[Lasers in dentistry. 5. The use of lasers in periodontology]

This literature review shows that the Nd:YAG laser and the Er:YAG laser can be beneficially used in periodontology for subgingival curettage and gingivectomy. Studies demonstrated that subgingival laser treatment can result in significant reduction of the initial levels of periodontal pathogens. It is beneficial to perform laser curettage under water irrigation prior to scaling in order to destroy of the structure of the calculus and its attachment to the root surface. During laser curettage sufficient haemostasis is obtained, which improves detection of subgingival calculus. Nd:YAG laser gingivectomy results in similar improvement of deep periodontal pocket as conventional flap surgery, with the advantages such as minimal bleeding and post-operative pain, no swelling, and neither sutures nor post-surgical dressing are needed. Both non-surgical and surgical laser treatments are often performed without local anaesthesia, making full-mouth treatment in one session possible. Treatments are well accepted by the patients and require about 50% less time than the conventional therapies. Laser-de-epithelialization for periodontal regeneration has been experimentally attempted, but more controlled studies are needed to establish its usefulness in the clinic. Laser treatment of peri-implantitis is not recommended.