Definitions

SULCI in RELATION TO PERIODONTAL LASER THERAPY

What  are sulci and how are they related to periodontal laser therapy?

(Sentence definition)

Periodontal laser therapy includes the use of a soft tissue laser within the sulci.

(Parenthetical definition)

The sulci (free area between gums and teeth), also known in the singular form as sulcus,  the “col space” or simply as a periodontal pocket.

(Comparison)

When compared to the use of only scaling and root planing (teeth cleaning) on patients with chronic periodontitis, (gum disease) the use of a laser has proven more effective in the sulci as an added adjunct in the maintenance or prevention of further disease.(1)

Image: Soft Tissue Laser image 1 – Saugus Dental Laser Center – Santa Clarita …www.saugusdental.com

Photo 1: healthy sulcus, photo 2: scaling/root planing of diseased sulcus, photo 3: use of laser therapy within a diseased sulcus

Why use laser in the Sulci?

(History/Expanded definition)

Chronic periodontitis is a common occurrence among adult dental patients, hence the reason lasers are slowly being implemented as adjuncts or alternatives to scaling and root planing in the sulci. Since their introduction in 1985, a heightened interest has developed through the use of lasers in the treatment of periodontal disease.(2,3) Periodontal patients can improve the healing of their gingival (gum) tissues and the reduce the depths of their periodontal pockets, through the use of a laser by a dental hygienist.(4) This process sterilizes the sulcus and contributes to the reduction, in some cases, the elimination of sub gingival pathogens (bacteria under the gums).(4)

Who is at risk for chronic periodontitis?

The pathogencity of bacteria within subgingival plaque determines the severity of periodontitis progression, including the destruction of both the periodontal ligament and surrounding alveolar bone.(1) Those with systemic disease, such as patients with diabetes have a higher risk of acquiring chronic periodontitis. Other factors linked to periodontitis include smoking and cardiovascular disease.(1) However, individuals without systemic disease or other risk factors can also be targets for the disease.

How is laser used in the Sulci?

(Examples)

Laser radiation is commonly emitted to the sulci through use of a fibre optic tip or light beam, which produces a continuous, pulsing or running pulse wave form.(2) The use of a topical anaesthetic is commonly applied in the sulcus being treated and both patient and clinician wear special protective laser safety glasses. There is usually minimal pain or discomfort involved and many patients actually state the treatment is relaxing.(5) However, laser therapy may not be indicated for everyone.

 

References:

(1)Berakdar M, Callaway A, Eddin MF, Rob A, Willershausen B. Comparison between scaling-root-planing (SRP) and SRP/photodynamic therapy: six-month study. Head and Face Medicine. 2012;8(12)1-6.

(2) Chanthaboury R, Irinakis T. The Use of Lasers for Periodontal Debridement:
Marketing Tool or Proven Therapy? J Can Dent Assoc 2005; 71(9):653–8.

(3) Lui J, Corbet EF, Jin L. Combined photodynamic and low-level laser therapies as an adjunct to non-surgical treatment of chronic periodontitis. J Periodont Res. 2011; 46:89–96.

(4) Caruso U, Nastri L, Piccolomini R, d’Ercole S, Mazza C, Guida L. Use of diode laser 980 nm as adjunctive therapy in the treatment of chronic periodontitis. A randomized controlled clinical trial. New Microbiologica. 2008; 31: 513-518.

(5) Giannelli M, Formigli L, Lorenzini L, Bani D. Combined photoablative andphotodynamic diode laser therapy as an adjunct to non-surgical periodontal treatment. A randomized split-mouth clinical trial. J Clin Periodontol. 2012; 39: 962–970.