ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Er:YAG Laser Therapy is An Effective Alternative to Scaling and Root Planing When Performing Non-Surgical Therapy for Treatment of Chronic Periodontitis
Clinical Question For patients with chronic periodontitis, is Er:YAG laser therapy an effective alternative in non-surgical therapy as compared to scaling and root planing?
Clinical Bottom Line Several studies have focused on comparing laser therapies to conventional scaling and root planing during non-surgical therapy. The literature supports the hypothesis that there are no significant differences in non-surgical therapy outcomes when comparing scaling and root planing to Er:YAG laser application.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25164559Zhao/2014Chronic Periodontitis PatientsSystematic review of randomized trials
Key resultsIn the 12 studies reviewed, there was no significant difference between outcomes of non-surgical therapy comparing Er:YAG application and scaling and root planing. The article concluded that both therapies resulted in similar clinical efficacy.
#2) 21553003Sgolastra/2012Chronic Periodontitis PatientsMeta-Analysis
Key resultsOf the clinical outcomes evaluated in five randomized controlled clinical trials, there was no statistical difference between therapies and no evidence to suggest a more profound result with Er:YAG therapy in patients with chronic periodontitis.
#3) 18724840Schwartz/2008Chronic Periodontitis Patients Systematic review of randomized trials
Key resultsThis systematic reviewed concluded similar efficacies in clinical outcomes during a short and long-term (24-months) follow-up between Er:YAG therapy and mechanical debridement. Due to the heterogeneity of the included studies, a meta-analysis was not possible to confirm the findings.
Evidence Search systematic[sb] AND ((("periodontal diseases"[MeSH Terms] OR ("periodontal"[All Fields] AND "diseases"[All Fields]) OR "periodontal diseases"[All Fields] OR ("periodontal"[All Fields] AND "disease"[All Fields]) OR "periodontal disease"[All Fields]) AND ("Expert Rev Mol Med"[Journal] OR "er"[All Fields] OR "Econ Rec"[Journal] OR "er"[All Fields])) AND YAG[All Fields]) AND systematic[sb]
Comments on
The Evidence
Validity: Of the three systematic reviews included, there was a moderate-high risk of bias, and increased heterogeneity prevented two of the studies from conducting a meta-analysis. Overall, with the inclusion of various randomized controlled trials and systemic review the evidence that supports this theory is moderate-to-high. Perspective: Based on the results of the studies reviewed, Er:YAG laser therapy is useful as an alternative method to scaling and root planing during non-surgical therapy. However, there are many factors that may influence the use of laser therapy in a private practice setting. A cost-benefit analysis would be beneficial in determining whether this therapy would enhance or hinder production.
Applicability Er:YAG laser therapy is an effective adjunct in non-surgical therapy for patients with chronic periodontitis, with similar clinical outcomes to scaling and root planing. The evidence demonstrates that utilization of Er:YAG laser ablates organic material through water vaporization in the sulcus without significantly damaging adjacent tissues. However, in a private practice setting the increased cost of purchasing a laser may influence the decision to use this therapy as an alternative.
Specialty/Discipline (Periodontics)
Keywords Chronic Periodontitis, Er:YAG laser, scaling and root planing.
ID# 2926
Date of submission: 10/13/2015spacer
E-mail klepperk@uthscsa.edu
Author Kandice L. Klepper, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Brian L. Mealey, DDS, MS
Faculty mentor/Co-author e-mail mealey@uthscsa.edu
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