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

Objectives: The aim of this triple-arm parallel prospective, randomized controlled 12-month trial was to evaluate in stage III/IV periodontitis the clinical efficacy of the adjunctive use of Nd:YAG laser, applied with two different protocols, to full-mouth scaling and root planing (FMS), compared to FMS alone. Materials and methods: Sixty healthy stage III/IV periodontitis patients were treated with FMS (control) or combined FMS/single Nd:YAG laser irradiation (3 W, 150 mJ, 20 Hz with Micro Short Pulse 100 µs) (Laser 1) or combined FMS/ double Nd:YAG laser irradiation (1 week interval, 2.0 W, 200 mJ, 10 Hz with Micro Short Pulse 100 µs) (Laser 2). Clinical parameters were evaluated at baseline, 6 weeks, 3, 6 and 12 months after treatment. Patient-reported parameters were also evaluated 1 week after treatment. Results: All groups presented significant (p<0.0001) clinical improvement for a 12-month period, except for clinical attachment level gain for Laser 2 at 12 months. Clinical improvement was similar among groups at all time points. The reported analgesic consumption was significantly higher for Laser 1. Conclusions: The combined FMS/Nd:YAG laser was significantly clinically effective for 12 months. The adjunctive use of Nd:YAG laser irradiation to FMS, applied with two different approaches, was similarly clinically effective to FMS for a 12-month period. A single post-FMS application of Nd:YAG laser for pocket epithelium removal and coagulation might non-statistically significantly further improve the PD reduction achieved with FMS alone. Clinical relevance: When Nd:YAG laser is used for sulcular epithelium removal and coagulation, it may provide minor improvements compared to FMS and Laser 2 long-term. The sense of discomfort seems to be more pronounced in Laser 1.