Effectiveness of Root Planing with Diode Laser Curettage for Periodontitis

Objective: This study investigated the effectiveness of scaling/root planing (SRP) using a closed approach, closed approach with laser-curettage, closed approach with laser-curettage/sealing, and open approach (papillae reflection) in treating moderate-advanced chronic periodontitis.

Methods:   Twenty-five subjects with five probing depths (PD) measuring 5-9mm with bleeding on probing (BOP) participated.  Each site was randomly assigned to one of the following: (1) SRP only; (2) papillae reflection/SRP/flap closure; (3) laser-curettage(Odyssey Navigator)/SRP; (4) laser-curettage/SRP/laser-disinfection/sealing; and (5) no treatment (control).  Using a custom-fabricated vacuform stent, a single examiner measured PD and clinical crown length (CCL).  Sites were re-examined at 3 and 6 months.  Supportive periodontal therapy was provided at 3 months.  Patients followed their usual oral hygiene regimens.  Repeated measure ANOVA and student t-test were used for analysis. 

Results: All treatments resulted in reduction of PD (average=1.74mm) and BOP (100% at baseline/30% at 3 months/31% at 6 months).  The greatest decrease in average PD was at 3 months with Groups 4 and 2.  However, the differences were not significant (p>0.05) between the treatment groups (table).  CCL did not significantly differ among the therapies.  However, Group 2 showed the greatest increase (1.05mm/3 months) (p<0.05) from the control (0.15mm/3 months), while the others showed an average increase of 0.39mm at 3 months.

 

	(1) SRP only	(2) PR/SRP/FC	(3) L/SRP	(4) L/SRP/L/S	Control
3 months	1.59	1.79	1.68	1.91	0.89
6 months	1.57	1.57	1.72	1.62	0.84

 

 

 

 

 

Conclusion: Groups 3 and 4 did not signficantly differ from Groups 1 or 2 in decreasing PD/BOP.  Although there were no significant differences in CCL between therapies, group 2 showed the greatest increase (largest amount of recession).  Groups 1 and 3 healed with minor recession and mostly by soft tissue repair or a long junctional epithelial attachment.  If there is an esthetic concern, the laser curettage would be preferable.