title: Long-term efficacy of microbiology-driven periodontal laser-assisted therapy.
abstract: Periodontitis represents a highly prevalent health problem, causing severe functional impairment, reduced quality of life and increased risk of systemic disorders, including respiratory, cardiovascular and osteoarticular diseases, diabetes and fertility problems. It is a typical example of a multifactorial disease, where a polymicrobial infection inducing chronic inflammation of periodontal tissues is favoured by environmental factors, life style and genetic background. Since periodontal pathogens can colonise poorly vascularised niches, antiseptics and antibiotics are typically associated with local treatments to manage the defects, with unstable outcomes especially in early-onset cases. Here, the results of a retrospective study are reported, evaluating the efficacy of a protocol (Periodontal Biological Laser-Assisted Therapy, Perioblast™) by which microbial profiling of periodontal pockets is used to determine the extent and duration of local neodymium-doped yttrium aluminium garnet (Nd:YAG) laser irradiation plus conventional treatment. The protocol was applied multicentrically on 2683 patients, and found to produce a significant and enduring improvement of all clinical and bacteriological parameters, even in aggressive cases. Microbiome sequencing of selected pockets revealed major population shifts after treatment, as well as strains potentially associated with periodontitis in the absence of known pathogens. This study, conducted for the first time on such a large series, clearly demonstrates long-term efficacy of microbiology-driven non-invasive treatment of periodontal disease.
authors.affiliation: Microdentistry, Via dell'Ariento 4, 50123, Florence, Italy. info@microdentistry.net.
authors.forename: F S
authors.initials: FS
authors.lastname: Martelli
authors.affiliation: Biomolecular Diagnostic srl, Via Nicola Porpora 5, 50144, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Fanti
authors.affiliation: Biomolecular Diagnostic srl, Via Nicola Porpora 5, 50144, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Rosati
authors.affiliation: Microdentistry, Via dell'Ariento 4, 50123, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Martelli
authors.affiliation: Department of Biology, University of Florence, Via Madonna del Piano 6, 50019, Sesto Fiorentino, Firenze, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bacci
authors.affiliation: Biomolecular Diagnostic srl, Via Nicola Porpora 5, 50144, Florence, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Martelli
authors.affiliation: Department of Oncology, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Medico
mesh_terms: D000328:Adult; D058491:Bacterial Load; D005260:Female; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008297:Male; D054892:Metagenome; D056186:Metagenomics; D008875:Middle Aged; D010514:Periodontal Pocket / Q000382:microbiology / Q000628:therapy; D010518:Periodontitis / Q000382:microbiology* / Q000628:therapy*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012336:RNA, Ribosomal, 16S
keywords: Bacterial infection; Dental practice; Nd: YAG laser; Perioblast™; Periodontal therapy; Periodontitis