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Published on: May 9, 2022
Microbiological effects and recolonization patterns after adjunctive subgingival debridement with Er:YAG laser
Ignacio Sanz-Sánchez1, Alberto Ortiz-Vigón2, David Herrera2,3
1Postgraduate Clinic in Periodontology, Faculty of Odontology, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N., 28040, Madrid, Spain. ignaciosanz@mac.com.
The adjunctive use of erbium-doped yttrium aluminium garnet (Er:YAG) laser in non-surgical periodontal treatment did not improve microbiological outcomes or bacterial recolonization patterns compared to ultrasonic debridement alone. Clinical benefits were observed, but without significant microbiological differences.
Area of Science:
- Periodontology
- Laser Dentistry
- Microbiology
Background:
- Chronic periodontitis requires effective non-surgical treatment to manage bacterial load and prevent disease progression.
- The erbium-doped yttrium aluminium garnet (Er:YAG) laser is explored as an adjunctive therapy to conventional periodontal debridement.
- Understanding the microbiological impact and recolonization patterns post-treatment is crucial for evaluating therapeutic efficacy.
Purpose of the Study:
- To assess the microbiological effects of adjunctive Er:YAG laser therapy in non-surgical periodontal treatment.
- To evaluate bacterial recolonization patterns following Er:YAG laser application compared to conventional ultrasonic debridement.
- To compare clinical outcomes between the test (laser-adjunctive) and control (ultrasonic only) groups.
Main Methods:
- Patients with chronic periodontitis were randomized into two groups: test (ultrasonic instrumentation + Er:YAG laser) and control (ultrasonic instrumentation only).
- Microbiological parameters (total counts, pathogen frequency, proportions) and clinical parameters were assessed at baseline, 3, and 12 months.
- The Er:YAG laser was applied to sites with probing pocket depth ≥4.5 mm one week after ultrasonic instrumentation in the test group.
Main Results:
- No significant differences were found between groups in total bacterial counts or the frequency of prevalent periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum).
- A non-statistically significant reduction in P. gingivalis proportions was observed at 3 months in both groups.
- The test group demonstrated a statistically significant greater reduction in probing depth at 12 months compared to the control group.
Conclusions:
- Adjunctive Er:YAG laser therapy does not provide additional microbiological benefits over conventional ultrasonic debridement for chronic periodontitis.
- While some clinical improvements were noted with the laser, microbiological outcomes and bacterial recolonization patterns remained similar between the treatment groups.
- The study suggests that the Er:YAG laser's role in non-surgical periodontal therapy may be primarily clinical rather than microbiological.
