EFFICACY AND EFFECT OF LOW LASER THERAPY IN THE MANAGEMENT OF LATERAL PERIODONTAL CYST

Aim. Laser is one of the most captivating technologies in dental practice. Laser therapy has bactericidal and detoxification effects, and it can remove epithelial lining, granulation tissue, plaque and calculus within the periodontal pocket with low mechanical stress and without leaving a smear layer on root surfaces and these effects may potentially improve periodontal healing. Lateral periodontal cyst (LPC) is a rare, but well recognized type of epithelial developmental odontogenic cyst. Until now, the effects of low power laser irradiation (LPLI) in the treatment of lateral periodontal cyst have not been well known, though some studies have shown that LPLI can promote the proliferation and differentiation of several cell types in vitro Materials and methods. Eighteen patients, 10 men and 8 women, aged 25–65 (mean age 46.7), who were diagnosed LPC were enrolled for this study. For each patient, the values of Probing Depth, Clinical Attachment Level and Bleeding on Probing were recorded. The histological diagnostic criteria for LPC were the presence of rests of Serres, a squamous non-keratinized or cubic epithelium composed of 1-3 cell layers, and epithelial plaques composed of fusiform clear cells. Orthopantomography and periapical radiograph of the site in each patient was taken. Local anaesthesia was used and full-thickness flap was elevated. The cyst capsule was detached from the adjacent bone by a treatment with a diode laser. The laser used it was a Diode laser 980 nm (Wiserlaser Doctor Smile, Lambda SPA - Italy). Results. All of the enrolled patients complete positively the study. The histological findings supported in all of the treated cases the diagnosis of LPC. The patients were evaluated at six and twelve months during the routine follow-ups and were registered the postoperative complications such as pain and persistent inflammation, swelling, edema, ecchymosis, alveolitis, temporary paresthesia, periodontal recessions, pulp vitality, worsening of periodontal pocket depth (PPD) parameters, gingival necrosis and root resorptions. Conclusions. The post-treatment course was uneventful in all our cases and no complications arose throughout the follow-up. This study demonstrates the clinical efficacy of a comprehensive periodontal treatment protocol for Lateral Periodontal Cyst, based on diode lasers used in combination with conventional surgical treatment. In comparison with a conventional surgery alone by means of hand instruments, the laser treatment led to a significant reduction of the postoperative complications and an improvement of all the clinical parameters assayed after a 12-month follow-up. In periodontal therapy, the use of low-level diode lasers has recently been considered to improve wound healing of the gingival tissue. With the LPLI treatments, the patients consistently showed a rapid and persistent abatement of the timing of the wound healing.