Evaluation of bradykinin, VEGF, and EGF biomarkers in gingival crevicular fluid and comparison of PhotoBioModulation with conventional techniques in periodontitis: a split-mouth randomized clinical trial

  • Francesca Angiero
  • Alessandro UgoliniEmail author
  • Francesca Cattoni
  • Francesco Bova
  • Sergio Blasi
  • Fabio Gallo
  • Gianguido Cossellu
  • Enrico Gherlone
Original Article


Periodontal disease is a chronic progressive inflammatory process leading to damage of tooth-supporting tissues. This comparative study assessed the effect of PhotoBioModulation (PBM) versus conventional therapy, and investigated biomarkers involved in the healing process. The test group comprised twenty systemically-healthy non-smoking subjects with chronic periodontitis with the presence of two matched contro-lateral premolar sites (probing depth > 5 mm); twenty subjects without chronic periodontitis (CP) served as control group. Patients were treated at baseline, either with scaling and root planing (SRP group) or with a procedure entailing SRP supported by PBM (PBM group). The laser used was a diode laser operating at 645 nm wavelength, 10 J/cm2, and 0.5 W/cm2 with a 600 μm fiber optic. Crevicular fluid levels of bradykinin (BK), vascular endothelial growth factor (VEGF), and epidermal growth factor z (EGF) were determined at both sites. Crevicular fluid specimens from both groups were analyzed with the ELISA TEST. Clinical differences in analyzed outcomes were observed in favor of PBM treatment. Taking average values as 100%, the reduction in BK concentration was 47.68% with SRP and 68.43% with PBM on day 3; the VEGF concentration decreased by 35.73% with SRP and 48.59% with PBM on day 7; the EGF concentration increased by 55.58% with SRP and by 58.11% with PBM on day 21.

Clinical parameters improved significantly in both groups (pooled mean values of probing depth decreased from 5.6 to 4.5 mm; gingival index from 1.92 to 1.1; and bleeding on probing from 49.67 to 23.23) but did not vary significantly between the PBM and the SRP group. The results confirmed that PBM have beneficial effects in the early phases of the healing process playing a role in modulation of BK, EGF, and VEGF in gingival crevicular fluid levels; both groups had significant clinical improvement over control but there was no significant difference between them, only a trend for PBM group. The overall results of the study suggest a potential benefit of PBM in conjunction with SRP in treating chronic periodontitis.


Periodontology Low-level laser therapy Wound healing Dentistry Effect of Lasers in Tissue Lasers in Dentistry Lasers Diode PhotoBioModulation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Local Ethics Committee, Milan, no. PR246.

Informed consent

Written informed consent was obtained from all study participants in accordance with the Helsinki Declaration (1975; revised, 2002).


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical Sciences and Diagnostic IntegratedUniversity of GenoaGenovaItaly
  2. 2.Dental SchoolVita-Salute San Raffaele UniversityMilanItaly
  3. 3.Section of Biostatistics, Department of Health Sciences (DISSAL)University of GenoaGenoaItaly
  4. 4.Department of Biomedical, Surgical and Dental SciencesUniversity of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoMilanItaly

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