The effect of low‐level laser therapy as an adjunct to non‐surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor‐beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non‐smoking chronic periodontitis patients: A split‐mouth, randomized control study

• Published in: Journal of periodontal research Vol. 52; no. 5; pp. 872 - 882
• Main Authors: Pamuk, F., Lütfioğlu, M., Aydoğdu, A., Koyuncuoglu, C. Z., Cifcibasi, E., Badur, O. S.
• Format: Journal Article
• Language: English
• Published: United States 01.10.2017
• Subjects: Adult; Chronic Periodontitis - pathology; Chronic Periodontitis - radiotherapy; Dental Plaque Index; Dental Scaling - instrumentation; Dental Scaling - methods; Dentistry; Gingival Crevicular Fluid - chemistry; Humans; Laser Therapy - methods; Low-Level Light Therapy - methods; low‐level laser therapy; Periodontal Index; Periodontal Pocket; periodontitis; plasminogen activator inhibitor 1; Plasminogen Activator Inhibitor 1 - analysis; Root Planing - instrumentation; Root Planing - methods; Smoking; Time Factors; tissue plasminogen activator; Tissue Plasminogen Activator - analysis; transforming growth factor; Transforming Growth Factor beta1 - analysis; Wound Healing - radiation effects; tissue plasminogen activator; transforming growth factor; low-level laser therapy; plasminogen activator inhibitor 1; periodontitis; smoking
• ISSN: 0022-3484; 1600-0765
• DOI: 10.1111/jre.12457

Background and Objective This study aimed to investigate the effects of low‐level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) on smoking and non‐smoking patients with chronic periodontitis. Material and Methods The study was conducted using a split‐mouth design with 30 patients with chronic periodontitis (15 smokers, 15 non‐smokers) and 30 healthy individuals matched for age, sex and smoking status as controls. Groups were constituted as follows: Cp+SRP+Sham: non‐smokers with chronic periodontitis treated with SRP; Cp+SRP+LLLT: non‐smokers with chronic periodontitis treated with SRP+LLLT; SCp+SRP+Sham: smokers with chronic periodontitis treated with SRP; SCp+SRP+LLLT: smokers with chronic periodontitis treated with SRP+LLLT; C: control group comprised of periodontally healthy non‐smokers; SC: control group comprised of periodontally healthy smokers. LLLT was first applied on the same day as SRP and again on days 2 and 7 after SRP treatment. Clinical parameters were recorded before non‐surgical periodontal treatment (baseline) and on day 30. Gingival crevicular fluid samples were collected before periodontal treatment (baseline) and during follow‐up visits on days 7, 14 and 30. Gingival crevicular fluid transforming growth factor (TGF)‐β1, tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI‐1) levels were measured using enzyme‐linked immunosorbent assay. Results All clinical parameters showed significant reductions between baseline and day 30 following SRP treatment in both the LLLT and sham groups (P<.001). No significant differences were observed between the LLLT and sham groups of either the smokers or non‐smokers (P>.05). Gingival crevicular fluid PAI‐1 levels decreased significantly in the SCp+SRP+sham and SCp+SRP+LLLT groups (P<.05), and gingival crevicular fluid tPA levels decreased significantly in the Cp+SRP+sham, Cp+SRP+LLLT and SCp+SRP+LLLT groups (P<.05). Gingival crevicular fluid TGF‐β1 levels decreased significantly in all treatment groups (P<.05). Although no significant differences were found between the gingival crevicular fluid PAI‐1, tPA and TGF‐β1 levels of the LLLT versus sham groups (P>.05) at any of the time points measured, both LLLT groups showed significant reductions in tPA/PAI‐1 ratios over time. Conclusion Within the limits of this study, LLLT may be understood to play a role in the modulation of periodontal tissue tPA and PAI‐1 gingival crevicular fluid levels, particularly in smoking patients with chronic periodontitis, and may thus be recommended as an adjunct to non‐surgical periodontal treatment.