치은염 환자에서 저출력 이산화탄소 레이저의 치은염 환자에서의 염증완화 효과에 관한 연구

Abstract

Laser treament has been expected to serve as an alternative or adjunctive treatment to conventional, mechanical therapy in periodontics due to various advantages, such as ablation or vaporization, hemostate, and sterilization effect. In this study, we investigated the effects of low-power CO2 laser on proliferation on human gingival fibroblast cells so that determine laser application mode. And we compared low-power CO2 laser treatment to ultrasonic scaling, which is generally approved as a power-driven mechanical instrumentation, and evaluated both of these treatments regarding their clinical effectiveness and change in the volume of in gingival crevicular fluid. In vitro study, MTT assay were used for assessment of proliferation on hGF. The result showed the most increase in group which were irradiated with 30 Hz, 150 usec mode in 60 secs. In clinical study, 20 patients who had gingivitis were selected. All patients haa no systemic problems. Randomly selected, one quadrant received ultrasonic scaling and CO2 laser irradiation(group 1), another quadrant received ultrasonic scaling only(group 2), the other quadrant received CO2 laser irradiation only(group 3). the last quadrant was control group. Clinical parameters measured at baseline, 1 weeks, 2weeks, 4weeks and 8weeks after the treatments. Pocket probing depth and clinical attachment level were not changed during study. Gingival index of all group were improved after treatment. At 1 weeks after treatment, group 2 was only significantly different compared to control group. At 2 weeks after treatment, all experimental group were significantly different compared to control group. At 4 and 8 weeks after treatment, GI index was increased in all group, but experimental group were lower than control group. Sulcus bleeding index was similar to the results of gingival index. At 1 weeks after treatment, all experimental group were significantly different compared to control group and it maintained during study. At 2 weeks after treatment, sulcus bleeding index of all group were lowest during study. GCF were measured with PeriotronⓇ 8000(OraflowⓇ, Inc. USA). At baseline, all group were showed moderately severe condition. at 1 week after treatment, group 3 was the most reduced inflammation, and all group were reduced inflammation. At 2 weeks after treatment, all group were healty state. at 4 and 8 weeks after treament, all group were showed recurrent of inflammation, and control group was the most significantly increased. This study shows that the effect of CO2 laser treatment was similar to conventional ultrasonic scaling and this effects was remained longer than control group. These results suggest possibility of CO2 laser treatment for altered periodontal therapy.