الفهرس 
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Abstract
This study is a clinical trial that was conducted in the orodental genetic department, National Research Center, Cairo. This study aims at finding out the effect of Low Level Laser Therapy on the clinical and microbiological parameters in Down syndrome patients with periodontitis.Thirty patients previously diagnosed as having Down syndrome suffering from periodontitis were included in the study. Their age ranged between 10 – 15 years of age. They were divided into two groups: Group I: Included 25 patients in which laser was applied to one half of the mouth and the other half was considered as a control. Group II: Included 10 patients in which basic periodontal treatment was applied. Inclusion criteria: Diagnosis of periodontitis as evidenced by clinical examination and Good general health. Exclusion criteria: Previous periodontal treatment during the last 6 months and anti-microbial drugs during the last 3 months. METHODS Before Laser application, the patients were systemically evaluated according to the dental modification of the Cornell Medical Index to standardize their systemic condition.I. Periodontal examination: The clinical parameters were measured by a single experience examiner and included: Plaque index, Gingival index, attachment loss, degree o mobility and Pocket depth.II. Basic periodontal treatment: Initially all participants received periodontal treatment including scaling and root planning of all the mouth. Then the mouth was divided into two halves Low Level Laser therapy was applied to one half and the other half served as a control.III. Laser treatment: It was done one week following baseline periodontal therapy and applied to the right half of the patient’s mouth according to our split mouth design. A Soft Laser SL-202 (PETROLASER, Pr. Stachen, Saint-Petrsburg, 198097, Russia) was used for Laser therapy. It was used in a continuous focused mode with 30 mw power setting and K30 tip type (supplied with the machine). The power density of laser irradiation = 498 mw/cm2 (it depends upon laser output power (pin in mw) and the fiber tip type (tip losds coefficient). The tip end was directed to the pocket probing depth and paralleled to the long axis of root surface aiming at the diseased soft tissues lining of the pockets and moved around the tooth. The tip moved from the apical point to the top of the pocket making overlapping horizontal and vertical movements maintaining slight contact with soft tissues at all times. The procedure was repeated 3 times each for 20 seconds period and 20 minutes time interval in between to ensure that all teeth were irradiated. IV. Isolation of Bacterial DNA from buccal swab using QIAamp DNA Mini kit (from Qiagen P/N 51304) RESULTS Regarding the clinical periodontal evaluation our results showed that after 2 weeks of therapy there was significant improvement in the Gingival index, plaque Index, attachment loss and level of attachment in both sides of the mouth. After 6 weeks; the previously mentioned clinical parameters were still significantly better in the right side of the mouth where scaling and root planning was done plus low level Laser therapy. While in the left side of the mouth and in the control group these clinical parameters were not significantly different from that of the baseline. After 12 weeks; the results of these parameters was no significantly difference from the baseline among the two sides of the mouth of the study group and the control group. Results of microbial evaluation showed that P. Gingivalis and capnocytopagea decreased significantly after treatment and this decrease extended to the 2nd week in the SRP alone group while it extended up to the 6th week in the SRP+LAS group. Results of A. Actinomycetcomitans was not significantly different among the three groups.