Short-term clinical and microbiologic effects of pocket debridement with an Er:YAG laser during periodontal maintenance.
BACKGROUND
The erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser is considered a useful tool for subgingival debridement because the laser treatment creates minimal damage to the root surface and has potential antimicrobial effects. The aim of this randomized controlled clinical trial was to evaluate clinical and microbiologic effects of pocket debridement using an Er:YAG laser in patients during periodontal maintenance.


METHODS
Twenty patients at a recall visit for maintenance were consecutively recruited if presenting at least four teeth with residual probing depth (PD) > or = 5 mm. Two pockets in each of two jaw quadrants were randomly assigned to subgingival debridement using 1) an Er:YAG laser (test) or 2) an ultrasonic scaler (control). The laser beam was set at 160 mJ with a pulse frequency of 10 Hz. Clinical variables were recorded at baseline, 1 month, and 4 months after treatment. Primary clinical outcome variables were changes in PD and clinical attachment level (CAL). Microbiologic analysis of subgingival samples was performed at baseline, 2 days, and 30 days after treatment using a checkerboard DNA-DNA hybridization technique against 12 periodontal disease-associated species.


RESULTS
The mean initial PD was 6.0 mm (SD: 1.2) in the test group and 5.8 mm (SD: 0.9) in the control group. At 1 month post-treatment, the PD reduction was significantly greater for test than control sites (0.9 versus 0.5 mm; P <0.05). The CAL gain also was significantly greater (0.5 versus 0.06 mm; P <0.01). At the 4-month examination, no significant differences were detected in PD reduction (1.1 versus 1.0 mm) or CAL gain (0.6 versus 0.4 mm). Both treatments resulted in reduction of the subgingival microflora. No significant differences in microbiologic composition were identified between the treatment groups at various time intervals. Degree of treatment discomfort scored significantly lower for the test than the control treatment modality.


CONCLUSIONS
The results of the trial failed to demonstrate any apparent advantage of using an Er:YAG laser for subgingival debridement, except less treatment discomfort perceived by the patients.
Tomasi
Cristiano
C
Department of Periodontology, Institute of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. cristiano.tomasi@odontologi.gu.se
Schander
Kerstin
K
Dahlén
Gunnar
G
Wennström
Jan L
JL
D000328:Adult; D000368:Aged; D000538:Aluminum Silicates; D001419:Bacteria / Q000145:classification; D003646:Debridement; D012534:Dental Scaling / Q000295:instrumentation; D004871:Erbium; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation; D015019:Yttrium
D000538:Aluminum Silicates; D015019:Yttrium; D004871:Erbium