Er:YAG Lazerin Diş Yüzeyi Temizliğinde Etkinliği ve İ-PRF'nin Biyomodifikatör Olarak Kullanılması: İn Vitro Bir Çalışma

Abstract

Periodontitis produces significant changes in the tooth, called the root surface, which are pathologically exposed. The etiology of periodontitis is bacteria that adhere to the root surface and thrive in a biofilm environment. One of the goals of periodontal therapy is to regenerate the lost periodontium and transform the root surface into a biologically favorable substrate for epithelial and connective tissue cell adhesion. Mechanical therapy for debridement of root surfaces affected by periodontitis focuses on removing the etiologic agents of periodontal disease and allowing attachment of periodontal tissues to restore biocompatibility. Mechanical debridement of root surface deposits is currently considered the gold standard treatment for these diseases. Considering the specific properties of the laser, such as hemostatic effects, selective calculus ablation or bactericidal activity, an appropriate laser application may provide an alternative to mechanical or amplified root debridement. Root biomodification refers to procedures performed to detoxify, decontaminate and demineralize the root surface to remove the smear layer and expose the collagen matrix of dentin and cementum. Autogenous platelet-derived products obtained from the patient's own blood have been used frequently in regenerative applications in recent years, and positive results have been obtained both clinically and histologically. For this purpose, the healing-enhancing effects of i-PRF, which has the capacity to be a biomodifier on root surfaces, on the attachment of gingival fibroblasts and wound healing are worth examining. Materials and Method A total of 36 previously extracted human teeth will be used in our study. These samples will be divided into 4 groups (n=9). The procedures to be performed on the groups, respectively, are scaling and root planning with mechanical treatment, scaling and root planning with Er:YAG laser, mechanical treatment + i-PRF application, and Er:YAG laser + i-PRF application. Prior to the procedure, the teeth will be cleaned with distilled water and stored in phosphate buffered saline (PBS) at 4 °C until the treatments are done. After the procedures applied to the teeth, samples will be obtained with the help of 4 mm diameter trepan burs. Obtained samples will be examined under scanning electron microscopy in order to compare the criteria of dentin demineralization, presence/absence of thermal damage, width of dentinal tubule diameters and presence/absence of smear layer.