The analyis of the effects of low level LASER application and/or azithromycin treatment on the RANKL/OPG ratio and IL-1α levels in gingival crevicular fluid in individuals with generalized aggressive periodontitis

The aim of this study is to analyze the effect of low level LASER application and/or azithromycin therapy in combination with full mouth scaling and root planning (FMSRP) on bone resorption parameters gingival crevicular fluid (GCF) in individuals with generalized aggressive periodontitis. Seventy seven patients with generalizedaggressive periodontitis and 20 periodontally healthy individuals were included in the study. Patients with periodontitis were divided into 4 groups; the FMSRP group which received only FMSRP therapy and the AZM, DDL, AZM+DDL Groups which received combined low level LASER application and/or azythromycin therapy together with FMSRP. Clinical periodontal parameters and receptor activator of nücleer factor kappa beta (NF-?B); (RANK), its ligand RANKL, osteoprotegerin (OPG) and interleukin (IL)-1? levels in gingival crevicular fluid were measured at the beginning and third month of the therapy. Although no significant differences were found in clinical parameters at the baseline between the generalized aggressive periodontitis groups and control group (p>0.05), in general the lowest values were observed in antibiotic groups at the third month. No significant differences were found in osteoimmunological parameters at the baseline between the generalized aggressive periodontitis groups and control group (except RANKL total) (p>0.05). However highest RANKL and OPG concentration and total values in LASER [DDL and AZM+DDL] and Antibiotic groups; highest RANKL/OPG ratio and lowest IL-1? concentration and total values in DDL group were observed at third month. Significant positive and negative corelations between all clinic parameters and osteoimmunologic parameters, GCF volume were observed. Additionally application of DDL in the treatment of GAP increases the RANKL levels while reduces IL-1?; use of AZM increases OPG levels. Also, LASER application and azithromycin therapy in combination FMSRP shows that additional clinical and immunological beneficial efficacy.Key Words: Aggressive periodontitis, Biostimulation, Low level LASER, Nonsurgical periodontal treatment, Osteoimmunology