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.
Source: PubMed


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.
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