ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Lasers as an Adjunct in Periodontal Surgical Therapy Do Not Result in Improved Outcomes for Patients
Clinical Question In patients with periodontitis, does the adjunctive use of lasers during surgery lead to improved outcomes?
Clinical Bottom Line No significant benefit was found for patients being treated with lasers as an adjunct to surgical therapy for the outcomes of probing depth, clinical attachment level, and gingival recession.
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) 26269936Behdin/20154 Studies IncludedMeta-Analysis
Key resultsThe studies were not supportive of the use of lasers in surgical periodontal therapy. For flap surgery with and without laser, the weighted mean difference (WMD) of Pocket Depth, the primary outcome, was 0.56 mm with a 95% Confidence Interval = -0.56 to 1.67 (P=0.33). For pocket depth reduction there was a "high degree of heterogeneity" among the results (P = <0.001 for X2 test). For the secondary outcomes, clinical attachment level had a WMD = 1.34 mm with a 95% Confidence Interval = -2.02 to 4.70 mm (P=0.44) and gingival recession had a WMD = -0.24mm with a 95% confidence interval = -0.82 to 0.35 mm (P=0.42).
Evidence Search Therapy/Broad[filter] AND (("laser therapy"[MeSH Terms] OR ("laser"[All Fields] AND "therapy"[All Fields]) OR "laser therapy"[All Fields] OR ("laser"[All Fields] AND "surgery"[All Fields]) OR "laser surgery"[All Fields]) AND moderate[All Fields] AND ("periodontitis"[MeSH Terms] OR "periodontitis"[All Fields]))
Comments on
The Evidence
Validity: The methods of review and collection of research legitimize the findings. There was no bias indicated for the review itself, but there was a moderate risk of bias in nearly half of the articles included in the review/analysis. Furthermore, it is noted that the study populations were not large, and a high degree of heterogeneity among the included studies is great. Perspective: The findings of the review/analysis are limited in their application and interpretation due to the limitations of the studies included in the review, but the information is helpful in guiding clinicians for expectations of laser use in flap surgery.
Applicability Operators, and the patients undergoing periodontal surgery, should consider surgical techniques without the use of lasers as the evidence is not conclusive for a significant benefit from their use.
Specialty/Discipline (Periodontics)
Keywords Lasers, surgical, periodontitis
ID# 3083
Date of submission: 04/07/2016spacer
E-mail maya3@livemail.uthscsa.edu
Author Austin May
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Richard Finlayson, DDS
Faculty mentor/Co-author e-mail finlaysonr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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