Mohammed Mustahsen Ur Rehman, Nadia Mansour Abdurrahman.
Use of laser in non surgical periodontal therapy.
J Pak Dent Assoc Jan ;12(4):227-31.

In the continuous quest of researchers for the ideal treatment modality for periodontal diseases, enormous strides have been made in the field of laser applications in periodontal therapy. The Food and Drug Authority (FDA) have already cleared laser for soft tissue applications. However, the use of laser to perform scaling and root planning still carries a great deal of controversy. Some have embraced the laser and advocated the use of laser on the basis of its capability to remove plaque, calculus and smear layer, exposing the dentinal tubules, reducing the amount of bacteria and their endotoxins, reducing IL-1 13, enhance the root compatibility with the adjacent tissues, disinfecting the root surface and periodontal pockets. The lased root surfaces showed higher number of well-attached fibroblasts. Other studied have shown that non-surgical periodontal therapy with laser or hand instrument lead to significant improvement in clinical parameters and microflora. Laser did not seem to be effective in destroying diseased cementum endotoxin and has harmful effects on the hard tissue surfaces. Temperature increase encountered with the laser use could damage the root surfaces. Surface cratering is considered high, especially when compared to craters caused by ultrasonic scaler. Root surface irregularities found more pronounced after irradiation with laser. Studies have not shown the laser to be of great value in removal of calculus on root surfaces as compared to ultrasonic or manual instruments. Both advocates and opponents agreed that further studies are needed before being ready to completely substitute the conventional instruments with the laser.

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