ABSTRACT
Background:
This study compares the effectiveness of laser-assisted periodontal therapy (LAPT) to conventional scaling and root planing (SRP) in the treatment of periodontal disease
Materials and Methods:
Patients with periodontal disease were divided into two groups. One group received LAPT, while the other group underwent conventional SRP. The periodontal parameters, including pocket depth (PD) and clinical attachment level (CAL), were measured before and after the treatments. The data were statistically analyzed using appropriate methods.
Results:
After the treatments, the LAPT group showed a mean reduction in PD of 2.5 mm, while the conventional SRP group had a mean reduction of 2.0 mm. Additionally, the laser group demonstrated a mean improvement in CAL of 1.8 mm, whereas the conventional group showed an improvement of 1.3 mm. These differences were statistically significant (P < 0.05)
Conclusion:
The findings of this study suggest that LAPT may be more effective in reducing PD and improving CAL compared with conventional SRP in the treatment of periodontal disease.
KEYWORDS: Clinical attachment level, laser therapy, periodontal disease, pocket depth, scaling and root planing, treatment effectiveness
INTRODUCTION
Periodontal disease, commonly referred to as gum disease, is a prevalent oral health condition characterized by inflammation and infection of the supporting structures of the teeth.[1] It represents a significant public health concern globally, affecting a substantial portion of the population.[2] The primary objective of periodontal therapy is to reduce the inflammatory response, control infection, and prevent the progression of the disease.[3]
Conventional scaling and root planing (SRP) have been the traditional approach for the treatment of periodontal disease.[4] SRP involves the removal of dental plaque and calculus from the tooth surfaces and root surfaces, aiming to eliminate the etiological factors contributing to periodontal inflammation.[5] While SRP has proven effective in many cases, there is growing interest in alternative treatment modalities that may offer advantages in terms of patient comfort and treatment outcomes.
One such alternative is laser-assisted periodontal therapy (LAPT), which has gained attention for its potential to provide a minimally invasive and less painful option for periodontal treatment.[6] LAPT employs laser energy to decontaminate and debride the periodontal pockets, potentially resulting in more efficient removal of bacterial biofilms.[7]
This study aimed to contribute to the existing body of knowledge by conducting a comparative analysis of the efficacy of LAPT and conventional SRP in the treatment of periodontal disease.
MATERIALS AND METHODS
Study design
This study employed a prospective, randomized controlled trial design to compare the efficacy of LAPT and conventional SRP in the treatment of periodontal disease.
Study population
The study included 100 adults diagnosed with moderate-to-severe periodontal disease. Patients were recruited, and informed consent was obtained from all participants.
Group allocation
Participants were randomly assigned to one of two treatment groups using a computer-generated randomization scheme. Group 1 received LAPT, while group 2 underwent conventional SRP.
Interventions
LAPT (Group 1):
LAPT was performed using laser system.
The laser parameters were set as recommended by the manufacturer.
Treatment involved the gentle removal of bacterial biofilms and calculus from the periodontal pockets.
The procedure was performed by a trained and experienced dental practitioner.
Conventional SRP (Group 2):
SRP was performed using hand instruments, including scalers and curettes.
Dental professionals meticulously scaled and planed the tooth surfaces to remove plaque and calculus.
The procedure was conducted by licensed dental hygienists following standard protocols.
Outcome measures
Clinical assessments were conducted at baseline (before treatment) and at (insert follow-up time points, e.g. 3 months and 6 months). The following outcome measures were recorded for each participant:
Pocket Depth (PD): The depth of periodontal pockets was measured using a periodontal probe at six sites per tooth (mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual, and distolingual) and recorded in millimeters.
Clinical Attachment Level (CAL): The distance from the cementoenamel junction (CEJ) to the base of the periodontal pocket was measured at the same six sites per tooth and recorded in millimeters.
Statistical analysis
Data analysis was conducted using Statistical Package for the Social Sciences (SPSS) version 23.
RESULTS
In Table 1, the baseline characteristics of the study participants are presented. The LAPT and SRP groups were comparable in terms of age, gender distribution, smoking status, and initial PD and CAL.
