Clinical and Immunological Effects of Er,Cr:YSGG Laser in Nonsurgical Periodontal Treatment: A Randomized Clinical Trial.

Objective: The aim of this study was to compare the clinical and immunological results of nonsurgical periodontal treatment with or without the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. Background data: As lasers have begun to be used in dentistry, the Er,Cr:YSGG laser has started to attract attention in the field of periodontology. Materials and methods: Fifty-nine nonsmoking patients with advanced chronic periodontitis were randomly allocated to a test group (full-mouth ultrasonic supra- and subgingival debridement+Er,Cr:YSGG laser application) and a control group (full-mouth ultrasonic supra- and subgingival debridement+root planing with Gracey curettes). The laser parameters were set as follows: 1.5 W output power, pulse mode H (pulse duration of 140 µs), pulse frequency of 20 Hz, and an air-water spray ratio of 10% air and 15% water. The instrumentation was performed until the operator felt that the root surfaces were adequately debrided. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index, interleukin-1 beta (IL-1ß), matrix metalloproteinase-8 (MMP-8), tissue inhibitor metalloproteinase-1 (TIMP-1), and MMP-8/TIMP-1 levels in gingival crevicular fluid were evaluated at baseline, 6 weeks, and 3 months postoperatively. Results: There were statistically significant differences in PD, which was our primary outcome, and BOP between the groups at both examinations [p < 0.001 and p < 0.001 (for PD) and p = 0.048 and p < 0.001 (for BOP), respectively], in favor of the laser group. However, there were no significant differences among groups at any time for CAL gain (p = 563 and p = 369, respectively). No significant differences in MMP-8, TIMP-1, and MMP-8/TIMP-1 levels were detected among groups. There was a statistically significant difference for IL-1ß levels among groups at 3-month evaluations in favor of the laser group. Conclusions: Using the Er,Cr:YSGG laser instead of hand instruments in nonsurgical periodontal treatment has shown additional improvements in terms of pocket reduction and gingival bleeding compared with traditional nonsurgical therapy.

Clinical and Microbiological Effects of the Use of Erbium: Yttrium-Aluminum-Garnet Laser on Chronic Periodontitis in Addition to Nonsurgical Periodontal Treatment: A Randomized Clinical Trial-6 Months Follow-Up.

Background and objective: The purpose of this randomized controlled clinical trial is to evaluate the efficiency of erbium-doped:yttrium-aluminum-garnet (Er:YAG) laser adjunct to nonsurgical periodontal debridement on clinical periodontal parameters and red complex periodontopathogens. Materials and methods: Thirty-eight systematically healthy, never-smoker patients with chronic periodontitis were randomly assigned to one of two groups in a parallel design: 1-scaling and root planing (SRP) and 2-SRP + Laser (SRP + L). SRP and SRP + L administration were completed within 24 h. Clinical attachment level (CAL), probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were recorded at baseline and 3 and 6 months after treatment. Subgingival plaque samples were also measured 1 month after treatment. Microbiological evaluation was performed using real-time polymerase chain reaction. Results: All clinical parameters significantly improved 3 and 6 months after treatment in both groups. In the deep and moderately deep pockets, PD reduction and CAL gain between baseline and 6 months were significantly different between the groups (p < 0.05). There were no statistically significant differences regarding BOP and PI between the groups. There were no statistically significant differences in Pg, Tf, and Td levels between the SRP and SRP + L groups at any time point (p > 0.05). Conclusions: Within the limits of this randomized clinical trial, the adjunctive use of Er:YAG laser with SRP may be beneficial in moderately deep and deep pockets to improve CAL and PD. However, Er:YAG laser failed to demonstrate additional microbiological benefits in nonsurgical periodontal treatment. Clinicaltrials.gov #NCT03387371.