Beatrijs Deruyter: The Use of Nd:YAG in One Stage, Full Mouth Disinfection: A Necessity in Long Term Periodontal Care
The challenge in periodontology lies in searching for a cost-effective periodontal therapy for a widespread disease that has his impact on general health. Treatment modalities also have to be adapted along the etiology of the disease. The treatment of periodontitis consists of two stages. In the first stage, a non-surgical instrumentation is performed, advancing further with surgical procedures when needed. This phase consists of a supra- and sub-gingival removal of dental plaque and calculus, with the purpose of disrupting the sub-gingival biofilm (the complex structure and layers of bacteria and debris) and decreasing the bacterial load as much as possible. This creates a beneficial environment for the healing of the periodontal tissues. At present, instrumentation of the dental root surfaces is mainly performed by hand instruments or ultrasonic devices. However, the full eradication of the sub-gingival biofilm is impossible. It has been shown that after instrumentation, 5 to 80% of the dental root surfaces still have residual biofilm and calculus over an area of up to 30%. In order to improve the clinical outcome of instrumentation procedures, the use of FRP 1064 nm Nd:YAG laser disinfection was introduced. These lasers have been shown to be able to eliminate biofilms, to remove infected soft tissues and to disinfect and restructure dentine tubules. Furthermore, near-infrared wavelengths like 1064 nm are reported to have bio-modulation effects, which might help with stimulation of the immune system, reduction of pro-inflammatory cytokines and the regeneration of periodontal structures. Some long-term clinical cases are presented.