Periodontal and peri-implant wound healing following laser therapy
Periodontal and peri-implant wound healing following laser therapy
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DOI：
10.1111/prd.12080
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发表时间：
2015-06-01
影响因子：
18.6
通讯作者：
Izumi, Yuichi
中科院分区：
文献类型：
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作者：
Aoki, Akira;Mizutani, Koji;Izumi, Yuichi
激光照射具有许多有利的特性，例如消融或汽化、止血、生物刺激（光生物调节）和微生物抑制和破坏，其诱导各种有益的治疗效果和生物反应。因此，使用激光被认为是有效的，适用于治疗各种炎症和感染性口腔疾病。CO2、掺钕钇铝石榴石（Nd：YAG）和半导体激光器主要用于牙周软组织治疗。随着掺铒钇铝石榴石（Er：YAG）和掺铒、铬钇钪镓石榴石（Er，Cr：YSGG）激光器的发展，不仅可以应用于软组织，而且可以应用于牙齿硬组织，激光的应用范围从牙周软组织治疗急剧扩展到硬组织治疗。目前，各种牙周组织（如牙龈，牙根和骨组织），以及钛种植体表面，可以用激光治疗，和各种牙科激光系统正在用于牙周和种植体周围疾病的管理。在牙周病学中，机械治疗通常是治疗的主流;然而，完全的细菌根除和/或最佳的伤口愈合可能不一定仅用传统的机械治疗来实现。因此，除了由抗生素和抗炎剂组成的化疗外，使用激光和发光二极管的光疗已逐渐与机械治疗相结合，以通过实现彻底的清创、去污和组织刺激来增强随后的伤口愈合。随着受益证据的增加，低强度和高强度激光治疗在牙周和种植体周围疾病的伤口愈合/组织再生中发挥着重要作用。本文讨论了激光治疗在软组织管理，牙周非手术和手术治疗，骨手术和种植体周围治疗的结果，重点是牙周和种植体周围组织的术后伤口愈合，基于现有的基础和临床研究的科学证据，以及病例报告。
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2, neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.