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Combination of Nd:YAG and Er:YAG lasers in non-surgical periodontal therapy: a systematic review of randomized clinical studies

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Abstract

Lasers are increasingly utilized in the non-surgical treatment of periodontal disease. The aim of the present systematic review with meta-analysis was to investigate the combination use of Nd:YAG and Er:YAG laser therapy in the treatment of severe periodontitis. A systematic review of the literature including searches in PubMed/Medline, Cochrane Library, Google Scholar, and Grey Literature databases, as well as manual searches, was performed until November 1, 2021. Only studies a combination of lasers during non-surgical treatment of pockets ≥ 6mm were included. The eligibility criteria for meta-analysis comprised randomized controlled trials (RCTs) comparing the use of combination laser therapy with/without adjunctive mechanical for the non-surgical management of periodontitis. From 57 initial articles, 6 full-text articles were assessed for eligibility. Two studies were excluded, one study was not a randomized clinical trial (case series), and one study was an in vitro study. Four RCTs were included in the meta-analysis. It was shown that combination of Nd:YAG and Er:YAG may be beneficial for non-surgical periodontal therapy with an additional average reduction in pocket depth and clinical attachment level reported at 1.01 and 0.77 mm respectively when compared to controls. The findings suggest that the combination of Nd:YAG and Er:YAG lasers may lead to additional clinical improvements compared to nonsurgical treatment alone. Future research is needed to substantiate these findings and optimize clinical guidelines including more specific laser protocols. Preliminary data suggest favorable outcomes following the combination of Nd:YAG and Er:YAG lasers for non-surgical periodontal therapy.

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Authors and Affiliations

  1. Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA

    Nathan E. Estrin & George E. Romanos

  2. Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil

    Vittorio Moraschini

  3. Department of Oral Implantology, Wuhan University, Wuhan, China

    Yufeng Zhang

  4. Department of Periodontology, University of Bern, Bern, Switzerland

    Anton Sculean & Richard J. Miron

Authors
  1. Nathan E. Estrin
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  2. Vittorio Moraschini
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  3. Yufeng Zhang
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  4. George E. Romanos
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  5. Anton Sculean
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  6. Richard J. Miron
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Contributions

All authors made substantial contribution to the conception and design of the manuscript. RJM, NEE, and VM performed the literature search, and interpretation of the data. All authors drafted the work and revised it critically for important intellectual content. All authors agree to be accountable for all aspects of the study design and its content. All authors approved the final submitted version.

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Correspondence to Nathan E. Estrin.

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Estrin, N.E., Moraschini, V., Zhang, Y. et al. Combination of Nd:YAG and Er:YAG lasers in non-surgical periodontal therapy: a systematic review of randomized clinical studies. Lasers Med Sci 37, 2737–2743 (2022). https://doi.org/10.1007/s10103-022-03548-6

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  • DOI: https://doi.org/10.1007/s10103-022-03548-6

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