Does deep periodontal pocket disinfection with a soft tissue diode laser work?
(Content under development)
The following question was submitted by a practising dentist: What clinical evidence is available for the efficacy of deep periodontal pocket disinfection with a soft tissue diode laser? What protocols are proven and recommended in terms of frequency of treatment?
JCDA Editorial Consultant Dr. Debora Matthews of Dalhousie University provided this initial response for consideration:
There are two issues related to this question. The first is, does a soft tissue diode laser disinfect periodontal pockets (pocket disinfection therapy, or PDT)? The more important question, however, is whether diode lasers provide any additional clinical benefit over traditional scaling and root planing (Because this is really the goal –we don’t just want to get rid of the pathogenic bacteria, but we want the pockets to shrink and attachment levels to increase).
There is good evidence that diode lasers, with or without photoactivation, will reduce bacterial levels. However, the evidence is limited as to whether this actually results in more clinically significant changes in periodontal health than standard non-surgical debridement.
There are few studies published on humans and most are of short-term duration (3 months or less). They all show that the results are either similar in terms of improving attachment levels or pocket depths, or if there is an advantage for lasers, the amount is clinically meaningless (i.e. less than 1 mm). The American Academy of Periodontology published a position statement on the efficacy of lasers in the non-surgical treatment of inflammatory periodontal disease in 2011.
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