Effect of Photodynamic Therapy, Diode Laser, and Deep Scaling on Cytokine and Acute-Phase Protein Levels in Gingival Crevicular Fluid of Residual Periodontal Pockets
Effect of Photodynamic Therapy, Diode Laser, and Deep Scaling on Cytokine and Acute-Phase Protein Levels in Gingival Crevicular Fluid of Residual Periodontal Pockets
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DOI：
10.1902/jop.2011.110281
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发表时间：
2012-08-01
影响因子：
4.3
通讯作者：
Mombelli, Andrea
中科院分区：
文献类型：
--
作者：
Giannopoulou, Catherine;Cappuyns, Isabelle;Mombelli, Andrea
背景：包括牙齿激光和光动力疗法(PDT)在内的治疗方案的益处一直存在争议。本研究的目的是比较光动力疗法、半导体软激光(DSL)和传统的深度刮治和根面平整(SRP)在残留牙周袋中的局部生物学效果。方法：根据既往牙周炎治疗史和探诊时探诊深度<4 mm和出血的部位的持续性，纳入32例患者。剩余的眼袋用超声波清创，然后随机分配给PDT、DSL或SRP。分别于治疗前、治疗后14天、治疗后2个月和6个月采集龈沟液。结果：与治疗前比较，PDT、DSL、SRP治疗后14天、2个月时，IL-17、碱性成纤维细胞生长因子、粒细胞集落刺激因子、粒细胞巨噬细胞集落刺激因子、巨噬细胞炎性蛋白1-α水平均明显降低。除粒细胞集落刺激因子外，这些差异在整个观察期内仍然显著。6个月时5种急性期蛋白(α-2巨球蛋白、结合球蛋白、血清淀粉样蛋白P、降钙素原和组织型纤溶酶原激活物)水平显著高于基线水平。三种治疗方式在任一时间点的各项生化指标均无显著差异。结论：无论何种治疗方式，治疗后多种细胞因子和急性期蛋白水平均有明显变化。没有证据表明特定的DSL或PDT增强了炎症介质的表达。《月刊》2012；83：1018-1027。
Background: There is an ongoing controversy on the benefits of treatment protocols, including dental lasers and photodynamic therapy (PDT). The purpose of this study is to compare the local biologic effects of PDT, diode soft laser (DSL) therapy, and conventional deep scaling and root planing (SRP) in residual pockets.Methods: Thirty-two individuals were included based on a history of previous treatment for periodontitis and the persistence of sites with probing depths >4 mm and bleeding on probing. Residual pockets were debrided with an ultrasonic device and then randomly assigned either to PDT, DSL, or SRP. Gingival crevicular fluid was collected before treatment, after 14 days, and at 2 and 6 months. Levels of 13 cytokines and nine acute-phase proteins were measured using a bead-based multiplexing analysis system.Results: Treatment with PDT, DSL, or SRP led to significant changes in several cytokines and acute-phase proteins: Compared with baseline, levels of interleukin-17, basic fibroblast growth factor, granulocyte colony-stimulating factor, granulocyte macrophage colony-stimulating factor, and macrophage inflammatory protein 1-alpha were lower 14 days and 2 months after treatment. Except for granulocyte colony-stimulating factor, these differences remained significant throughout the observation period. The levels of five acute-phase proteins (alpha-2 macroglobulin, haptoglobin, serum amyloid P, procalcitonin, and tissue plasminogen activator) were significantly higher at 6 months than at baseline. No significant differences were observed among the three treatment modalities at any time point for any biochemical parameter.Conclusions: Levels of several cytokines and acute-phase proteins significantly changed after treatment regardless of treatment modality. There was no evidence for a specific DSL- or PDT-enhanced expression of inflammatory mediators. J Periodontol 2012;83:1018-1027.