Correlation Between Gingival Parameters and LDH Enzyme Activity in Orthodontic Patients After LLLT and Ozone Irrigation: A Split Mouth Study

Objectives The study aimed to assess and compare the clinical outcomes of low-level laser therapy (LLLT) and subgingival ozone irrigation on gingival inflammation in patients undergoing fixed appliance therapy and to relate the clinical outcomes with lactate dehydrogenase (LDH) activity in gingival crevicular fluid (GCF). Materials and Methods 15–25 year-old 30 healthy patients undergoing orthodontic treatment were selected in this prospective, cross-sectional study. In each subject, the upper right and left quadrants of the mouth were randomly designated as the control side and the interventional side, respectively. Clinical parameters (gingival index, plaque index, gingival bleeding index) and LDH enzyme activity were recorded at baseline (0th day) on both sides. The interventional side was irradiated with a soft tissue 980 nm diode laser (Zolar Photon Plus) with a power density of 100 mW cm –2 and an energy density of 18 J cm –2 , and the control side was irrigated subgingivally with 0.01 mg/l ozonated water using the Kent Ozone Dental Jet TY-820. All the clinical parameters, except LDH, were reassessed on the 7th, 14th and 28th day, whereas LDH levels in GCF were reevaluated on the 28th day. Results Both groups showed a significant reduction ( p < .05) in gingival parameters and LDH activity after the study period. A greater decrease of clinical parameters and LDH activity (417.117 mU ± 22.59 to 154.11 mU ± 12.943) was seen on the LLLT side than on the ozone irrigation side (419.417 mU ± 27.128 to 229.387 mU ± 14.636). Also, a significant correlation existed among the clinical parameters assessed and the LDH activity in GCF after the treatment period. Conclusions LLLT and ozone irrigation were both effective in controlling gingival inflammation among which LLLT was superior. Clinical Relevance Fixed mechanotherapy makes oral hygiene difficult, necessitating the need for adjunctive methods. From this study, it was proved that ozone and laser therapy were effective in controlling gingival inflammation in orthodontic patients, thus enabling their use in the monthly visits.