Adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy: a randomized controlled clinical study.

ABSTRACT

OBJECTIVE: To evaluate clinically and microbiologically the outcomes following the combined application of InGaAsP diode laser and Er,CrYSGG laser for nonsurgical treatment of chronic periodontitis (ChP). METHOD AND MATERIALS Forty-two patients (age 45.31 ± 9.78 years, 22 female, 23 smokers) with ChP were randomly treated with subgingival debridement (SD) by means of ultrasonic and hand instruments (control group, n = 21) or with InGaAsP followed 1 week later by InGaAsP + SD + Er,CrYSGG (test group, n = 21). In the test group, a second laser treatment was performed for all residual sites (bleeding sites with probing depth [PD] ≥ 4 mm) 2 months after the first laser therapy. At baseline and 6 months after therapy, periodontal clinical and microbiologic parameters were evaluated. RESULTS: Six months after therapy, statistically significant clinical and microbiologic improvements (PD reduction, clinical attachment level [CAL] gain, quantitative reduction of periopathogens) were observed in both groups compared to baseline. However, the use of InGaAsP followed by SD and the adjunctive use of an Er,CrYSGG laser, yielded statistically significantly higher clinical (PD, CAL, bleeding on probing, number of sites with PD ≥ 5 mm, PD ≥ 6 mm, PD ≥ 7 mm) and microbiologic (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum) improvements (P < .05) compared to SD alone. CONCLUSIONS: In patients with ChP, the adjunctive use of InGaAsP and Er,CrYSGG to SD may additionally improve the clinical and microbiologic parameters obtained with SD alone, thus representing a valuable approach in nonsurgical periodontal therapy.