Adjunctive clinical effect of a water-cooled Nd:YAG laser in a periodontal maintenance care programme: a randomized controlled trial.
BACKGROUND
Various laser systems are currently available for intra-oral use. Neodymium:Yttrium-Aluminium Garnet lasers(Nd:YAG) have been approved by the US Food and Drug Administration for soft tissue treatment in the oral cavity.


OBJECTIVE
The aim of this study was to test whether the use of a water-cooled Nd:YAG laser during a maintenance care programme as an adjunct to supragingival and subgingival debridement (scaling and root planing, SRP) with hand and ultrasonic instruments results in clinical improvement compared with SRP alone.


METHODS
This study was an examiner-blind, randomized and controlled clinical trial using a split-mouth design. Thirty subjects were selected, originally diagnosed with moderate to severe generalized periodontitis, following a periodontal maintenance care programme (PMC). Immediately after SRP in two randomly assigned contra-lateral quadrants, all pockets ≥5 mm were additionally treated with a Nd:YAG laser (1064 nm, 4W, 250-μsec pulse). Clinical assessments [probing pocket depth PPD, bleeding on pocket probing (BOPP)] were performed pre-treatment and at 6 months. Based on these assessments, the periodontal inflamed surface area (PISA) was calculated.


RESULTS
At 6 months, the clinical parameters had significantly improved for both regimens. No statistically significant differences between treatment modalities were observed for PPD and BOPP scores at any time. PISA scores supported these findings.


CONCLUSIONS
In residual pockets ≥5 mm, treated in a PMC, the adjunctive use of an Nd:YAG laser does not provide a clinically significant additional advantage.
Department of Periodontology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
Dagmar E
DE
Slot
Mark F
MF
Timmerman
Paula A
PA
Versteeg
Ubele
U
van der Velden
Fridus A
FA
van der Weijden
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery; D000700:Analgesics / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000601:surgery*; D003646:Debridement; D012534:Dental Scaling / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D010514:Periodontal Pocket / Q000601:surgery; D059745:Piezosurgery; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014867:Water
D000700:Analgesics; D014867:Water