An evaluation of diode laser as an adjunct to scaling and root planning in the nonsurgical treatment of chronic periodontitis: A clinico-microbiological study

Abstract

Introduction: Laser is an acronym for "light amplification by stimulated emission of radiation." They are being developed for a variety of uses in periodontal therapy. The diode laser in dentistry is used for treatment of diseased periodontal soft tissue, allowing significant bacterial reduction, and removal of the inflammatory products while creating excellent hemostasis. A flexible fiber optic delivery system allows the clinician easy and safe access around the periodontal pocket. The wavelengths are transmitted through water and are very poorly absorbed in apatite crystals, making them an excellent choice to use in a periodontally involved sulcus that has inflamed tissue and pigmented bacteria. This study was undertaken to evaluate the effectiveness of diode laser as an adjunct to scaling and root planing (SRP) in the nonsurgical treatment of chronic periodontitis. Aim: To evaluate the effectiveness of diode laser on plaque index (PI), gingival index (GI) probing pocket depth (PPD) and clinical attachment level (CAL) in chronic periodontitis patients and to compare the outcome with SRP alone. To evaluate the efficacy of diode laser on plaque microorganisms namely Aggregatibacter actinomycetemcomitans and Prevotella intermedia. Materials and Methods: A total number of 20 generalized chronic periodontitis patients were selected for the study. A randomized split-mouth design was followed to assign quadrants in each to one of the two treatment groups: SRP alone (Group I control group) and diode laser as an adjunct to SRP (Group II test group). The assessment of clinical parameters was carried out at baseline, day 30, 90, and 180. The microbiological analysis was done prior to the start of the treatment at baseline, day 15, 30, 90, and 180, respectively. Results: At baseline mean colony count was equal in both groups, however, at all the subsequent time intervals, mean colony count was lower in Group II as compared to Group I. All the groups showed statistically significant reduction in relation to PI, GI, PPD, CAL, and microbial count. Discussion: In this study, an attempt was made to evaluate the adjunctive role of diode lasers on gingival inflammation, pocket probing depth, the level of clinical attachment, and microbial count in relation to SRP using a case-control design. Recently, the use of laser has emerged as an adjunctive procedure in enhancing the clinical outcome of the periodontal treatment. It is one of the most promising new technical modalities for nonsurgical periodontal treatment and has an advantage of reaching sites that cannot be approached by conventional mechanical instrumentation. Conclusion: In the present study, an attempt was made to evalute the adjunctive role of diode lasers on plaque index, gingival index, pocket probing depth, level of clinical attachment and microbial count in relation to scaling and root planning using a case-control design. On the basis of these findings, adjunctive treatment with diode laser at a higher but clinically safe frequency (940nm) at repeated intervals showed a better efficacy in ensuring a better periodontal health as compared to SRP alone.

Keywords

• Aggregatibacter actinomycetemcomitans
• chronic periodontitis
• diode laser
• Prevotella intermedia