙袋的微生物组测序揭示了治疗后的主要种群变化，以及在没有已知病原体的情况下可能与牙周炎相关的菌株。这项研究首次进行了如此大规模的系列研究，清楚地证明了微生物学驱动的非侵入性牙周病治疗的长期疗效。
Periodontitis represents a highly prevalent health problem, causing severe functional impairment, reduced quality of life and increased risk of systemic disorders, including respiratory, cardiovascular and osteoarticular diseases, diabetes and fertility problems. It is a typical example of a multifactorial disease, where a polymicrobial infection inducing chronic inflammation of periodontal tissues is favoured by environmental factors, life style and genetic background. Since periodontal pathogens can colonise poorly vascularised niches, antiseptics and antibiotics are typically associated with local treatments to manage the defects, with unstable outcomes especially in early-onset cases. Here, the results of a retrospective study are reported, evaluating the efficacy of a protocol (Periodontal Biological Laser-Assisted Therapy, Perioblast (TM)) by which microbial profiling of periodontal pockets is used to determine the extent and duration of local neodymium-doped yttrium aluminium garnet (Nd: YAG) laser irradiation plus conventional treatment. The protocol was applied multicentrically on 2683 patients, and found to produce a significant and enduring improvement of all clinical and bacteriological parameters, even in aggressive cases. Microbiome sequencing of selected pockets revealed major population shifts after treatment, as well as strains potentially associated with periodontitis in the absence of known pathogens. This study, conducted for the first time on such a large series, clearly demonstrates long-term efficacy of microbiology-driven non-invasive treatment of periodontal disease.