Treatment of periodontal pockets with a diode laser

Abstract

Background and Objective:The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition. Study Design/Materials and Methods: Fifty patients were randomly subdivided into two groups (laser-group and controlgroup) and microbiologic samples were collected. There have been six appointments for 6 months following an exact treatment scheme. After evaluating periodontal indices (bleeding on probing, Quigley-Hein) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients, the deepest pockets of each quadrant of the laser-group's patients were microbiologically examined. Afterwards, all teeth were treated with the diode laser. The control-group received the same treatment but instead of laser therapy were rinsed with H 2 O 2 . Each appointment also included a hygienic checkup. After 6 months the final values of the periodontal indices and further microbiologic samples were measured. The total bacterial count as well as specific bacteria, such as Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis, were assessed semiquantitatively. Results: The bacterial reduction with diode laser therapy was significantly better than in the control group. The index of bleeding on probing improved in 96.9% in the laser-group, whereas only 66.7% in the control group. Pocket depths could be more reduced in the laser group than in the control group. Conclusion:The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling. The diode laser therapy, in combination with scaling, supports healing of the periodontal pockets through eliminating bacteria.

Combined photoablative and photodynamic diode laser therapy as an adjunct to non‐surgical periodontal treatment. A randomized split‐mouth clinical trial

“…Another issue of controversy is related to the fact that most of the previous studies limit the laser treatment to periodontal pocket curettage (Lin et al 2011), which has been recently stated to be substantially ineffective in a consensus report of the AAP Board of Trustees (2011). Notwithstanding this, our findings support previous reports that treatment with Pa (Moritz et al 1998, Andreana 2005, Lin et al 2011 or Pd (Polansky et al 2009, Cappuyns et al 2011, Ge et al 2011) diode lasers can afford significant advantages over SRP alone in patients with chronic periodontitis. Thus, the results of the different studies are hardly comparable because they are largely dependent on individual skills and background photobiological knowledge of the different investigators.…”

Laser-Assisted Nonsurgical Periodontal Therapy

“…[19][20][21][22] Although not specific to certain bacteria, the argon (Ar), neodymium-doped yttrium-aluminum-garnet (Nd:YAG), and diode lasers have strong absorption in darkly pigmented bacteria, causing a direct, increased effect on the [19][20][21][22] Although not specific to certain bacteria, the argon (Ar), neodymium-doped yttrium-aluminum-garnet (Nd:YAG), and diode lasers have strong absorption in darkly pigmented bacteria, causing a direct, increased effect on the…”

“…Diode lasers are bactericidal 19,41,42 and aid in coagulation. However, no definitive studies yet show that the superior absorption in water leads to superior clinical results compared with other diode wavelengths.…”

“…26,27 The absorption of laser energy by tissues produces a photothermal effect. Moritz et al 19 reported that the bleeding index improved in 96.9% of the patients treated with laser-assisted periodontal therapy after conventional therapy, compared with 66.7% of patients treated conventionally without laser. Working within the recommended parameters of 60° C, 30 the healthy tissue beneath the nonhealing granulation layer is not affected by the low energy.…”

“…With the appropriate parameters, most nonsporulating bacteria, including anaerobes, are readily deactivated at 50° C. 28,29 In laser-assisted active phase I periodontal infection therapy, the diseased biofilm-infested tissues of periodontal pockets are debrided. 19 Administering laser energy to the affected tissues at specific, repeated intervals is key in targeting biofilm during periodontal therapy. As noted earlier, biofilm can penetrate soft tissues.…”