Evaluation of the Clinical and Antimicrobial Effects of the Er:YAG Laser or Topical Gaseous Ozone as Adjuncts to Initial Periodontal Therapy

Yılmaz, Selçuk; Algan, Serdar; Gürsoy, Hare; Noyan, Ülkü; Kuru, Bahar; Kadir, Tanju

doi:10.1089/pho.2012.3379

Cited by 51 publications

(64 citation statements)

References 22 publications

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“…In addition, our data also support the findings of Yilmaz et al. (, ), who observed that positive changes in clinical parameters such as attachment gain and PD reduction were significantly greater in the ERL + SRP group than the SRP group. Likewise, Saglam et al.…”

Section: Discussionsupporting

confidence: 91%

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

Zhou

Zhang

et al. 2019

J Clinic Periodontology

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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.

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Section: Discussionsupporting

confidence: 91%

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

Zhou

Zhang

et al. 2019

J Clinic Periodontology

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“…, Yilmaz et al. , ). The smoking rate varied among selected studies, with five including non‐smoking populations.…”

Section: Resultsmentioning

confidence: 98%

Er:YAG laser versus scaling and root planing as alternative or adjuvant for chronic periodontitis treatment: a systematic review

Zhao

Yin

et al. 2014

J Clinic Periodontology

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“… There is substantial heterogeneity between studies, in design, selection of laser parameters and length of study, all of which limit the number of studies that can be entered into a meta‐analysis. Differences in average post‐treatment probing depth reduction, control vs. test groups, ranged from 0.07 mm at 3 months to 0.16 mm at 6 months (Table ) – a clinically insignificant difference at both time intervals. Differences in average post‐treatment gains in clinical attachment level, control vs. test groups, ranged from 0.08 mm at 3 months to 0.29 mm at 6 months (Table ) – clinically insignificant at both time intervals. Differences in average post‐treatment reduction of bleeding on probing, control vs. test groups, were approximately 0% at 3 months but decreased to 3% at 6 months (Table ) – a clinically insignificant difference at both time intervals. As one of the primary rationales for incorporation of lasers into a periodontal treatment regimen is the purported antimicrobial effect, it is disappointing that nine of 19 studies did not measure this parameter. Of the remaining 10 studies, eight demonstrated no significant difference between control and test groups ; one favored the adjunctive use of the laser with scaling and root planing ; and one showed a significant reduction in T. forsythia following use of the laser as a monotherapy ; and in one study only the scaling and root planing group produced a significant reduction in levels of spirochetes and motile rods vs. baseline . Overall, one must conclude that the laser, at best, is equivalent to scaling and root planing and has no added clinical benefit regarding reduction in subgingival microbial loads. There is no evidence that the Er:YAG laser, used as a monotherapy or adjunctive to scaling and root planing, is capable of “sterilizing” a periodontal pocket (Table ). Currently, there is no evidence showing that use of the Er:YAG laser in treatment of periodontitis has a beneficial impact on the levels of inflammatory cytokines as only two conflicting studies have addressed the subject. Currently, there is no consistent evidence supporting routine use of the Er:YAG laser in the treatment of periodontitis, either as an alternative monotherapy or adjunctive to traditional scaling and root planing . …”

Section: Summary Of Er:yag Laser and Treatment Of Periodontitismentioning

confidence: 99%

Lasers and the treatment of periodontitis: the essence and the noise

Cobb¹

2017

Periodontology 2000

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The dental literature contains 25 years of accumulated reports and clinical studies addressing the utility of lasers in the treatment of periodontitis, both as a monotherapy or as an adjunct to surgical and nonsurgical therapy. Yet, the evidence from the 118 human clinical studies cited in this narrative review remains conflicted and insufficient to suggest that integration of a laser in a periodontal treatment protocol will provide antimicrobial and healing outcomes superior to those achieved by traditional therapy. When viewed as a collective body of evidence, it becomes apparent that a majority of the studies are underpowered and exhibit significant heterogeneity in design. Furthermore, the collected studies report a varied choice of parameters, even within the same wavelength of laser. There is little uniformity between studies in the reporting of measured clinical parameters. Most studies reported 3- and/or 6-month post-treatment results; however, the range of time intervals includes studies reporting results from 1 week to up to 1-12 months or longer. Lastly, many studies were considered at risk for bias as a result of a lack of examiner masking and/or calibration. There is great need for well-designed, highly controlled multicenter clinical trials that are adequately powered in terms of subject enrollment, that use similar protocols in terms of laser parameters and that report measureable outcomes in a uniform manner. Without such studies, the questions surrounding the use of lasers in the treatment of periodontal disease will persist.

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Evaluation of the Clinical and Antimicrobial Effects of the Er:YAG Laser or Topical Gaseous Ozone as Adjuncts to Initial Periodontal Therapy

Cited by 51 publications

References 22 publications

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

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

Er:YAG laser versus scaling and root planing as alternative or adjuvant for chronic periodontitis treatment: a systematic review

Lasers and the treatment of periodontitis: the essence and the noise

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