The objective of this literature review was to critically review the evidence available in the literature regarding the expediency of erbium family of lasers for root bio modification as a part of periodontal therapy. The literature search was performed on the Pubmed using MeSH words such as "lasers/therapeutic use, scaling, dental calculus, tooth root/anatomy and histology, ultrasonic therapy". The studies were screened and were grouped as follows: those evaluating a) efficacy for calculus removal with the Erbium family of laser b) root surface changes following Er YAG and Er Cr YSGG application c) comparative studies of the Er YAG, Er Cr YSGG lasers versus conventional methods of root surface modification d) Bio compatibility of root surface following Erbium laser treatment e) Studies on the combined efficacy of laser root modification with conventional methods towards root surface bio-modification f) Studies on effectiveness of root surface bio-modification prior to root coverage procedures. In conclusion, the erbium family has a proven anti-bacterial action, predictable calculus removal, minimal root substance removal, and appears to favor cell attachment. The Erbium family of lasers appears to be a useful adjunct for the management of periodontal disease.

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Gingival fenestrations are of uncertain etiology having rarely been reported in the dental literature. It seems to have a multifactorial origin and is commonly associated with the anterior region of the arch, especially the incisors. They are usually associated with chronic periapical inflammation. The resorption of bone is usually not associated with such defects. The routine therapeutic modalities used for these defects include mucogingival procedures such as free gingival graft, subepithelial connective tissue graft, pouch and tunnel technique and guided tissue regeneration. The following case describes a rare clinical situation where a gingival fenestration is associated with a large bone defect treated with bone grafting and guided tissue regeneration.

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Background:During the progression of periodontal disease, the cementum undergoes alterations in its structure and composition. Understanding the nanostructure of cementum, in terms of its mechanical properties, will provide an insight into the milieu that periodontal ligament cells encounter in health and chronic periodontitis. This study aims to analyze the nanomechanical properties of the cervical third of the cementum (transverse section) in health and chronic periodontitis.Materials and Methods:Twenty teeth (10 healthy and 10 periodontally diseased) were collected and the nanomechanical properties of the transverse section of the cervical third cementum were evaluated with depth-sensing nanoindentation technique under dry conditions. A total of 100 nanoindentations were performed to analyze the modulus of elasticity and hardness of cervical third of the cementum.Results:The nanomechanical properties of the healthy cervical third cementum sections were significantly higher (P < 0.05) (hardness: 0.720 ± 0.305 GPa; modulus: 15.420 ± 3.902 GPa) than the diseased cementum section (hardness: 0.422 ± 0.157 GPa; modulus: 11.056 ± 3.434 GPa).Conclusion:The results of our study indicate that the hardness and modulus of elasticity of the cervical third cementum decreases significantly in chronic periodontitis.