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Updated: Jun 3, 2026
Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
1064 nm Nd:YAG versus 940 nm diode laser-assisted periodontal therapy in stage II periodontitis: a randomized
Nada W Shaban1, Gehan S Kotry2, Maha R Taalab2
1Department of Periodontology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. nada.wagdy.dent@alexu.edu.eg.
Background:
Stage II periodontitis develops in the presence of a dysbiotic subgingival biofilm that sustains chronic inflammation and progressive loss of periodontal support. While scaling and root planing (SRP) remains the primary treatment for periodontitis, adjunctive methods have been suggested to improve subgingival debridement and microbial control. Laser-assisted new attachment procedure (LANAP®) is a proprietary, minimally invasive protocol originally designed for the 1064 nm neodymium: yttrium-aluminum garnet (Nd:YAG) laser system. 940 nm diode laser preferentially interacts with inflamed, blood-rich tissues and pigmented periodontopathogens. This study aimed to evaluate the immediate microbiological and short-term clinical effects of laser-assisted periodontal therapy performed in accordance with the clinical principles of LANAP®, but without using the proprietary LANAP® system.
Methods:
This randomized controlled trial included thirty-three stage II periodontitis patients, randomly allocated to three equal groups. Test group I received Nd:YAG 1064 nm laser-assisted therapy based on LANAP®-derived clinical steps; test group II received 940 nm diode laser-assisted periodontal therapy using a comparable, minimally invasive protocol; and control group III received SRP only. Subgingival biofilm samples were obtained at baseline and immediately following each intervention. T. denticola and P. intermedia levels were measured using real-time quantitative polymerase chain reaction (qPCR). Clinical outcomes, including clinical attachment level (CAL), probing pocket depth (PPD), and bleeding on probing (BOP), were documented at baseline and at 3-month follow-up.
Results:
All three treatment modalities significantly reduced T. denticola and P. intermedia immediately post-treatment relative to baseline (P = 0.003). Inter-group analysis demonstrated significant differences for P. intermedia and T. denticola (P = 0.001 and 0.004), with both laser-assisted groups outperforming the SRP group. At 3 months, CAL and PPD demonstrated significant inter-group differences, while BOP did not.
Conclusions:
Laser-assisted periodontal therapy based on LANAP®-derived principles, using either an Nd:YAG 1064 nm or a 940 nm diode laser, offers superior immediate microbiological suppression and more favorable clinical outcomes than SRP alone.
Trial Registration:
This trial was retrospectively registered at ClinicalTrials.gov; trial registration number: NCT06509412; date of registration: 19 July 2024.
