The effect of a pulsed Nd:YAG laser in non-surgical periodontal therapy.

BACKGROUND Laser treatment may serve as an alternative or adjunctive treatment to conventional mechanical therapy in periodontics. The neodymium-doped:yttrium, aluminum, and garnet (Nd:YAG) laser has been used in periodontics. Systematic reviews aid in clinical decision-making. The aim of this study was to evaluate, in a systematic manner and after a comprehensive search of the literature, the (additional) therapeutic effects of using a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis. METHODS The focused question for this systematic review was, "What is the efficacy of a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis, either as monotherapy or as an adjunct to non-surgical periodontal treatment?" The efficacy of this technique was compared to conventional therapy (ultrasonics and/or hand instrumentation) in removing plaque, as well as in improving clinical parameters, such as periodontal inflammation and probing depth. Articles published before May 2008 in the databases of MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials were searched to identify appropriate studies. Clinical parameters of periodontal inflammation, namely, plaque, bleeding, gingivitis, probing depth, clinical attachment level, and gingival recession, were selected as outcome variables. RESULTS Independent screening of the titles and abstracts of 285 PubMed and 38 Cochrane articles resulted in eight publications that met the eligibility criteria. Means +/- SDs were collected by data extraction; only descriptive analysis was possible. CONCLUSIONS The majority of the studies analyzed showed no beneficial effect of a pulsed Nd:YAG laser compared to conventional therapy (ultrasonics and/or hand instrumentation) in the initial treatment of patients with periodontitis. The pulsed Nd:YAG laser was assessed as monotherapy and as an adjunct to non-surgical periodontal treatment; efficacy was determined by the extent of plaque removal and the reduction of periodontal inflammation. This literature review suggests that there is no evidence to support the superiority of the Nd:YAG laser over traditional modalities of periodontal therapy.