title: The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoking chronic periodontitis patients: A split-mouth, randomized control study.
abstract: OBJECTIVE
  This study aimed to investigate the effects of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) on smoking and non-smoking patients with chronic periodontitis.
  
  
  METHODS
  The study was conducted using a split-mouth design with 30 patients with chronic periodontitis (15 smokers, 15 non-smokers) and 30 healthy individuals matched for age, sex and smoking status as controls. Groups were constituted as follows: Cp+SRP+Sham: non-smokers with chronic periodontitis treated with SRP; Cp+SRP+LLLT: non-smokers with chronic periodontitis treated with SRP+LLLT; SCp+SRP+Sham: smokers with chronic periodontitis treated with SRP; SCp+SRP+LLLT: smokers with chronic periodontitis treated with SRP+LLLT; C: control group comprised of periodontally healthy non-smokers; SC: control group comprised of periodontally healthy smokers. LLLT was first applied on the same day as SRP and again on days 2 and 7 after SRP treatment. Clinical parameters were recorded before non-surgical periodontal treatment (baseline) and on day 30. Gingival crevicular fluid samples were collected before periodontal treatment (baseline) and during follow-up visits on days 7, 14 and 30. Gingival crevicular fluid transforming growth factor (TGF)-β1, tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) levels were measured using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  All clinical parameters showed significant reductions between baseline and day 30 following SRP treatment in both the LLLT and sham groups (P<.001). No significant differences were observed between the LLLT and sham groups of either the smokers or non-smokers (P>.05). Gingival crevicular fluid PAI-1 levels decreased significantly in the SCp+SRP+sham and SCp+SRP+LLLT groups (P<.05), and gingival crevicular fluid tPA levels decreased significantly in the Cp+SRP+sham, Cp+SRP+LLLT and SCp+SRP+LLLT groups (P<.05). Gingival crevicular fluid TGF-β1 levels decreased significantly in all treatment groups (P<.05). Although no significant differences were found between the gingival crevicular fluid PAI-1, tPA and TGF-β1 levels of the LLLT versus sham groups (P>.05) at any of the time points measured, both LLLT groups showed significant reductions in tPA/PAI-1 ratios over time.
  
  
  CONCLUSIONS
  Within the limits of this study, LLLT may be understood to play a role in the modulation of periodontal tissue tPA and PAI-1 gingival crevicular fluid levels, particularly in smoking patients with chronic periodontitis, and may thus be recommended as an adjunct to non-surgical periodontal treatment.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Yeditepe Univesity, Istanbul, Turkey.|Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Pamuk
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Ondokuzmayis University, Samsun, Turkey.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-1499-5902
authors.initials: M
authors.lastname: Lütfioğlu
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Istanbul Research and Application Center, Baskent University, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Aydoğdu
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey.
authors.forename: C Z
authors.initials: CZ
authors.lastname: Koyuncuoglu
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Cifcibasi
authors.affiliation: Division of Virology and Immunology, Department of Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: O S
authors.initials: OS
authors.lastname: Badur
mesh_terms: D000328:Adult; D055113:Chronic Periodontitis / Q000473:pathology / Q000532:radiotherapy*; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000295:instrumentation / Q000379:methods; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D028022:Low-Level Light Therapy / Q000379:methods*; D010512:Periodontal Index; D010514:Periodontal Pocket; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis*; D016745:Root Planing / Q000295:instrumentation / Q000379:methods; D012907:Smoking; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000032:analysis*; D053773:Transforming Growth Factor beta1 / Q000032:analysis*; D014945:Wound Healing / Q000528:radiation effects
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D053773:Transforming Growth Factor beta1; C067262:PLAT protein, human; D010959:Tissue Plasminogen Activator
keywords: low-level laser therapy; periodontitis; plasminogen activator inhibitor 1; smoking; tissue plasminogen activator; transforming growth factor