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Adjunctive Nd:YAG laser irradiation in the treatment of stage III/IV periodontitis: a 12-month, randomized, controlled trial

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Abstract

Objectives

The aim of this study was to evaluate the clinical efficacy of the adjunctive use of Nd:YAG laser (1064 nm) to full-mouth scaling and root planning (FMS), in stage III/IV periodontitis patients.

Materials and methods

Sixty stage III/IV periodontitis patients were randomly assigned to three groups. The control group received FMS, laser 1 group received combined FMS/single Nd:YAG laser irradiation (3 W, 150 mJ, 20 Hz,100 μs), and laser 2 group received combined FMS/double Nd:YAG laser irradiation with 1-week interval (2.0 W, 200 mJ, 10 Hz, 100 μs). PD, CAL, FMPS, GI, FMBS, and GR were evaluated at baseline, 6 weeks, 3, 6, and 12 months after treatment. Patient-reported outcomes were evaluated 1 week after treatment.

Results

A significant improvement (p < 0.001) for all clinical parameters was observed during the entire study period, with the exception of mean CAL gain for the laser 2 group at 12 months. The percentage of pockets ≤ 4 mm was significantly higher compared to baseline for all groups throughout the study, with no inter-group differences at any time point. Patient-reported analgesic consumption was higher for laser 1 group.

Conclusions

The adjunctive use of Nd:YAG laser irradiation was similarly effective to FMS alone, during the entire study period. A slightly higher, though not statistically significant improvement was reported for PD at 6 and 12 months after a single post-FMS application of Nd:YAG laser for pocket epithelium removal and coagulation.

Clinical relevance

Additional Nd:YAG laser application for sulcular epithelium removal and coagulation may provide minor long-term improvements compared to FMS or laser irradiation for pocket disinfection and detoxification.

Trial registration

ISRCTN26692900. Registration date: 09/06/2022

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Notes

  1. PCPUNC 15 mm probe, Hu-Friedy® Hu-Friedy Chicago, IL, USA.

  2. Piezon Master, EMS, Nyon, Switzerland.

  3. HuFriedy® Hu-Friedy Chicago, IL, USA.

  4. Sealed Envelope Ltd. 2021. Create a blocked randomization list. [Online] Available from: https://www.sealedenvelope.com/simple-randomiser/v1/lists

  5. Fotona XP-2, Model:M001-14F, Code: 69283.

  6. GraphPad InStat version 3.10 for Windows, GraphPad Software, San Diego California USA, ww.graphpad.com.

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Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece

    Nikolaos Markou, Anastasia Papadelli, Eudoxie Pepelassi, Phoebus Madianos & Ioannis K. Karoussis

  2. Department of Periodontology, 401 Athens Military Hospital, Athens, Greece

    Nikolaos Markou

  3. Private Practice Limited to Periodontology & Implantology, Heraklion, Greece

    Dimitris Nikolidakis

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  1. Nikolaos Markou
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  2. Anastasia Papadelli
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Contributions

P.M., I.K. and N.M. have made substantial contributions to conception and design of the study. A.P. has been involved in data collection. N.M. has been involved in the patients’ therapies. D.N. has been involved in data collection, interpretation and statistical analysis. P.M., E.P., I.K. and N.M. have been involved in drafting the article. All authors have been involved in revising it critically and have given final approval of the version to be published. The authors report no conflict of interest to this study.

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Correspondence to Nikolaos Markou.

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A written informed consent was obtained from all study participants.

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Markou, N., Papadelli, A., Nikolidakis, D. et al. Adjunctive Nd:YAG laser irradiation in the treatment of stage III/IV periodontitis: a 12-month, randomized, controlled trial. Clin Oral Invest 27, 3045–3056 (2023). https://doi.org/10.1007/s00784-023-04908-4

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