Laser treatment of periodontal disease. Price, contraindications, is it better with a vector, reviews

Periodontal disease, or inflammation of the tissues surrounding the teeth, Is one of the leading diseases in the structure of dental pathologies. In a chronically ongoing process, the affected tooth can loosen and fall out. Laser treatment helps to remove pathogenic microflora in the gum pocket, restore damaged tissues and preserve the tooth.

The price for this procedure is quite high, but it is comparable to other innovative and effective methods. Laser therapy can be used in combination with conservative (drug) treatment and surgery.

Indications for laser treatment of periodontal disease

Treatment of periodontal disease with a laser, the price of which is indicated below in the article, is carried out with damage to the periodontal tissues (in the modern terminology of ICD-10 - periodontitis).

This disease is characterized by the following symptoms:

• the appearance of distinct borders of gum pockets - depressions between the gum and the tooth;
• discharge of pus from them;
• increased bleeding of the gums;
• Loosening or mobility of the teeth;
• redness and swelling of the gums in the affected area as a result of the inflammatory process;
• bad breath;
• hard or soft dental plaque;
• pain in the gums.

Contraindications to photodynamic therapy

Common contraindications for laser therapy are:

• malignant blood diseases, tumors;
• acute infectious pathologies;
• sclerosis of cerebral vessels of the brain with impaired cerebral circulation;
• pathology of the thyroid gland;
• cardiovascular diseases, diabetes mellitus in the stage of decompensation;
• chronic renal failure.

In dentistry, laser treatment is not used if the following disorders are present in the oral cavity:

• malignant neoplasms;
• active mucous membrane tuberculosis;
• violation of keratinization processes under the influence of chemical, physical or mechanical factors (manifests itself in the form of white spots, in some cases with erosion);
• papillomas (proliferation of the papillary layer of the mucous membrane);
  
• lesions of the tongue (rhomboid glossitis) associated with a fungal infection.

Laser advantages and disadvantages

Laser treatment of periodontal disease, the price of which is quite significant in comparison with conservative methods, has the following advantages.

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• minimally invasive technology;
• sterility, instant disinfecting effect;
• absence of allergic, toxic and mutagenic reactions typical for antibacterial drugs;
• sterility of the procedure;
• reduction of swelling of the gums;
• resistance of pathogenic microorganisms to laser radiation is not developed;
• low risk of recurrent periodontitis;
• the formation of a photocoagulation film, which has an anti-inflammatory effect;
• increased local immunity and increased blood flow;
• high efficiency in the treatment of both acute and chronic infections;
• no destructive effect on tooth enamel, smoothing of the inner surface of the gums;
• regenerating (restoring) effect on tissues, hemostatic (hemostatic) effect;
• the possibility of simultaneous removal of dental calculus and teeth whitening, combination with other methods of treatment.

The disadvantages include the following:

• the need for local anesthesia due to the presence of a feeling of discomfort;
• a slight increase in the mobility of the teeth, the activation of chronic inflammation in the periodontal tissues immediately after the procedure (later this leads to the stimulation of local immunity);
• temporary bleeding of the gums;
• the need for a series of sessions;
• high cost.

Specificity of laser treatment

The peculiarity of laser therapy is that the periodontium is exposed to a focused beam of electromagnetic waves. As a result, the water in the tissues boils and evaporates, while the destruction of the affected areas of the gums occurs. The power of the laser installation can be different.

A low-intensity beam is used for tissue biostimulation (1-6 mW / cm²), with a higher one - for the treatment of inflammatory processes, for surgical purposes, for tooth preparation.

In addition to local "evaporation" of the affected elements of the gums, the laser beam has a general effect - immunological, hematopoietic, anti-inflammatory and decongestant, thrombolytic; increased activity and cell division, stimulation of metabolic processes.

Laser radiation affects tissues at the molecular level:

• increased production of DNA and RNA in cell nuclei;
• increased oxygen metabolism in cells;
• activation of redox reactions;
• launching photobiological processes;
• destruction of the shell of pathogenic microorganisms;
• decreased activity of nerve fibers and pain sensitivity.

Training

A traditional examination of the patient is preliminarily performed:

• inquiry and analysis of complaints;
• assessment of the state of the oral mucosa;
• determination of the gum bleeding index using probing (pressure on the gingival papilla);
• checking the correctness of the bite (its anomalies are a factor in the development of periodontitis);
• calculation of the KPU index of teeth - the entire surface on which caries is diagnosed, and other parameters.

Laser treatment of periodontal disease is carried out in a complex manner, so the price of this procedure can vary greatly. Before the start of exposure, it is necessary to clean the teeth - remove tartar and mineralized plaque. This is done using a pulsed laser or ultrasonic method.

At the patient's request, the doctor performs a local application of anesthesia (for sensitive teeth).

If the inflammatory process is diagnosed in a generalized form and is in an exacerbation phase, then preliminarily it is recommended to eliminate pronounced phenomena with the help of medication, and then carry out laser cleaning of the gingival pockets.

Procedure, duration

The procedure is performed in the following order:

1. A dental retractor is inserted into the patient's oral cavity.
2. The doctor determines the depth of the periodontal pocket.
3. The device is adjusted to a certain pulse power and laser radiation length (on average 2 W and 0.98 μm).
4. The tip of the light guide is carefully inserted into the dental pocket, not reaching 1 mm to its bottom.
5. The laser is activated. The doctor guides the light guide up and down along the axis of the tooth root, gradually treating its surface. The exposure duration is about 10-20 s.
   
