Petrovski, Mihajlo and Minovska, Ana (2021) Influence of different periodontal therapeutic protocols on cementum thickness. Knowledge–International Journal.
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Abstract
The main goal of periodontal therapy is to eliminate the infection and achieve healthy periodontal enviroment by removing bacterial deposits of dental plaque, dental calculus and the presence of subgingival concrements and endotoxins from the root surface. The ultimate goal of all periodontal procedures is to make the treated root surface biologically compatible with the host's periodontal tissues and to enable proper healing of the periodontium. During the initial periodontal treatment, mechanical debridement is performed on the periodontally compromised root surface to eliminate all calcified deposits (supra- and subgingival concrements), as well as bacteria and their cement endotoxins to restore the biological compatibility of the root to the disease. Thorough mechanical debridement of the root surfaces allows fibroblasts to attach to previously pathologically affected or non-affected areas of the tooth roots. This procedure is a significant prerequisite for proper regeneration of lost periodontal tissues. There are two basic therapeutic modalities in periodontology - conventional and laser-assisted therapy. Conventional therapy involves ultrasound instrumentation followed by mechanical debridement. Laser-assisted therapy involves laser treatment preceded by ultrasound instrumentation. Based on these facts, the main goal of this research was to determine the thickness of the remaining cement after performing different types of periodontal therapy procedures (ultrasound instrumentation, conventional therapy or laser-assisted periodontal therapy). For the realization of the main goal, a randomized controlled in vitro study was conducted. The examined sample included a total of 100 teeth that had an indication for extraction. The patients from whom the examined sample originated - extracted teeth - were older than 35 years. All extracted teeth that are part of the sample confirm the diagnosis - stage III and IV of periodontal disease according to the new classification framework of periodontal diseases from 2018. All research samples were divided into five groups of 20 teeth, according to which of the performed therapeutic procedures was applied. The basic division included the following groups: (I) samples treated with ultrasound instruments; (II) samples treated with ultrasound instruments and Gracey's curettes or conventional periodontal therapy; (III) samples treated with laser-assisted treatment using LiteTouch Er: YAG laser; (IV) samples from parodontal diseassed teeth and (V) control group: impacted teeth that have an indication for extraction or teeth that are extracted for non-periodontal cause (occlusal trauma, orthodontic therapy or prosthetic cause). With the SEM analysis of each of the examined surfaces, the thickness of cement was determined. Before the analysis of the samples with the help of SEM, an efficient procedure for dehydration and drying was performed in order to avoid the formation of artifacts that could distort the quality of the obtained microphotographs. After the analysis, it was noticed that the average thickness of the remaining cement after the performed therapy only with ultrasonic instrumentation was 146.0324 ± 13.42917 micrometers. The average thickness of the remaining cement after conventional periodontal therapy was the lowest and was 103.3144 ± 13.52161 micrometers. Finally, the thickness of the remaining cement after laser-assisted periodontal therapy in this study was 123.0332 ± 15.83445 micrometers. The result of SEM evaluation revealed a significant ( P < 0.001) decrease in the thickness of cementum layer on the diseased root surfaces compared to the healthy surfaces. Based on the results of this study, we can conclude that during periodontal disease there is a significant reduction in the thickness of the cement in relation to the healthy tooth. Regarding the therapeutic modalities, it can be concluded that in conventional periodontal therapy there is a greatest loss of tooth cement. Also, it can be noted that the most appropriate therapeutic modality for periodontal disease is laser-assisted therapy in which there is no significant loss of cement.
Keywords: acellular extrinsic fibrilar cement; ER: YAG laser, periodontal therapy, laser assisted pocket debridement, cement thickness.
| Item Type: | Article |
|---|---|
| Subjects: | Medical and Health Sciences > Health sciences Medical and Health Sciences > Other medical sciences |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Mihajlo Petrovski |
| Date Deposited: | 07 Jul 2021 16:00 |
| Last Modified: | 07 Jul 2021 16:00 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/28291 |
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