Adjunctive Non‐Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial

Nguyen, Naomi Trang; Byarlay, Matthew R.; Reinhardt, Richard; Marx, David B.; Meinberg, Trudy A.; Kaldahl, Wayne B.

doi:10.1902/jop.2015.150152

Cited by 37 publications

(54 citation statements)

References 40 publications

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“… There is no evidence that dark pigment‐producing bacteria create such pigments in the human periodontal pocket. Thus, at this point, claims regarding the targeting of black/brown pigmented bacteria in situ by the diode laser must be viewed with skepticism. There is no evidence that the diode laser used as a monotherapy or adjunctive to scaling and root planing is capable of “sterilizing” a periodontal pocket. There is a developing body of evidence indicating that low‐level‐light therapy can be of benefit regarding healing of periodontal tissues, but as yet the evidence is insufficient to allow establishment of protocols or parameters for routine application in clinical practice. There is little to no evidence supporting the use of the diode laser either as a monotherapy or adjunctive to scaling and root planing for the treatment of periodontitis . As stated by Dederich : “With consistently beneficial results from adjunctively using the diode laser not being demonstrated, it then becomes moot to speculate on potential mechanisms of claimed benefits by proponents of this technique.” …”

Section: Summary Of Diode Lasers and Periodontal Therapymentioning

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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Section: Summary Of Diode Lasers and Periodontal Therapymentioning

confidence: 99%

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

Cobb¹

2017

Periodontology 2000

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“…[10][11][12] In contrast to this, few studies found no additional effects of lasers. 37,38 Meta-analysis/systematic reviews also showed no additional effect of laser. 39,40 These changes in the results may be due to small sample size, difference in the definitions considered for classification of the disease, use of different laser system and its parameters.…”

Section: Discussionmentioning

confidence: 99%

Diode Laser as an Adjunctive to Nonsurgical Periodontal Therapy during Maintenance Phase: A Randomized Controlled Clinical Trial

Suprith¹,

Setty²,

Thakur³

2016

International Journal of Laser Dentistry

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Aim:The aim of the study was to determine and compare the pocket depths (PD), relative attachment levels (RAL), bleeding on probing (BOP) and plaque indices (PI) in patients treated with scaling and root planning (SRP) alone and along with diode laser. Materials and methods:The study was carried out on 30 subjects who fulfill the inclusion and exclusion criteria. Group I: 15 patients treated with SRP along with diode laser irradiation. Group II: 15 patients treated only with SRP. The clinical parameters were probing PD, RAL, BOP and PI which were recorded at base line, 7 days and after 1 month. Statistical analysis was done using Kolmogorov-Smirnov, Shapiro-Wilk, t-test, chi-square test. Results:The use of diode lasers as an adjunct to SRP during maintenance phase showed better results when compared to SRP alone. Moderate periodontal pockets with moderate attachment loss showed significant improvement in group I than in group II. There was no change in deep pockets with severe attachment loss in both groups.Clinical significance: The study shows that the specified laser parameter and the modality of application of the same results in faster healing. This can be recommended as an appropriate treatment for moderate pockets.

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“…None of these average differences, regardless of clinical parameter, can be considered as clinically significant. 48,49 Reductions in subgingival bacterial loads were insignificant because four 16,18,23,28 of the seven diode studies did not measure this effect. Of the remaining three studies, only one favored treatment by SRP + adjunctive laser, and two studies detected no significant differences between the test groups.…”

Section: The Datamentioning

confidence: 99%

“…Table 1 shows only seven 16‐19,23,24,28 of the 21 human clinical studies involving a diode laser that may be considered to be without bias. The summary of these seven studies shows that 236 patients participated in the studies (an average of 33.7 patients per study).…”

Section: The Datamentioning

confidence: 99%

“…Lack of calibration and masking of clinicians/examiners is a major reason for biased data and should be a red flag when evaluating reported results in a clinical trial. 47 Table 1 shows only seven [16][17][18][19]23,24,28 of the 21 human clinical studies involving a diode laser that may be considered to be without bias. The summary of these seven studies shows that 236 patients participated in the studies (an average of 33.7 patients per study).…”

Section: The Datamentioning

confidence: 99%

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Commentary: Is There Clinical Benefit From Using a Diode or Neodymium:Yttrium‐Aluminum‐Garnet Laser in the Treatment of Periodontitis?

Cobb

2016

Journal of Periodontology

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Despite a quarter of a century of laser research, there is a persistent debate regarding the efficacy of dental lasers in the treatment of periodontitis or periodontal maintenance therapy. There are many claims and much hyperbole surrounding the use of lasers, either as a monotherapy or adjunctive to scaling and root planing, to treat periodontitis. There is little evidence that using a diode or neodymium:yttrium-aluminum-garnet laser adds clinical value over and above conventional non-surgical or surgical periodontal treatment. There is a significant need for better designed human clinical trials. Data from such trials should be analyzed according to initial probing depth and characteristics of the treated sites, such as non-molar, molar flat surfaces, and molar furcations, and evaluated for long-term post-treatment results.

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Adjunctive Non‐Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial

Abstract: In periodontal maintenance patients, SRP + L did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with ≥ 5 mm PD.

Cited by 37 publications

References 40 publications

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

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

Diode Laser as an Adjunctive to Nonsurgical Periodontal Therapy during Maintenance Phase: A Randomized Controlled Clinical Trial

Commentary: Is There Clinical Benefit From Using a Diode or Neodymium:Yttrium‐Aluminum‐Garnet Laser in the Treatment of Periodontitis?

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