Method: Seventy seven GAP patients and 20 periodontally healthy controls were included in the study. Patients were divided into 4 groups; applied FRP alone, FRP combined with LLL, FRP combined with AZM and FRP combined with LLL+AZM. After clinical measurements and samplings, GCF RANKL and OPG levels were determined by enzyme-linked immunosorbent assays at baseline and 3 months after treatment.
Result: A significant differences were found in the clinical parameters between the GAP groups and control group at the baseline (p > 0.05), in general the lowest values were observed in antibiotic groups [AZM and AZM+LLL] at 3 months. No significant differences were detected in osteoimmunological parameters between the GAP groups and control group at the baseline (except RANKL total) (p>0.05). However, highest RANKL and OPG concentration and total values were found in laser [LLL and AZM+LLL] and antibiotic groups, while highest RANKL/OPG ratios were observed in LLL group at 3 months. Significant positive and negative corelations between all clinic parameters and osteoimmunologic parameters, GCF volume were observed.
Conclusion: While FRP combined with LLL in GAP treatment increases RANKL levels, FRP combined with AZM increases OPG levels. Furthermore, AZM+LLL combined with FRP for GAP provides an additional clinical and immunological benefit.