(LLLT) utilizes laser light of an intensity less than 250 mW/cm2 to treat various medical conditions. Over the last 20 years, LLLT has efficacious in wound healing, pain management, physiotherapy, gynecology and dentistry. There is evidence that LLLT acts as both an anti-bacterial and anti-inflammatory agent, as well as a stimulant to bone growth. Over the last decade, much progress has been made in elucidating the underlying principles.
Light defuses through the tissue in three modes:
1. Forming volumes of partially polarized light,
2. Forming points of high light intensity,
3. Forming areas of high difference in light intensity.
When volumes of partially polarized light are formed, light is absorbed in cytochrome molecules. This creates oxygen that leads to the formation of ATP, stimulating cAMP and enzymes and triggering an immunological chain reaction. Macrophages are activated. Mast cells increase in number. Procollagen is synthesized in fibroblasts. This process lead to anti-inflammatory action, regeneration of tissue and healing.
When points of high light intensity appear, as well as when areas of high difference in light intensity levels are present, the electrical field across the cell membrane creates a dipole moment on the bar shaped lipids that influence the permeability of the cell membrane that effects transport channels for Ca, Na, K. The receptor activity on cell membranes increases. The level of serotonin in the blood increases. C-fiber activity decrease. Synthesis of endorphins is stimulated. At the points of high light intensity levels, potential nerve cell action increases. All of these mechanisms influence the pain and anti-inflammatory processes.
The FDA approved LLLT for the following medical applications:
1. Temporary relief
2. The temporary relief of stiffness
3. The temporary relief of minor arthritis
4. The temporary increase of local circulation where applied
5. The relaxation
In this study we seek to study the effects of LLLT on advanced chronic periodontitis that has caused severe destruction of the periodontal structures, i.e. clinical attachment loss over 5 mm. increased bone loss, increased pocket depth (usually 5 mm or grater) and increased tooth. The symptoms of the disease are a red, swollen, tender gingiva, bleeding while brushing, flossing or spontaneous, loose or separating teeth, pain or pressure when chewing, pus around the teeth or gingival tissues,
The promising results of prior clinical pilot studies involving human subjects with periodontal disease have provided the impetus for the proposed work. These studies showed that subjects receiving LLLT in addition to traditional treatment enjoyed markedly better recovery and healing than subjects treated without LLLT. LLLT resulted in shorter bleeding and pain recovery time, reduced post surgery complications (edema, inflammation, infection,), faster forming and maintaining of the clot, and better maintenance of the masticator functions. Overall we observed improved healing of the soft tissue, rapid recovery of a more compact bone tissue and stability restoring of the teeth, complete and maintenance of the masticatory and esthetic functions, with healthier gingival tissue. The effectiveness of LLLT varied somewhat as a function of the age, general health and metabolic problems of the patient. Very good results were obtained in diabetics for whom wound healing is compromised.