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Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review

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Abstract

The aim of the study was to assess the efficacy of adjunctive use of laser therapy (LT) alone or antimicrobial photodynamic therapy (aPDT) to improve clinical periodontal and HbA1c levels in patients with both chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). Electronic search of the MEDLINE, PubMed, EMBASE, Science Direct, and SCOPUS databases were combined with hand searching of articles published from 1975 up to and including March 2016 using relevant MeSH terms. Six studies were selected for this review. In these six studies, laser treatment was applied, after scaling and root planing (SRP), in two ways: Three studies used laser alone and three studies used laser with photosensitizer. All the six included studies reporting clinical periodontal and glycemic parameters showed that LT and aPDT were effective in the treatment of CP in T2DM subjects at follow-up. Two studies showed significantly better periodontal outcomes for LT as an adjunct to SRP as compared to SRP alone, whereas four studies showed comparable periodontal outcomes among adjunctive LT or aPDT with SRP. Two studies showed significant reduction of HbA1c levels in LT and aPDT as compared to SRP, whereas three studies showed comparable percentage levels at follow-up. It remains debatable whether LT or aPDT as adjunct to SRP is more effective as compared to SRP alone in the improvement of clinical periodontal and glycemic control in patients with both CP and T2DM, given that the scientific evidence is weak.

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Author information

Authors and Affiliations

  1. Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

    Tariq Abduljabbar & Fahim Vohra

  2. Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, 14620, Rochester, NY, USA

    Fawad Javed

  3. Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia

    Altaf Shah

  4. Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia

    Mazin Saleh Samer

  5. Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, 75600, Pakistan

    Zohaib Akram

Authors
  1. Tariq Abduljabbar
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  2. Fawad Javed
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  3. Altaf Shah
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  4. Mazin Saleh Samer
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  5. Fahim Vohra
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  6. Zohaib Akram
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Corresponding author

Correspondence to Zohaib Akram.

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Conflict of interest

The authors declare that they have no conflict of interest and all authors have read and approved the final draft.

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Not required. The manuscript does not contain clinical studies or patient data.

Source of funding

The authors extend their sincere appreciations to Deanship of Scientific Research at King Saud University for funding this prolific research group (PRG-1437-38).

Appendix A

Appendix A

List of excluded studies. Reason for exclusion is shown in parenthesis.

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    Obradović R, Kesić L, Mihailović D, Antić S, Jovanović G, Petrović A, Peševska S (2013) A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus. Lasers Med Sci 28:19-24. doi:10.1007/s10103-012-1058-7 [Ex vivo]

  2. 2.

    Obradović R, Kesić L, Mihailović D, Jovanović G, Antić S, Brkić Z (2012) Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther 14:799-803. doi:10.1089/dia.2012.0027 [Ex vivo]

  3. 3.

    Bin G, Qianqian L, Yan L, Min F, Yuanyuan C, Yifang Y, Yingchao L (2014) Effect of Er: YAG laser on the dynamic changes in subgingival flora in type 2 diabetic patients with periodontitis. Hua Xi Kou Qiang Yi Xue Za Zhi 32:171-176. [Chinese]

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    Martelli FS, Fanti E, Rosati C, Martelli M, Bacci G, Martelli ML, Medico E (2016) Long-term efficacy of microbiology-driven periodontal laser-assisted therapy. Eur J Clin Microbiol Infect Dis 35:423-431. doi:10.1007/s10096-015-2555-y [Focus question not answered]

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  6. 6.

    de Almeida JM, Theodoro LH, Bosco AF, Nagata MJ, Bonfante S, Garcia VG (2008) Treatment of experimental periodontal disease by photodynamic therapy in rats with diabetes. Journal of periodontology 79:2156-2165. doi:10.1902/jop.2008.080103 [Experimental]

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Abduljabbar, T., Javed, F., Shah, A. et al. Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 32, 449–459 (2017). https://doi.org/10.1007/s10103-016-2086-5

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