Use of a Carbon Dioxide Laser as an Adjunct to Scaling and Root Planing for Clinical New Attachment: A Case Series

Severe, chronic periodontitis (CP) is typically treated either with scaling and root planing (SRP) or surgical therapy in an effort to gain clinical attachment. The advantage of non-surgical therapy is decreased morbidity to the patient; however, the site typically heals by formation of a long junctional epithelium. The advantage of surgical therapy is access for debridement and the use of bone or bone substitutes in combination with a barrier membrane for epithelial exclusion. Compared with a non-surgical approach, surgical therapy is more invasive, and patient acceptance of treatment is typically more challenging. The use of lasers in dentistry appears to be rapidly increasing, as evidenced by the influx of new lasers into the dental market as well as numerous anecdotal reports of beneficial results with their use.

This report presents a novel approach to the treatment of severe CP using a carbon dioxide (CO₂) laser in combination with SRP. This study presents the findings of 17 patients (nine males and eight females, aged 34 to 71 years; mean age: 54 years) that were compared in a split-mouth design and followed for 3 months. To the best of the authors' knowledge, this is the first reported case series using a CO₂ laser for de-epithelialization in combination with SRP for the treatment of CP.

Sites treated with the CO₂ laser tended to show a greater decrease in probing depths, greater amounts of recession, and greater gains in clinical attachment levels, but the results were not statistically significantly better than SRP alone.