title: Effect of laser-assisted scaling and root planing on the expression of pro-inflammatory cytokines in the gingival crevicular fluid of patients with chronic periodontitis: A systematic review.
abstract: BACKGROUND
  The aim of the present systematic review was to assess the efficacy of laser-assisted (low level laser therapy [LLLT], high intensity laser therapy [HILT], or antimicrobial photodynamic therapy [aPDT]) scaling and root planing (SRP) compared with SRP alone on the expression of inflammatory cytokines in the gingival crevicular (GCF) of patients with chronic periodontitis (CP).
  
  
  METHODS
  In order to address the focused question: "What is the efficacy of SRP with and without laser and/or aPDT on the expression of pro-inflammatory cytokines in the GCF of patients with CP?" an electronic search without time or language restrictions was conducted up to and including February 2017 in indexed databases using various key words.
  
  
  RESULTS
  Twenty-two randomized control trials were included in the present systematic review. Nine studies and six studies assessed the efficacy of LLLT and HILT, as adjunct to SRP, respectively. Seven studies assessed the efficacy of aPDT as adjunct to SRP on down-regulating the expression of pro-inflammatory cytokines in the GCF among patients with CP. The outcomes of the studies included based upon the reduction in the levels of pro-inflammatory cytokines were inconsistent.
  
  
  CONCLUSIONS
  The role of laser-assisted SRP on the expression of pro-inflammatory cytokines in the GCF of patients with CP remains unclear. Further long term and well-designed randomized clinical trials are needed in this regard.
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA. Electronic address: sergio_kellesarian@urmc.rochester.edu.
authors.forename: Sergio Varela
authors.initials: SV
authors.lastname: Kellesarian
authors.affiliation: Department of Dentistry, Universidad Santa Maria, Caracas, Venezuela.
authors.forename: Vanessa Ros
authors.initials: VR
authors.lastname: Malignaggi
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Hasham Abdullah
authors.initials: HA
authors.lastname: Majoka
authors.affiliation: Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Al-Kheraif
authors.affiliation: College of Health Sciences, Barry University, Miami Shores, FL, USA.
authors.forename: Tammy Varela
authors.initials: TV
authors.lastname: Kellesarian
authors.affiliation: Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Frankfurt, Germany; Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
mesh_terms: D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D016207:Cytokines / Q000276:immunology*; D012534:Dental Scaling / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005883:Gingival Crevicular Fluid / Q000276:immunology*; D006801:Humans; D053685:Laser Therapy / Q000706:statistics & numerical data*; D010518:Periodontitis / Q000453:epidemiology / Q000276:immunology* / Q000628:therapy*; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D015995:Prevalence; D016896:Treatment Outcome
chemical_list: D016207:Cytokines
keywords: Chronic periodontitis; Cytokines; Lasers; Periodontal diseases; Photochemotherapy