Effectiveness of root planing with diode laser curettage for the treatment of periodontitis
Department of Periodontics, Arthur A. Dugoni School of Dentistry, San Francisco, CA 94115-2333, USA.Journal of the California Dental Association 10/2012; 40(10):786-93.
This study investigated the effectiveness of scaling/root planing using closed approach, closed approach with laser-curettage, closed approach with laser-curettage/laser-sealing, and an open approach (papilla reflection/flap closure) in treating moderate-advanced chronic periodontitis. All treatments resulted in a reduction in probing depth and bleeding upon probing. The closed approach therapies: SRP, laser-curettage/SRP, and laser-curettage/SRP/laser-sealing resulted in less gingival recession than the open approach (papilla reflection/flap closure). If esthetics are a concern, laser-curettage is a viable option.
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ABSTRACT: What is the adjunctive effect of a diode laser following non-surgical periodontal debridement (SRP) during the initial phase of periodontal therapy on the clinical parameters of periodontal inflammation. The MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched up to September 2013. Probing pocket depth (PPD) and clinical attachment loss (CAL) were selected as outcome variables. Also plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were considered outcome measures. Data were extracted and a meta-analysis was performed where appropriate. Independent screening of 416 unique papers resulted in 9 eligible publications. The meta-analysis evaluating PPD, CAL and PS showed no significant effect. The only significance favoring adjunctive use of the diode laser was observed for the outcome parameters GI and BS. The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favoring the diode laser, however, the clinical relevance of this difference is remains a question. This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL. This article is protected by copyright. All rights reserved.Journal Of Clinical Periodontology 01/2014; 41(7). DOI:10.1111/jcpe.12233 · 4.01 Impact Factor
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ABSTRACT: Objective: To systematically review currently available evidence regarding the role of diode lasers (810 nm-980 nm) as adjuncts to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). Background data: Mechanical instrumentation of periodontal tissues followed by diode laser application leads to complete removal of pocket epithelium compared to conventional SRP. Materials and methods: To address the focused question "Is SRP with adjunct diode lasers (810 nm-980 nm) therapy more effective in the treatment of CP as compared to when CP is treated by SRP alone?" Databases were searched using different key words: "Chronic periodontitis", "diode laser", "surgical", and "Scaling and root planing", “Periodontal diseases”, “Periodontal therapy” and “Periodontal treatment”. Original studies were included. Letters to the Editor, case-reports, commentaries, and reviews were excluded. Results: Ten clinical studies were included. In all studies, patients were systemically healthy and cigarette smokers were included in two studies. In 5 studies SRP+diode laser application was more effective in the treatment of CP than SRP and 3 studies showed no difference. In 2 studies, there was a moderate reduction in periodontal inflammation using SRP+diode laser. The diameter of optic fiber, laser wavelengths, power, pulse repetition rate and duration of laser exposure ranged between 300 microns-2 mm, 810 nm-980 nm, 0.8 W-2.5 W, 10-60 Hz and 10-100 milliseconds, respectively. Conclusion: In CP patients with probing depths ≤5mm, diode lasers, SRP+diode laser (800 nm-980 nm) is more effective in the treatment of CP as compared to when SRP is used alone.Photomedicine and Laser Surgery 08/2015; 33(11). DOI:10.1089/pho.2015.3914 · 1.67 Impact Factor
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