Title: Influence of periodontal therapy on chemical and mineralogical characteristics of root surface
Abstract:
Introduction. Dental cementum is an avascular and non-innervated mineralized tissue covering the root surface that is continuously and slowly created throughout life. The distribution of minerals and different chemical elements in mature dental cementum shows great variability, and changes in chemical and mineralogical characteristics also occur during the implementation of different therapeutic procedures in periodontology.
The main aim of this research was to compare the chemical and mineralogical characteristics after performing three different therapeutic procedures.
Material and method. The examined sample included a total number of 60 teeth in which there was an indication for extraction. All extracted teeth that were part of the sample had stage III and IV of periodontal disease. The total number of teeth that met the criteria for participation in this research were divided into three groups of 20 teeth, according to which of the performed therapeutic procedures was applied: (1) Group I: Teeth that have undergone a therapeutic procedure including usage of ultrasonic instruments and manual instruments. All of them were chemically analysed using ICP with mass spectrophotometry and X-ray diffractometry; (2) Group II: Consisted of teeth in which, after ultrasonic instrumentation, laser-assisted treatment with Er: YAG laser were used that were chemically analysed using ICP with mass spectrophotometry and X-ray diffractometry and (3) Control group: Impacted teeth with an indication for extraction or teeth that are for extraction for a non-periodontal reason. These teeth were chemically analysed using ICP with mass spectrophotometry and X-ray diffractometry.
Results. There was a reduction in the calcium present in the treated root surfaces, and the calcium loss was greater in the laser treated root surfaces. There were changes in the ratio of organic and inorganic constituents of cementum observed in root surfaces of treated teeth compared to root surfaces obtained from healthy teeth. The greatest loss of inorganic components in the cement structure was observed in surfaces treated with conventional periodontal therapy. There was a significantly closer ratio of the organic and inorganic part of cementum on root surfaces obtained from laser-treated teeth and healthy teeth. There were insignificant changes in the mineralogical composition of the cementum observed in treated teeth compared to root surfaces obtained from healthy teeth. Root surfaces originating from healthy teeth were dominated by hydroxyl-apatite and carbonate apatite, root surfaces treated with conventional periodontal therapy are dominated by amorphous apatite (indicating loss of the proper crystal structure of apatite), while root surfaces from teeth treated with laser-assisted therapy, apart from hydroxyl apatite, portlandite (calcium hydroxide with a grid similar to brushite) also occurs.
Conclusion. Changes in the chemical characteristics of the root surfaces occur during the application of any therapeutic procedure in relation to the surfaces of healthy teeth. There are numerous chemical changes observed in untreated periodontal affected root surfaces compared to root surfaces obtained from healthy teeth.
Audience take away notes:
- Authors want to present the effects of conventional and laser-assisted periodontal therapy on the chemical and mineralogical characteristics of the dental cementum covering the root surfaces of teeth affected by chronic periodontitis. All these data are compared with those of untreated healthy root surfaces which are assumed which are considered the most adequate, because they originate from unaffected teeth.
- All findings that will be presented indicate that there is essential importance of the chemical and mineralogical characteristics of the root surface and it can be noted that the application of laser-assisted periodontal treatment can contribute to the design of an appropriate biomimetic root surface that is most important for adequate process of healing.
- Based on this, the obtained results will make a scientific contribution in the field of modern therapy of periodontal disease and will confirm the scientific findings, which indicate that the use of laser light gives greater benefit on the healing process of the periodontium after the therapy.
- Presented results and the consequential conclusions of this presentation are important both for the clinical dentists and for the scientific knowledge for the effect of different therapeutic modalities in the periodontology.
- At the end, it is can be noted that laser-assisted periodontal treatment has numerous advantages over conventional therapy. This gives a significant scientific contribution that will have significance in everyday dental practice.
- This presentation is also aimed for avoiding all dilemmas that dental clinicians have about the dental lasers, their superiority and opportunities.
- Nowadays, all technological advances and enhancements have increased the possibilities of available laser systems in everyday dental practice. Among them, the laser devices that produce Er: YAG laser beams seem to have most promising use and are considered to become an indispensable tool in modern dentistry.
