Lasers in periodontics: use and abuse

Area of Science:

• Periodontology
• Biomedical Engineering
• Dental Laser Technology

Background:

• The Nd:YAG laser is FDA-approved for periodontal root instrumentation, positioning it as a potential alternative to traditional methods.
• Despite approval, concerns exist regarding the safety and efficacy of laser use in clinical periodontal therapy.

Purpose of the Study:

• To evaluate the risks and benefits of using lasers for periodontal root instrumentation.
• To assess the potential for laser-induced damage and its impact on soft tissue reattachment.
• To compare laser calculus removal efficiency with traditional root planing.

Main Methods:

• Review of peer-reviewed articles on in vitro and in vivo studies of laser use in periodontology.
• Analysis of data concerning root surface integrity after laser exposure.
• Evaluation of residual char layer formation and its effect on cellular behavior.
• Comparison of laser efficacy in calculus removal versus conventional root planing.

Main Results:

• High potential for irreparable physical damage to the root surface from laser application.
• Residual char layers can inhibit soft tissue reattachment.
• Lasers may be more efficient for subgingival calculus removal but might necessitate subsequent root planing.

Conclusions:

• Clinical application of lasers for periodontal root instrumentation requires significant caution.
• Potential for root surface damage and impaired healing necessitates further investigation.
• Optimized laser parameters and adjunctive root planing may be crucial for successful outcomes.