The combined use of Nd:YAG laser and enamel matrix proteins in the treatment of periodontal infrabony defects.

BACKGROUND

The objective of regenerative periodontal therapy is the reconstitution of lost periodontal structures, such as cementum, periodontal ligament, and alveolar bone. Enamel matrix proteins (EMP) are used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The aim of this split-mouth study evaluates and compares the healing of intrabony defects after treatment with an EMP with or without neodymium-doped:yttrium-aluminum-garnet (Nd:YAG) laser application for root surface conditioning.

METHODS

Forty-two intrabony defects in 21 patients with chronic periodontitis were randomly assigned to an access flap surgery with application of Nd:YAG laser (1 W, 10 Hz, 100 mJ, 1064 nm) and EMP (test group), and on the contralateral defect to an access flap surgery with application of EDTA and EMP alone (control group). Clinical periodontal parameters were assessed at baseline and after 6 and 12 months.

RESULTS

Both treatments yielded significant improvements in terms of decrease in probing depth (PD) and gain in clinical attachment level (CAL) compared to baseline values. At 12 months after therapy, in the test group, the mean PD value was reduced from 7.3 ± 0.6 to 3.3 ± 0.4 mm and the mean CAL value changed from 9.5 ± 0.7 to 6.9 ± 0.7 mm (P <0.001). The sites treated with EMP (control) showed a reduction in mean PD value from 7.3 ± 0.7 to 3 ± 0.4 mm and a change in mean CAL value from 9.3 ± 0.8 to 6.4 ± 0.5 mm (P <0.001). The control group showed a greater reduction in PD and gain in CAL compared to the test group (P <0.05).

CONCLUSION

Within the limits of the present study, it may be concluded that both therapies led to improvements of the clinical parameters, and Nd:YAG laser root conditioning as used in this study compared to EDTA root conditioning did not improve the outcome of EMP use.