Er:YAG laser in the treatment of periodontal sites with recurring chronic inflammation: a 12-month randomized, controlled clinical trial.
OBJECTIVE
The objective of this randomized, controlled clinical trial was to compare the clinical and microbiological effects of pocket debridement using erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser with conventional debridement in maintenance patients.


METHODS
Fifteen patients, all smokers, having at least four teeth with residual probing depth (PD) ≥ 5 mm were recruited. Two pockets in two jaw quadrants were randomly assigned to subgingival debridement using an Er:YAG laser (test) or ultrasonic scaler/curette (control) at 3-month intervals. Relative attachment level (RAL), PD, bleeding on probing and dental plaque were recorded at baseline and at 6 and 12 months. Microbiological subgingival samples were taken at the same time points and analysed using a checkerboard DNA-DNA hybridization technique.


RESULTS
A significant decrease in PD took place in both treatments from baseline to 12 months (p < 0.01). In the control, the mean initial PD decreased from 5.4 to 4.0 mm at 12 months. For the test, a similar decrease occurred. No significant between-treatment differences were shown at any time point. The mean RAL showed no overall significant inter- or intra-treatment differences (p > 0.05). No significant between-treatment differences were observed in subgingival microbiological composition or total pathogens.


CONCLUSIONS
The results failed to support that an Er:YAG laser may be superior to conventional debridement in the treatment of smokers with recurring chronic inflammation. This appears to be the first time that repeated Er-YAG laser instrumentation has been compared with mechanical instrumentation of periodontal sites with recurring chronic inflammation over a clinically relevant time period.
Department of Clinical Dentistry - Periodontotics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Ivar
I
Krohn-Dale
Olav E
OE
Bøe
Morten
M
Enersen
Knut N
KN
Leknes
D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D055113:Chronic Periodontitis / Q000382:microbiology / Q000601:surgery; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery / Q000628:therapy; D006094:Gram-Positive Bacteria / Q000145:classification; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000601:surgery; D057747:Periodontal Debridement / Q000379:methods*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology / Q000601:surgery*; D059745:Piezosurgery / Q000379:methods; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D011446:Prospective Studies; D016037:Single-Blind Method; D012907:Smoking; D013357:Subgingival Curettage / Q000379:methods; D048373:Treponema denticola / Q000302:isolation & purification