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
PubMed ID Author / Year Patient Group Study type (level of evidence) 25164559 Zhao/2014 Chronic Periodontitis Patients Systematic review of randomized trials Key results In 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. 21553003 Sgolastra/2012 Chronic Periodontitis Patients Meta-Analysis Key results Of 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. 18724840 Schwartz/2008 Chronic Periodontitis Patients Systematic review of randomized trials Key results This 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	(Periodontics)
Keywords	Chronic Periodontitis, Er:YAG laser, scaling and root planing.
ID#	2926
Date of submission	10/13/2015
E-mail	klepperk@uthscsa.edu
Author	Kandice L. Klepper, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Brian L. Mealey, DDS, MS
Faculty mentor e-mail	mealey@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?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available