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Title Use Of Diode Lasers in Addition to Conventional Non-Surgical Periodontal Therapy Does Not Produce a Decrease in Probing Depths or Clinical Attachment Loss (CAL)
Clinical Question For patients in the initial phase of chronic periodontal therapy, does adjunctive treatment with diode lasers result in decreased probing depth and clinical attachment loss (CAL) as compared to those treated with conventional non-surgical periodontal therapy?
Clinical Bottom Line The use of diode lasers in addition to scaling and root planing does not produce a decrease in probing depths or CAL for those undergoing the initial phase of chronic periodontal treatment. A review of 9 studies including a large number of patients indicates that the combined therapy produces results comparable with conventional debridement alone.
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) 24460795Slot/2014247 patients in 9 included studies Meta-Analysis
Key resultsMeta-analysis of probing depths and CAL showed no significant benefit from the use of diode lasers: Probing depth difference in means (DiffM) = -0.11, p = 0.68, 95% CI [-0.65, 0.43]. CAL DiffM = 0.04, p = 0.80, 95% CI [-0.26, 0.34].
Evidence Search ("chronic periodontitis"[MeSH Terms] OR ("chronic"[All Fields] AND "periodontitis"[All Fields]) OR "chronic periodontitis"[All Fields]) AND ("lasers"[MeSH Terms] OR "lasers"[All Fields] OR "laser"[All Fields]) AND Review[ptyp]
Comments on
The Evidence
Validity: The review included a detailed search for relevant trials with strict selection parameters. Two independent reviewers assessed all studies for methodological quality. Meta-analysis was performed using a random effects model. Perspective: The 9 studies reviewed included 247 patients who were followed for up to 6 months. This is a large patient pool, but more long-term studies are indicated. The main advantage of the diode laser is the energy absorption in the soft tissues to remove the epithelial lining of the pocket without damaging hard tissues.
Applicability Studies included patients 18 and older who were in good health. The effects of smoking and systemic disease were not analyzed. The novelty of diode lasers makes them appealing to patients and clinicians, but the cost can be prohibitive, and not all models are approved for use in the US.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Adjunctive laser therapy, diode laser, chronic periodontitis, non-surgical periodontal therapy, scaling and root planing, probing depth, clinical attachment level
ID# 3187
Date of submission: 03/25/2017spacer
E-mail mosierm@livemail.uthscsa.edu
Author Meredith Mosier
Co-author(s) e-mail
Faculty mentor/Co-author Yong-Hee Chun, DDS, PhD
Faculty mentor/Co-author e-mail ChunY@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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None available
Comments and Evidence-Based Updates on the CAT
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by Christine Melch, DDS (San Antonio, TX) on 10/10/2022
As of 2022, research has still failed to demonstrate efficacy of laser therapy over conventional therapy. A PubMed search in October of 2022 found two meta-analyses (Ren 2017 PMID 26932392, and Salvi 2020 PMID 31859395) that found no significant differences between adjunctive laser therapy and conventional non-surgical therapy, although both note a high heterogeneity in research making it difficult to ascertain definitive conclusions. A similar study comparing Er,Cr:YSGG laser therapy as an adjunct to scaling and root planing versus scaling and root planing alone (Klokkevold 2022 PMID 35239185) also failed to demonstrate a difference between laser therapy and conventional non-surgical therapy.

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