Long-term effects of a single application of a water-cooled pulsed Nd:YAG laser in supplement to scaling and root planing in patients with periodontal inflammation.

The aim of this work was to investigate the long-term effects of a single application of a water-cooled pulsed neodymium yttrium aluminium garnet (Nd:YAG) laser, in combination with scaling and root planing (SRP) for the treatment of periodontal inflammation. Twenty-two patients were included in this split-mouth single blind randomized controlled clinical trial. The parameters of the air and water-cooled Nd:YAG laser were: 4 W, 80 mJ/pulse, 50 Hz and a pulse width of 350 µs. The "test side" was treated with a single application of Nd:YAG laser and SRP; while the "control side " was treated with SRP alone. At baseline, and after a median follow-up time of 20 months (range 12-39), periodontal inflammatory parameters (plaque index [PI], gingival index [GI], probing pocket depth [PPD]), and marginal bone loss (on digital bite-wing radiographs) were measured. Gingival crevicular fluid (GCF) was collected from the teeth 35, 36, 45, and 46 at baseline and at follow-up. Pl (p < 0.01), GI (p < 0.01), and PPD (p < 0.001) were significantly lower on the test side compared to the control side at follow-up. Radiological results showed significantly less bone loss on the test side compared to the control side (p < 0.05). GCF volume was lower on the test side compared to the control side (p < 0.01). In conclusion, a single application of Nd:YAG laser in combination with SRP had a positive long-term effect on periodontal health compared to treatment by SRP alone.

A short-term evaluation of Nd:YAG laser as an adjunct to scaling and root planing in the treatment of periodontal inflammation.

BACKGROUND: This split-mouth, single-masked, randomized, controlled clinical trial compares the short-term outcomes of a combined treatment with scaling and root planing (SRP) and neodymium-doped:yttrium, aluminum, and garnet (Nd:YAG)-laser irradiation with treatment with SRP alone. METHODS: Thirty patients were recruited. The mandibular left or right side was randomly assigned as the test side (SRP with laser treatment) or control side (SRP alone). The water-cooled Nd:YAG laser was used at 4 W, 80 mJ/pulse, 50 Hz, and with a pulse width of 350 micros. At baseline, gingival crevicular fluid (GCF) samples were taken from the test and control sides, and levels of matrix metalloproteinase (MMP)-8 and interleukin (IL)-1beta, -4, -6, and -8 were measured using standard techniques. The plaque index (PI), gingival index (GI), and probing depth (PD) were measured by calibrated examiners. RESULTS: At the 1-week follow-up, PD (P <0.001), PI (P <0.05), and GCF volume (P <0.001) showed significant improvement on test sides compared to control sides. At the 3-month follow-up, PD (P <0.01), PI (P <0.01), GI (P <0.01), and GCF volume (P <0.05) also showed significant improvement on test sides compared to control sides. At the 1-week follow up, IL-1beta and MMP-8 levels were significantly reduced on test sides compared to control sides. The 3-month follow-up confirmed that the improvements on test sites had been sustained compared to the treatment outcomes of control sites. CONCLUSION: In the short-term, SRP in combination with a single application of a water-cooled Nd:YAG laser significantly improves clinical signs associated with periodontal inflammation compared to treatment with SRP alone.