title: Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical parameters and crevicular cell population, particularly leukocyte counts, changes after initial periodontal therapy with different instruments by a chairside laboratory technique, in severe periodontitis patients.
  
  
  BACKGROUND
  Although scaling and root planing (SRP) with hand curettes or ultrasonic scalers may alter the subgingival microbial composition and improve clinical parameters, it is known that this effect decreases as the pocket depth (PD) increases.
  
  
  METHODS
  Thirty systemically healthy subjects with severe chronic periodontitis were randomly assigned to three groups (n=10), and were treated either with hand curettes, ultrasonic scalers, or Er:YAG laser alone. Clinical measurements were made before and 90 days after treatment. A total of four subgingival plaque samples were collected from pockets with a PD 4-6 and ≥7 mm and were analyzed with a phase-contrast microscopy for microorganism proportions and leukocyte counts at baseline and 7 and 90 days after treatment.
  
  
  RESULTS
  From day 0 to day 90, clinical parameters were significantly improved in all groups (p<0.01), but there were no significant differences among groups. Laboratory assessments revealed significant differences in all groups between baseline, day 7, and day 90. However, considering changes from day 7 to day 90, hand curettes were the most successful for maintaining the levels of micro-organisms and leukocytes.
  
  
  CONCLUSIONS
  Although Er:YAG lasers are promising in treating periodontitis, the results of this study favor finishing SRP with hand curettes. Moreover, as there is a similar tendency between micro-organism and leukocyte count changes, leukocyte counts may be used as chairside marker to evaluate the efficacy of SRP.
authors: Department of Periodontology, Faculty of Dentistry, Marmara University, İstanbul, Turkey. ezgimalali@hotmail.com
authors: Ezgi
authors: E
authors: Malali
authors: Tanju
authors: T
authors: Kadir
authors: Ulku
authors: U
authors: Noyan
mesh_terms: D000704:Analysis of Variance; D003762:Dental Instruments; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State; D007958:Leukocyte Count; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008858:Microscopy, Phase-Contrast; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000382:microbiology / Q000628:therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014465:Ultrasonics / Q000295:instrumentation*