Lasers in periodontics: use and abuse

Despite the suggestions that lasers are a desirable alternative to traditional periodontal root instrumentation and the recent FDA approval of the Nd:YAG laser for such application, numerous peer-reviewed articles concerning in vitro and in vivo results strongly suggest caution with respect to clinical application. There appears to be a high potential for laser-induced irreparable physical damage to the root surface. Further, residual char layers resulting from repeated laser exposure or improper choice of parameters may inhibit reattachment of soft tissues to the root surface. In addition, the use of lasers to remove calculus from subgingival pockets appears to be more efficient or predictable than traditional instrumentation and may, in fact, require root planing subsequent to the laser therapy to achieve the desired clinical goal.