Dynamics of clinical and immunological parameters in the integrated management of endo-­periodontal lesions, including laser therapy

Aim. To determine the dynamics of clinical changes and indicators of local immunity in integrating the diode laser into the treatment of the endo-periodontal lesion. Methods. We performed a prospective study of 110 patients of both sexes aged 2555 years with endo-periodontal lesions. The patients were randomized into two groups the main group (n=54), whose received root canal treatment and periodontal pockets with a diode laser in addition to standard therapy, which included endodontic and periodontal treatment, and control group (n=56), whose patients received only standard treatment. The GreenVermillion oral hygiene index and Russells periodontal index, as well as the levels of immunoglobulin (Ig) A, tumor necrosis factor-alpha (TNF-alpha) and cytokine interleukin-10 (IL-10) in the mixed saliva of patients, were determined during the study. Quantitative data were described using median, lower and upper quartiles. These data were visualized using boxplots. The MannWhitney U test was used to compare differences between an independent set of quantitative data. Differences were considered significant at a confidence level of p 0.05. Results. The median oral hygiene index decreased from 2.9 to 1.0 (p 0.001) in the main group and from 2.9 to 1.6 (p 0.001) in the control group. The median Russell's periodontal index decreased from 3.38 to 1.3 (p 0.001) in the main group and from 3.95 to 2.0 (p 0.001) in the control group. The median immunoglobulin A content decreased from 5.25 to 3.13 mg/L (p 0.001) in the main group and from 5.23 to 4.21 mg/L (p 0.001) in the control group. The tumor necrosis factor-alpha level decreased from 16.65 pg/ml in the main group and 18.28 pg/ml in the control group to 3.96 and 8.44 pg/ml (p 0.001), respectively. The median cytokine interleukin-10 levels increased from 0.83 to 2.94 pg/ml (p 0.001) in the main group and from 1.29 to 2.13 pg/ml (p 0.001) in the control group. Conclusion. The use of a diode laser in the treatment of endo-periodontal lesions has a positive effect on the dynamics of clinical and immunological parameters, as evidenced by a statistically significant decrease in clinical indices, as well as the normalization of the immunoglobulin A and cytokine levels in mixed saliva.