Clinical effect of Nd:YAG laser-assisted non-surgical periodontal treatment on stage II/III periodontitis.

BACKGROUND

The aim of this study was to investigate the clinical effect of Nd:YAG laser-assisted non-surgical periodontal treatment on patients with stage II/III periodontitis.

METHODS

A total of 599 teeth from 22 patients with stage II/III periodontitis were included in this study. A split-mouth design randomly assigned one side to the laser group (subgingival instrumentation + Nd:YAG laser) and the other to the control group (subgingival instrumentation alone). Clinical parameters, including probing depth (PD), gingival recession (GR), clinical attachment loss (CAL), and bleeding on probing (BOP) were measured at baseline, 6 weeks, and 3 months post-treatment. Biochemical parameters (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and malondialdehyde [MDA]) were analyzed from gingival crevicular fluid (GCF) samples collected at the same time points. Treatment method, site location, site type, age, and gender were evaluated using a multilevel logistic regression model.

RESULTS

At 6 weeks, the laser group demonstrated limited but statistically significant improvements in PD and more notable reductions in biochemical parameters compared to the control group. At 3 months, reductions in IL-6 and TNF-α remained significant compared to the control. Multilevel logistic regression analysis indicated that adjunctive laser therapy reduced the odds ratio of disease persistence (OR = 0.58, 95 % CI: 0.38-0.89). In sites with PD ≥ 7 mm, the laser group showed greater improvements in PD, CAL, and healing rate of BOP (+) sites at 3 months, while no differences were found in sites with PD 4-6 mm.

CONCLUSIONS

While Nd:YAG laser adjunct to subgingival instrumentation lacked broad efficacy in stage II/III periodontitis, it selectively enhanced outcomes in deep pockets (≥7 mm) in stage III periodontitis, emphasizing its role as an adjunct for severe periodontal defects. (This study was registered at ClinicalTrials.gov under the registration number NCT06587334.) CLINICAL SIGNIFICANCE: Nd:YAG laser adjunct to subgingival instrumentation enhances clinical outcomes in deep periodontal pockets (≥7 mm) in stage III periodontitis and reduces inflammatory mediators, but shows minimal impact on shallow pockets (4-6 mm) across stages. It highlights selective efficacy, reinforcing its adjunctive use in managing severe periodontal defects.