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ePaper created 2016-10-12, 10:31:46 | version 1.38.0
21 3 2016 laser industry | of periodontal pockets. Their effectiveness in elimi- natingperiodontalpathogensanddecreasingpocket depth is widely documented. Neodymium: Yttrium– Aluminum: Garnet (Nd:YAG) laser with a wavelength of 1,064 nm can decontaminate periodontal pocket without causing necrosing or carbonization of the underlaying connective tissue.6 Periodontopatho- gens can persist within cells outside the pocket epi- thelium after mechanical conventional mechanical periodontal debridement, and Gianelli et al. reported thattheNd:YAGiscapableoferadicatingperiodonto- pathogenicbacteriatrappedwithingingivalepithelial cells.7 Erbium:YAG (Er:YAG) with a wavelength of 2,940 nm hasbeenappliedforeffectiveeliminationofgranula- tiontissue,gingivalmelaninpigmentationandgingi- valdiscoloration. Thislaserisalsousedforcontouring and cutting of bone with minimal damage and en- hances healing.8 In addition, irradiation with the Er:YAG laser has a bactericidal effect with reduction oflipopolysaccharide,isefficientincalculusremoval, with the effect limited to a very thin layer of the sur- face and is effective for implant maintenance. A case report A 47-year-old female patient was diagnosed with advanced generalised periodontal disease, numer- ous missing teeth, lack of prosthetic supplements in the posterior region, periapical lesions, and an in- completeendodontictreatment.Thepatientrequired a comprehensive dental treatment. To create a pre- liminarytreatmentplan,itisnecessarytoimplement initial treatment (hygienisation) to check the pa- tient's motivation to continue the highly specialised treatment and assess the prognosis of her teeth. Detailed clinical examination should include, among others, data on the periodontal pocket depth (PD),bleedingonprobing(BOP)andplaqueindex(PI). Inthecaseofasignificantlyseveredisease,hightooth mobility,numerousmissingteeth,itisrecommended to carry out a molecular-biological test to assess periopathogens quantitatively and qualitatively. Before the treatment the patient underwent su- pragingival hygienic procedures done with ultra- Figs. 2a–f: a) Clinical improvement of the gum after hygienisation, reduction of swelling, bleeding and bacterial plaque; b) Clinical view of the periodontal treatment, electronic probe testing (pa-on, Orangedental); c) electronic probe, pa-on view and molecular-biological test; d) the result of pocket-depth probing (PD) and clinical attachment level (CAL), Bleeding on Probing (BOP), mean value of PD = 38; RC = 1.19; AT = 3.57; BOP = 33%; e) Plaque Index (PI), PI = 11%; f) baseline values of molecular- biological test (PET Plus test, MIP Pharma, Germany). Fig. 2b Fig. 2c Fig. 2f Fig. 2a Fig. 2d Fig. 2e 32016