6. At the same time, a thin stream of water is cooled and excised tissues are removed.
7. At the final stage, the doctor can use an antibacterial solution of Furacilin for irrigation, and a special gel with fluoride to protect tooth enamel.

For 1 session, 6-8 teeth are usually processed. Removal of damaged gingival epithelium stimulates tissue regeneration. This process is slow. As a result, the tissues become smooth and tightened, the undesirable phenomenon of periodontitis, such as sagging of the gums, is eliminated.

Is pain felt during treatment?

Patients with sensitive teeth may experience discomfort during this procedure. In this case, it is necessary to use local anesthesia, which reduces pain to almost zero. Some patients, who are treated without anesthesia, note only a slight tingling sensation in the area of ​​laser exposure.

Rehabilitation and recovery

After laser treatment of the gums, the following recommendations must be adhered to:

• Since the mucous membrane is thinned and weakened, in the first 1-2 days there may be increased bleeding of the gums. It is necessary to purchase a new soft-bristled toothbrush, and brush your teeth carefully, in a gentle manner.
• You should also avoid toothpastes with abrasive (whitening) ingredients that can damage your gums. For faster recovery, your doctor may recommend a repair gel. After applying it, it is not recommended to eat for 2 hours.
• As a tooth rinse, it is better to choose formulations that do not contain alcohol, which can irritate the mucous membranes.
  
• Food should not contain reactive dyes, as they can stain the enamel.

Forecast

Positive trends from laser treatment, according to medical research, are manifested in the following (with periodontitis of moderate severity).

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• reduction of pain after the first procedure;
• decrease in gum bleeding by 1.4 times and 1.7 times after 1 and 2 weeks, respectively;
• complete disappearance of redness and swelling of the gums on the third day;
• no complaints in 65% of patients after 1 month; in 25% of patients, there is a periodic feeling of fullness in the area of ​​some teeth;
• after 30-45 days, 75% of patients note a decrease in the temperature sensitivity of the periodontium and necks of the teeth.

The persistence of the clinical effect persists in 95-100% of patients after 3 and 6 months, and after a year - in 93% of patients. Also, after laser treatment, the frequency of the release of pathogenic microorganisms that contribute to the development of periodontal inflammation decreases.

During the course of laser therapy, the periodontal condition improves gradually.

So, in some patients, swelling and redness of the gums persists after 5 procedures, serous discharge may also be present. This is due to the fact that laser radiation causes a temporary exacerbation of a chronic sluggish process, but in the future there is a positive change in clinical signs.

Laser treatment prices

Compared to traditional medical therapy for periodontitis, laser treatment is more expensive. However, with a disease of moderate to high severity (generalized inflammation), the cost becomes quite comparable.

Average prices for laser procedures are shown in the table below:

Operation type	Average price, rub.
Treatment of a pocket of 1 tooth with medications	300-500
Treatment of generalized periodontitis, 1 segment	8000
Supportive treatment of 1 segment	1500
Treatment of generalized periodontitis, 1 jaw	15000
Laser cleaning of 1 gum pocket for mild periodontitis	700-900

Treatment of periodontal disease with a laser, the price of which is indicated in the table, may also cost more due to the fact that in Some dental clinics charge a separate fee for the dentist appointment and diagnosis of the disease.

Comparison of laser efficiency with vector

"Vector" is a dental unit that is fundamentally different from the laser method. Its effect on the periodontium is based on ultrasonic radiation. Vector can also be used to clean tooth pockets and treat gum disease.

The comparative characteristics of these two methods are shown in the table below:

Comparison parameter	Laser	"Vector"
Painlessness of the operation	It is equally painless as the procedure is performed under local anesthesia.
Duration of the procedure for 1 tooth	1-2 minutes	2-3 minutes
The need for repeated cleaning	Multiple sessions recommended	One-time procedure; according to indications, in rare cases, repeated cleaning is carried out. After treatment, a mandatory tooth polishing is required.
Injury to surrounding tissues	Deeper, penetrating cleaning	Thinner, more gentle processing
Average cost of treatment for 1 tooth, rubles	600	500
Features of restrictions	· Leukoplakia of the oral cavity; · Papillomatosis of the mucous membrane; Hyperkeratosis; · Diamond-shaped glossitis (chronic inflammation of the tissues of the tongue).	· The presence of a pacemaker in the patient; · Titanium implants for dental restoration; · Preliminary restoration of the tooth; · Demineralization of enamel.

The method of laser therapy for periodontal disease shows a high degree of effectiveness in comparison with the traditional treatment regimen. Despite the fact that the LED is backlit to control the depth of immersion, during this procedure there is still a risk of injury to soft tissues. The price of treatment depends on the degree of damage to the oral cavity, the type of laser device and the qualifications of the dentist.

With mild inflammation, 1 session is sufficient. Severe forms of the disease require 2-3 or more procedures (1 time per week). Photodynamic therapy has been used in dental practice since 1999. and is still one of the leading methods in comparison with other techniques.

Treatment of periodontitis should be carried out in a comprehensive manner, with the restoration of a group of damaged teeth, fillings and crowns with sharp edges that injure the gums.

Video about the treatment of periodontal disease with a laser

Features of the treatment of periodontal disease with a laser: