Adjunctive Nd:YAG laser application in chronic periodontitis: clinical, immunological, and microbiological aspects

Abstract

In recent years, the use of laser radiation has been investigated as an alternative or adjunctive tool to conventional procedures employed in the treatment of periodontal disease. Various beneficial characteristics of Nd:YAG laser radiation, such as hemostatic and bactericidal effects, might lead to improved treatment outcomes. The objective of the present study was to examine the clinical, microbiological, and anti-inflammatory efficacy of Nd:YAG laser periodontal pocket irradiation as an adjunct to scaling and root planing (SRP). Thirty patients with chronic periodontitis (CP) were randomly assigned in parallel groups to receive SRP alone or SRP followed by Nd:YAG laser (λ = 1,064 nm) (SRP+NDL). Probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI) were recorded, and samples of gingival crevicular fluid (GCF) and subgingival microbiota were taken at baseline and post-therapy (4 and 8 weeks after treatment). The laser therapy was performed 1 day after the SRP procedure. The GCF samples were analyzed for interleukin-1beta (IL-1β), tumor necrosis factor alpha (TNF-α), and total antioxidative status (TAS). Microbiological samples were cultured and analyzed for ten bacteria. No statistically significant differences were detected for clinical or microbiological variables between SRP and SRP+NDL treatments. However, levels of IL-1 β in GCF were significantly lower after SRP+NDL treatment when compared to IL-1 β levels obtained by SRP alone after 4 weeks of treatment. Levels of TNF-α were significantly lower after the SRP+NDL treatment during post-therapy. TAS of GCF increased during post-therapy after the SRP+NDL treatment. However, after SRP alone, it remained constant. In this short-term clinical study Nd:YAG laser radiation in the treatment of CP is showed to be a potential adjunct to conventional SRP.