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Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3–4, Grade C periodontitis patients: a split-mouth, randomized control study

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Abstract

Aim

To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system.

Materials and Methods

Stage 3–4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA.

Results

Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05).

Conclusion

Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels.

Clinical relevance

LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3–4 Grade C leads to reduced plasminogen activation.

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Data Availability

N/A.

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Funding

This study was supported by the Scientific Research Fund of Beykent University (Grant/Award Number: 2018–19-BAP-05).

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Authors and Affiliations

  1. Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium

    F. Pamuk

  2. Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey

    F. Pamuk

  3. Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey

    M. Lütfioğlu & S. Yildirim

  4. Hamidiye Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey

    T. Paksoy

  5. Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey

    C. Z. Koyuncuoglu

  6. Clinical Laboratory, Unit of Immunology and Allergy, Koç University Hospital, Istanbul, Turkey

    N. G. Polat

  7. Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul, Turkey

    E. Cifcibasi

  8. Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA

    A. Kantarci

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Contributions

Pamuk F prepared the manuscript and applied all treatment protocols. Lütfioğlu M prepared the manuscript and applied the statistical analysis and sample size calculation. Paksoy T prepared the manuscript and organised tables. Koyuncuoglu CZ performed all clinical measurements and GCF sampling. Polat NG performed ELISA. Cifcibasi E contributed to all ethical procedures and patient screening. Yildirim S organized the figures and organized data and the results. Kantarci A edited the manuscript and guided the study.

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Correspondence to F. Pamuk.

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Pamuk, F., Lütfioğlu, M., Paksoy, T. et al. Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3–4, Grade C periodontitis patients: a split-mouth, randomized control study. Clin Oral Invest 27, 6439–6449 (2023). https://doi.org/10.1007/s00784-023-05248-z

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