This summary is adapted from the Review Analysis and Evaluation published in the Journal of Evidence-Based Dental practice: Laser Therapy is Safe but not Superior to Conventional Treatment of Peri-implantitis (June 2015)
Context
The Review Analysis and Evaluation examined a systematic review published in 2014 by Kotsakis, Konstantinidis, Karoussis, Ma, and Chu entitled: Systematic review and meta-analysis of the effect of various laser wavelengths in the treatment of peri-implantitis.
Purpose of the Review
The investigation centered on the use of laser therapy as mono-therapy or as an adjunct in the treatment of peri-implantitis with a report of clinical indices of peri-implant disease, including clinical attachment level (CAL) and probing depth (PD).
Key Findings
- Based on the limited number of controlled clinical studies, any superiority of laser treatment in comparison to conventional treatment of peri-implantitis could not be definitively identified.
- However, non-surgical laser therapy may be investigated as phase I therapy for the treatment of peri-implantitis.
- There is limited clinical information on the application of CO2 lasers and surgical treatment for peri-implant defects in conjunction with bone grafting techniques; however, their use seems to be promising.
- The authors also emphasized that there is no information available regarding the efficacy of specific laser wavelengths.
- The review contributes to the evidence that lasers may be used as decontamination methods for the treatment of peri-implantitis.
- This study showed there is a distinct difference among various laser wavelengths (i.e., Er:YAG, CO2, or diode lasers) and clinical efficacy, thus underlining the importance of reporting laser characteristics such as wavelength, energy settings, and mode of application in future studies.
- There is no evidence for use of diode lasers (810 and 980 nm) and Nd:YAG laser in the treatment of peri-implant diseases. Potential risks, such as overheating of the implant body, may be the main reason for the lack of such studies.
References of Review Analysis and Evaluation
Do you really think the purchasers of lasers will be guided by sound scientific investigation? If they were, they would not have purchased the laser in the first place. Lasers in dentistry is all marketing and little else. It is an attempt to give the illusion that a laser-using-dentist is “more advanced” then the rest. Once you have deceived yourself that it works, deceiving patients is a piece of cake. It comes down to basic human psychology… “Don’t confuse me with the facts; my mind is made up.”
The laser peri-implantitis treatment findings as reported by Kotsakis et al mirror the treatment of periodontal pocket findings as reported in this January’s issue of the respected “Clinicians Report”. Not one of the five claims made by manufacturers could be confirmed! (1. Pocket depth improvement better than scaling and root planning alone, 2. Pocket sterilization, 3. Resolution of bleeding and suppuration, 4. Less pain and 5. “Biostimulation” with faster healing and increased bone regeneration.) Similar papers continue to appear in the literature including JCDA.
The developing “let the buyer beware” environment is not encouraging for the relationship between the profession and the manufacturers of lasers. Manufacturers underestimate the value of trust.
I have to wonder if Paul is correct. Is laser therapy just marketing? Thanks for the information in this article.