PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
PERIO - Periodontal Practice Today 1 (2004), No. 4 (12.01.2005)
Clinic and Histologic Evaluation of Human Intrabony Defects Treated with an Er:YAG Laser. A Case Report Study
Sculean, Anton/Schwarz, Frank/Windisch, Peter/Keglevich, Tibor/Gerharz, Dieter/Becker, Jürgen
The aim of the present report was to clinically and histologically investigate the healing of advanced intrabony defects in humans following access flap surgery with root surface and defect debridement using an Er:YAG laser. Six patients, each of whom displayed one advanced intrabony defect around teeth or roots scheduled for extraction, were included in the study. The defects were treated with access flap surgery followed by root surface and defect debridement with an Er:YAG Laser (KEY2® KaVo, Biberach, Germany) (160 mJ, 10 pulses/s). The following clinical parameters were recorded at baseline and at 6 months: probing pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). Healing was uneventful in all cases. Six months after surgery, the teeth or roots were extracted together with some of their surrounding soft and hard tissues and processed for histologic evaluation. Clinical examination revealed PD reduction and a CAL gain in all six cases. The histologic evaluation revealed that healing was predominantly characterized by formation of a LJE along the instrumented root surface. Formation of a new connective tissue attachment (i.e. new cementum with inserting collagen fibers) was observed in two out of the six specimens. New connective tissue attachment was also accompanied by bone regeneration in one of these two specimens. There was no evidence of laser induced thermal side effects in any of the evaluated specimens. Within its limits, the present study failed to show predictable periodontal regeneration in advanced human intrabony defects following access flap surgery with root surface and defect debridement using an Er:YAG laser.
Keywords: surgical periodontal treatment, Er:YAG laser, human histology, intrabony defects, long junctional epithelium