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DHONY MIFTAHUL HUDA
A Short Term Comparative Clinical Evaluation of Diode
Laser and Hand Instruments for Gingival Curettage
Chirag Shah, Bhavesh Modi, Shilpa Budhiraja, Khushboo
Desai

Professor and Head, Department of Periodontics,

Karnavati School of Dentistry, Gandhinagar, India.
Post Graduate Student, Department of Periodontics,
Karnavati School of Dentistry, Gandhinagar, India.
Lecturer, Department of Periodontics, Karnavati School of
Dentistry, Gandhinagar, India

Journal Adv Hum Biol 2013

Correspondence: Dr. Bhavesh Modi Karnavati School of

Dentistry, Uvarsad, Gandhinagar, Gujarat, India. E-mail:
bbm23985@gmail.com
 PROBLEM
Penelitian ini mengevaluasi kuretase gingiva dengan menggunakan diode

laser dan hand instruments pada pasien periodontitis kronis

Tujuan utama dari perawatan periodontal adalah untuk

menghilangkan periodontitis
Selama sepuluh tahun terakhir penelitian dan studi kasus klinis
menunjukkan bahwa Laser digunakan dapat meningkatkan
efektivitas perawatan periodontal,

Dioda laser mudah digunakan dan terjangkau untuk

 INTERVENTION
Studi klinis Sampel Kriteria inklusi Kriteria eksklusi
1.kelompok usia 30 tahun sampai 1. Adanya penyakit
komparatif ini 34 pasien 65 tahun. sistemik yang dapat
dilakukan di 2.5 mm atau poket periodontal mempengaruhi hasil
Dept. of (hingga 7mm), diindikasikan terapi.
Periodontics, untuk prosedur kuretase. 2. Sedang hamil atau
Karnavati School (kedalaman poket minimal ≥ 5 kondisi fisik yang
mm dalam tiga gigi di setiap membatasi untuk
of Dentistry, kuadran diperlukan). menggunakan
Uvarsad, Gujarat 3. riwayat medis mengungkapkan instrumen.
baik kesehatan umum. 3. Konsumsi obat yang
4. Tidak termasuk M3 , masing- kemungkinan yang
masing subjek harus memiliki akan mempengaruhi
minimal 20 gigi dalam mulut. kesehatan gingiva.
4. Merokok.
  kelompok kontrol (kuretase gingiva dengan
kuret gracey)
 kelompok eksperiment (kuretase gingiva dengan
dioda laser - 980 nm)
 Pasien SRP sebelum kuretase
 Kuretase dilakukan dengan menggunakan laser diode
(980 nm)
 A 980 nm diode laser operated at a power output
of 2.5 W in a pulse mode (pulse duration 10 ms)
was used. Laser light was delivered by means of
a 400μm fiber optic delivery system.
 kelompok uji diiradiasi selama 30 detik dua kali, dengan
interval 60 detik
 Kelompok kontrol dengan menggunakan kuret gracey
COMPARATION
Membandingkan
penggunaan diode laser dan
hand instruments untuk
kuretase gingiva.
Semua pasien kembali untuk semua kunjungan yang dijadwalkan.
Tidak ada komplikasi seperti abses atau infeksi yang melihat
selama penelitian.
Probing kedalaman poket (PPD) menunjukkan penurunan yang signifikan
(p <0,0001) dan Relative lampiran tingkat (RAL) menunjukkan signifikan
dalam dua kelompok di 3 bulan (p <0,0001).

Kuretase dengan dioda laser untuk perawatan periodontitis kronis dapat lebih
baik setelah 1 minggu, 6 minggu, 3 bulan dibandingkan dengan prosedur
kuretase dengan kuret Gracey.
Signifikan (p <0,0001) pada skor RAL kedua kelompok setelah 3 bulan.
Table 1 shows mean probing pocket
depth (PPD) at baseline in control group
was 3.372±0.196 mm and in
experimental group 3.360±0.175 mm.
Probing pocket depth (PPD) showed
significant reduction after 3 months
(p<0.0001) post treatment in both control
group (2.808±0.102 mm) and
experimental group (2.593±0.108 mm)
 The present study is in accordance with a similar study conducted
by Kreisler et al. who compared efficacy of laser application as an
adjunct to conventional scaling and root planing. The study showed
baseline probing depth (PD) was 4.2±1.15 in experimental site and
4.3±1.26 in control site. After 3 months in the probing depth was
2.4±0.67 in experimental site and 2.7±0.73 in control site. These
values were statistically significant (p<0.001) when compare to
baseline values. The difference between the groups was also
significant (p<0.001) with greater reduction in experimental site.

