Efficacy of the Er,Cr:YSGG Laser Application Versus the Conventional Method in Periodontal Flap Surgery: A Split-Mouth Randomized Control Trial.

Introduction

the Er,Cr:YSGG laser has a suitable wavelength for the ablation of both hard and soft tissues of the periodontium and can be considered as a potential tool in periodontal surgeries. The current study aimed at evaluating the application of this laser versus conventional instruments in periodontal pocket reduction flap surgery.

Methods

Eight patients (16 dental arches) requiring periodontal surgery were included (Trial registration number: IRCT201711129014N199). Using a split-mouth study design, two posterior sextants of a dental arch were randomly allocated into either a test group, open flap debridement periodontal surgery using the Er,Cr:YSGG laser or a control group using the conventional method. Laser parameter settings of a 2780 nm wavelength, H mode (60 µs pulse duration), 25-50 Hz, 2-3.5 W output powers and Air-20%, Water-60-80% were applied and adjusted individually for each step of the flap surgery procedure. Baseline, 1 and 3-month measurements of plaque index (PI), Gingival Index (GI), gingival recession (GR), probing depth (PD) and clinical attachment level (CAL) were recorded for comparisons. Data were analyzed by a linear model for correlated data using the generalized estimating equations (GEE) method and the least significant difference (LSD).

Results

In both treatment groups, reductions in PI and GI were observed in the 3-month follow-up period. These indices were significantly lower in the laser-treated sides compared to the conventional group (P<0.05). The Mean PD and CAL were lower at 1 month and 3 months compared to the baseline in both groups (P<0.05). However, these parameters were not statistically different in the treatment groups during these follow-up timelines. An increase in GR was observed from the baseline to 1 month and 3 months with less recession in the laser-treated sides (P=0.016).

Conclusion

Based on the results of the present study, the Er,Cr:YSGG laser assisted periodontal flap surgery resulted in similar treatment outcomes to the conventional method and may be considered as a safe and effective treatment modality.