Comparações clínica e radiográfica de duas técnicas de aplicação do laser de baixa potência como adjuvante à terapia periodontal básica em pacientes com periodontite - um ensaio clínico controlado e randomizado

Abstract

Aim: To assess and compare two techniques of low-level laser application - transgingival (LLLTT) and intrasulcular (LLLTI) - used in Photobiomodulation as an adjunct to BPT in patients with periodontitis. Methods: This is a randomized, split-mouth, double-blind clinical trial where, from each patient, 3 diseased periodontal sites in different quadrants were selected for one of three treatment groups: SRP group (control group), SRP + LLLTT group (test 1), and SRP + LLLTI group (test 2). Low-level laser therapy in the test groups was performed at three time points, 48 hours, 7 and 14 days after completing full-mouth SRP. Clinical parameters of probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed before treatment (T0), and at 3 months (T1) and 6 months (T2). Additionally, standardized periapical radiographs were used to measure and compare radiographic bone density 6 months after treatment completion. Repeated-measures ANOVA was conducted for quantitative variables, and the chi-square test was used for the categorical variable, with a significance level of p < 0.05 and 95% confidence intervals. Results: Statistically significant reductions in PD (p < 0.001) and CAL (p < 0.001) were observed in all three treatment groups at 3 and 6 months follow-up compared to baseline, with no significant differences between the groups. No significant differences were found in bleeding on probing at 3 and 6 months and in radiographic bone density at 6 months of follow-up. Conclusion: The results indicated that, compared to isolated basic periodontal therapy (TPB), adjunctive photobiomodulation did not provide additional benefits, regardless of the laser application technique used.