Efficacy of Er:YAG laser on periodontitis as an adjunctive non‐surgical treatment: A split‐mouth randomized controlled study

Abstract

Aim To evaluate the adjunctive efficacy of Er:YAG laser use with mechanical scaling and root planing (SRP) for non‐surgical treatment of periodontitis. Materials and Methods In a randomized, single‐blinded, controlled trial, 27 patients were recruited. Using a split‐mouth design, two quadrants were randomly allocated into either a test group or a control group. The test quadrants received Er:YAG laser (ERL; 100 mJ/pulse; 15 Hz to hard tissue and 50 mJ/pulse; 30 Hz to soft tissue) plus SRP treatment, while the control quadrants received SRP only. We evaluated periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI) at baseline, 3 months, and 6 months. Results The PD and CAL means in the ERL + SRP group were significantly lower than those in the SRP group at 3‐month follow‐up (PD: 2.98 ± 0.38 mm vs. 3.09 ± 0.35 mm; CAL: 4.51 ± 0.69 mm vs. 4.72 ± 0.67 mm) and 6‐month follow‐up (PD: 2.91 ± 0.31 mm vs. 3.02 ± 0.30 mm; CAL: 4.52 ± 0.65 mm vs. 4.72 ± 0.66 mm; p = 0.03 for both PD and CAL). There were no significant differences in BI and PLI between two groups. Conclusions The Er:YAG laser treatment combined with conventional SRP significantly improved PD and CAL compared to SRP therapy alone; however, these differences were very small and, as a result, the adjunctive effect of Er:YAG laser is likely to be minimal clinically important.

Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? A Systematic Review

“…In total 11/20 (55%) articles showed a low risk of bias with the following grading: 10/10 one article [ 24 ] 9/10 three articles [ 17 , 21 , 22 ] 8/10 seven articles [ 14 , 15 , 16 , 18 , 23 , 31 , 33 ] …”

“…Regarding the primary outcome, positive outcomes in all examined parameters have been described in 3/20 (15%) studies [ 14 , 17 , 30 ], whereas positive results in some of the parameters and non-significant difference in the rest of them were shown in 11/20 (55%) [ 15 , 16 , 19 , 20 , 21 , 22 , 23 , 28 , 29 , 31 , 33 ].…”

“…Concerning the laser protocol applied, 14/20 (70%) showed incomplete laser parameter description [ 15 , 16 , 18 , 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The deficiencies concerned the following parameters: Tip or spot size: 5/14 Frequency: 2/14 Fluence/irradiance (either missing or wrongly calculated): 5/14 Pulse duration: 9/14 Irradiation time: 8/14 …”

“…For free-running pulsed lasers, Zhou, et al [ 15 ], Celik, et al [ 16 ], Sanz-Sanchez, et al [ 20 ] and Rotundo, et al [ 32 ] did not list any power parameters, leaving the reader to perform the calculations.…”

“…Table 2 ’s risk of bias shows that 55% of the studies [ 14 , 15 , 16 , 17 , 18 , 21 , 22 , 23 , 24 , 31 , 33 ] included in this review demonstrated a low risk of bias, and the remaining 45% [ 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 32 ] showed a moderate risk, with two lowest scores of 6.…”