الفهرس 
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Abstract
This study was aimed to clinically and radiographically evaluate the effect of Low Level Laser Therapy (LLLT) on the healing of periapical bony defects in diabetic patients after surgical endodontic treatment.
Two groups of patients (n=40) of single rooted maxillary teeth with approximate dimensions of radiological lesions were selected for the study. Group I [Non-diabetic]: twenty non-diabetic individuals. This group was subdivided into two subgroups: Subgroup IA (non-lased normal): patients were managed with periradicular surgery, n=10.
Subgroup IB (lased normal): patients in this group were managed by periradicular surgery combined with laser irradiation, n=10.Group II [Diabetic]: twenty patients which were diagnosed with controlled Diabetes mellitus. These patients were subdivided into two subgroups according to the treatment modality: Subgroup IIA (non-lased diabetic): these patients were managed by periradicular surgery, n=10. Subgroup IIB (lased diabetic): these patients were managed by periradicular surgery combined with laser irradiation, n=10.
A full thickness mucoperiosteal flap was raised to expose the buccal plate of bone. The root tip was exposed with a round bur and a fissure bur used for root resection. The periapical lesion was curetted and root end cavity was prepared 3mm in depth. Laser application: a first intra operative laser irradiation was applied on the bony cavity using the gallium-aluminum- arsenide (Ga-Al-As) semiconductor diode laser with a wavelength of 810 nm and 100mW maximum output power in the continuous mode. The root end filling material, Intermediate Restorative Material (IRM), was placed in the root end cavity. After the flap repositioned and sutured then another laser irradiation was applied to the surgical wound. Postoperative low level laser irradiation of the intra oral wound was repeated after 3 and 7 days. Patients were evaluated clinically and radiographically in the first visit, and these data were recorded as a base line for further comparison. During the first week, patients were evaluated for pain, swelling, inflammation and bleeding. Radiographic evaluation was achieved by standard periapical radiograph taken in the first visit then at 3, 6 and 12 months intervals using standardized technique for comparison of the results.
A supportive animal study was performed to histologically evaluate the effect of LLLT on healing of artificially created bony defects in rats. Twenty rats were used; diabetes was induced in 10 rats by streptozotocin injection and the other 10 rats were normal.
LLLT had no statistically significant difference on the reduction of bone defect area or increase in gray value in the diabetic patients at the different time intervals (P>0.05). There was no statistically significant difference of LLLT at the three evaluation periods between the lased and non-lased normal patients in the mean of bone area or gray level.