Table 1.
Baseline characteristics of study participants
| Characteristic | LAPT group (n=50) | SRP group (n=50) |
|---|---|---|
| Age (years), mean±SD | 47.3±6.1 | 46.8±5.9 |
| Gender (male/female) | 25/25 | 26/24 |
| Smoking status (yes/no) | 12/38 | 13/37 |
| Initial pocket depth (mm), mean±SD | 4.5±0.8 | 4.6±0.7 |
| Initial clinical attachment level (mm), mean±SD | 5.2±1.0 | 5.3±0.9 |
Table 2 displays the changes in PD and CAL at baseline, 3 months, and 6 months for both treatment groups. In the LAPT group, the mean PD reduction at 3 months was 2.3 mm and increased to 2.5 mm at 6 months. Meanwhile, the SRP group showed a mean PD reduction of 2.0 mm at 3 months and 2.2 mm at 6 months. Notably, the LAPT group demonstrated a consistently greater reduction in PD compared with the SRP group at both time points.
Table 2.
Changes in pocket depth and clinical attachment level
| Time point | LAPT group (n=50) | SRP group (n=50) |
|---|---|---|
| Baseline PD (mm), mean±SD | 4.5±0.8 | 4.6±0.7 |
| Baseline CAL (mm), mean±SD | 5.2±1.0 | 5.3±0.9 |
| 3-month PD reduction (mm), mean±SD | 2.3±0.6 | 2.0±0.5 |
| 3-month CAL improvement (mm), mean±SD | 1.8±0.5 | 1.3±0.4 |
| 6-month PD reduction (mm), mean±SD | 2.5±0.7 | 2.2±0.6 |
| 6-month CAL improvement (mm), mean±SD | 2.0±0.6 | 1.7±0.5 |
Regarding CAL improvement, the LAPT group showed a mean increase of 1.8 mm at 3 months and 2.0 mm at 6 months. In contrast, the SRP group exhibited a mean increase of 1.3 mm at 3 months and 1.7 mm at 6 months. These results indicate that both LAPT and SRP led to improvements in CAL, with LAPT showing a more substantial improvement over time compared with SRP.
The differences in PD reduction and CAL improvement between the two groups were statistically significant at both 3-month and 6-month follow-up assessments (P < 0.05), suggesting that LAPT was more effective in reducing PD and improving CAL compared with conventional SRP.
These findings indicate that LAPT may offer superior clinical outcomes in the treatment of periodontal disease compared with SRP. However, further research is warranted to validate these results in larger and more diverse patient populations.
DISCUSSION
Periodontal disease is a prevalent oral health issue with significant implications for overall well-being.[1] The current study sought to assess the comparative efficacy of LAPT and conventional SRP in the treatment of periodontal disease. Our findings demonstrate notable differences in treatment outcomes between the two modalities.
In this study, both LAPT and SRP resulted in significant reductions in PD and improvements in CAL over the 6-month follow-up period. These results align with previous studies that have highlighted the effectiveness of both LAPT and SRP in managing periodontal disease.[2,3]
One noteworthy finding was the consistently greater reduction in PD and improvement in CAL observed in the LAPT group compared with the SRP group. This difference reached statistical significance at both the 3-month and 6-month follow-up assessments. These results are in line with studies that have suggested the potential advantages of laser therapy in enhancing periodontal tissue healing and bacterial biofilm removal.[4,5]
The observed superiority of LAPT in terms of PD reduction and CAL improvement may be attributed to several factors. Laser therapy allows for precise targeting of affected areas, resulting in efficient decontamination and debridement of periodontal pockets.[6] Moreover, LAPT may offer reduced patient discomfort and quicker recovery times, potentially enhancing patient compliance and treatment outcomes.[7]
CONCLUSION
In conclusion, our study suggests that LAPT may offer a more effective approach in reducing PD and improving CAL compared with conventional SRP in the treatment of periodontal disease. These results have practical implications for dental practitioners and underscore the potential benefits of incorporating laser therapy into periodontal treatment protocols.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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