Table 2 shows relative attachment level (RAL) at baseline in control group was 9.324±0.535
and in experimental group was 9.382±0.493. Gain in Relative attachment level (RAL) was
around 1.853 mm in control group and 2.353 mm in experimental group after 3 months. Gain in
relative attachment level was significant (p<0.0001) in both control and experimental group
after 3 months when compare to baseline. The difference in RAL between control group
(7.471±0.507mm) and experimental group (7.029±0.577mm) was statistically significant
(p=0.001) after 3 months.
 This study is in agreement with the study done by Kreisler et al. in
which teeth treated with the laser revealed a significantly higher gain
in clinical attachment level.

Clinical study by Jiang Lin was to examine nonsurgical treatments of

periodontal disease comparing a diode laser curettage to
subgingival curettage with conventional hand instruments. The
results demonstrated a statistically significant reduction of the GI,
SBI and PD and a significant gain in CAL in both groups after 4
weeks
 Conclusion
01 Penelitian ini telah dilakukan
untuk membandingkan efek dari
kuretase gingiva menggunakan Evaluasi statistik dari
laser diode (980 nm)dan kuretase hasil yang diperoleh
gingiva menggunakan kuret observasi dari 3 bulan
Gracey.
menunjukkan bahwa
perlakuan kuretase
PPD dan RAL dengan dioda laser
dapat memberikan
03 menunjukkan
memberikan
02 pengaruh yang
pengaruh signifikan signifikan setelah 1, 6
dalam kedua minggu dan 3 bulan,
kelompok
eksperimen dan
kontrol setelah 3
bulan.
 Critical
Appraisal
Yes Can’t No
Tell
1. Were the following clearly stated
• Patients √
• Intervention √
• Comparasion intervention √
• Outcome(s) √
• ARE THE RESULTS OF THIS SINGLE TRIAL VALID?
A. The main questions to answer:

Yes Can’t Tell No

1. Was the assignment of patients to √
treatment randomized?
2. Was the randomization list √
concealed? Can you tell?
3. Were all subjects who entered the √
trial accounted for at its
conclusion?
4. Were they analysed in the groups √
to which they were randomized, i.e.
intention-to-treat analysis
B. Some finer points to address :

Yes Can’t Tell No

5. Were subjects and clinicians √
‘blind’ to which treatment was being
received, i.e. could they tell?
6. Aside from the experimental √
treatment, were the groups
treated equally? √
7. Were the groups similar at the
start of the trial?
9. How large was the treatment effect? Relative risk (RR) = = 0,923
Consider
• How were the results expressed (RRR, NNT, Relative risk (RRR) =
etc) = = 0,07

Absolute risk (ARR) = CER - EER

Reduction
Pain one day post-surgery = 2,808 - 2,593

= 0.215

Number needed To threat (NNT)

= = = 4,651

10.How precise were the results?
• Were the results presented
with confidence intervals?
kuretase dengan dioda laser
dapat memberikan pengaruh
yang signifikan setelah 1, 6
minggu dan 3 bulan
CAN I APPLY THESE VALID, IMPORTANT RESULTS TO MY PATIENT?

Yes Can’t Tell No

11.Do these results apply to my patient?

• Is my patient so different from those in the trial √
that the results don’t apply?
• How great would the benefit of therapy be for my √
particular patient

12.Are my patient’s values and preferences satisfied

by the intervention offered?
√
• Do I have a clear assessment of my patient’s
values and preferences?
√
• Are they met by this regimen and its potential
consequences
MATUR NUWUN
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