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The main etiologic factor of periodontitis is bacteria inhabiting the oral cavity, especially gram negative anaerobes. These bacteria contain proteases and endotoxin that can destroy periodontal tissue. Most of them in periodontal pockets form a biofilm and attach to subgingival calculus or the inner surface of pockets, or even invade into periodontal tissue. In addition, bacterial entotoxin invade into diseased cementum. Therefore, during periodontal treatment not only calculus but also diseased cementum infected by bacteria must be removed.<BR>Nd: YAG, Er: YAG, CO<SUB>2</SUB>, Er, Cr: YSGG, and diode laser devices with various conditions have been used in periodontal treatment until now. The advantages of laser irradiation in periodontal treatment are that it is possible to evaporate most of the bacteria because of momentary heat, and laser irradiation, unlike a hand scaler, does not injure the healthy surface of the pocket to avoid bacteria infection. However, laser light only travels in a straight line and so does not reach the bottom of spiral pockets caused by occlusal trauma.<BR>In the past several years, fundamental studies of photodynamic therapy (PDT) using laser devices and photosensitizers for periodontal treatment have been reported. The advantage of PDT is that it only affects the target tissue by a combination of laser light with a specific wavelength to activate a photosensitizer and this photosensitizer does not have any toxicity. There fore, the heat effect from the laser device on other tissues is reduced. Additionally, it may be possible to destroy bacteria in the pocket where the laser fiber can not reach and to avoid side effects such as those caused by antibiotics.<BR>In this paper, various basic studies of photodynamic therapy (PDT) which have been reported until now and our studies are introduced. The possibility of applying PDT to periodontal treatment is also discussed.
- 日本レーザー歯学会の論文