Effect of Low-Level Laser Therapy on Early Wound Healing and Levels of Inflammatory Mediators in Gingival Crevicular Fluid Following Open Flap Debridement

Abstract

IntroductionLow-level laser therapy (LLLT) has a beneficial effect on pain relief and wound healing. This study aims at a clinical evaluation of early wound healing and a biochemical evaluation of inflammatory mediators in gingival crevicular fluid (GCF) following LLLT with an open flap debridement (OFD) in periodontal therapy. Material and methodsThis randomized controlled trial included 40 chronic periodontitis patients with bilateral attachment loss, pocket depths of 5 mm affecting at least two quadrants, and radiographic evidence of horizontal bone loss. 120 control sites were randomly selected to receive OFD, and contralateral 120 test sites received biostimulation with a diode laser (890 nm) after OFD. The wound healing index was recorded at the 1st and 2nd weeks, and clinical parameters such as the plaque index, gingival index, pocket probing depth, clinical attachment level, and GCF inflammatory mediators were evaluated at baseline, 3, and 6 months. ResultsFrom the start of the study to 6 months later, there was a statistically significant drop in plaque index, gingival index, probing pocket depth, and gain clinical attachment levels in both groups. However, when the two groups were compared, there were no significant differences at any time intervals. GCF inflammatory mediators tumor necrosis factor (TNF) alpha and matrix metalloproteinases (MMP-8) decrease, and osteoprotegerin (OPG) levels increase in both the test group and control group from baseline to 3 months and 6 months. In intergroup comparisons, there was a statistically significant reduction in the test group as compared to the control group at 6 months. There was a decline in gingival crevicular fluid -interleukin-6 (GCF IL-6) levels from baseline to 3 months and 6 months in both the groups but when analysed statistically, the results were not significant on intergroup and intragroup comparison at any time interval. The Landry Wound Healing Index values in the 1st and 2nd weeks were showing statistically significant improved healing in the test group as compared to the control group. There was significantly better wound healing at sites where a diode laser was used. ConclusionLLLT increases early wound healing after periodontal surgical procedures.

Clinical efficacy and pain control of diode laser-assisted flap surgery in the treatment of chronic periodontitis:A systematic review and meta-analysis

“…Diode lasers offer the advantages of high efficiency, low thermal damage, stable output power, and ease of use [ 37 ]. Soft tissue surgery using lasers allows for hemostasis and disinfection with minimal postoperative pain when compared with conventional surgery [ 20 ]. PPD has a significant impact on the results' long-term stability, and CAL is the gold standard for assessing the efficacy of periodontal therapy.…”

“…The GI reflects the condition of the gingiva, including changes in morphology and texture. There was a statistically significant decrease in the GI scores in both the laser and control groups in the four included studies [ 11 , 20 , 19 , 24 ], demonstrating the effectiveness of periodontal flap surgery in removing inflammation caused by tartar and infected granulation tissue. One of the studies by Shakoush et al [ 19 ] showed that laser-assisted flap surgery at 3 months resulted in better gingival condition.…”

“…Diode lasers can inhibit interleukin (IL)-6, monocyte chemotactic protein-1, IL-10, and tumor necrosis factor (TNF) to exert anti-inflammatory effects [ 43 ]; reduce edema by restoring the circulation of microcapillaries; and normalize the permeability of the vascular wall [ 44 ]. The remaining studies [ 11 , 12 , 20 ] showed statistically significant decreases, but comparisons between groups did not show statistical differences, probably because the participants in both groups followed proper oral hygiene practices and performed effective oral cleaning.…”

Biomedical Applications of Lauric Acid: A Narrative Review

“…The prepared nanogel formulation with lauric acid showed excellent wound-healing activity and cell migration with nanogel-treated cells compared to the control group in an in-vitro scratch wound-healing assay. They revealed that the LA nanogel had a good cytocompatibility effect and increased cell viability of hGF cells at 4 0µl/ml concentration [31]. Another study by them used the same formulation and reported excellent antioxidant and anti-inflammatory properties of LA-containing nanogel.…”

“…Lauric acid was used along with thiocolchicoside and chitosan to develop a nanogel formulation by Ameena et al [31]. It was explored for wound healing and cytocompatibility in human gingival fibroblasts.…”