This literature review shows that the
Nd:YAG laser and the
Er:YAG laser can be beneficially used in periodontology for
subgingival curettage and
gingivectomy. Studies demonstrated that subgingival
laser treatment can result in significant reduction of the initial levels of periodontal pathogens. It is beneficial to perform
laser curettage under water irrigation prior to scaling in order to destroy of the structure of the
calculus and its attachment to the root surface. During
laser curettage sufficient haemostasis is obtained, which improves detection of subgingival
calculus.
Nd:YAG laser gingivectomy results in similar improvement of deep
periodontal pocket as conventional flap surgery, with the advantages such as minimal
bleeding and
post-operative pain, no swelling, and neither
sutures nor post-surgical dressing are needed. Both non-surgical and surgical
laser treatments are often performed without local anaesthesia, making full-mouth treatment in one session possible. Treatments are well accepted by the patients and require about 50% less time than the conventional
therapies.
Laser-de-epithelialization for periodontal regeneration has been experimentally attempted, but more controlled studies are needed to establish its usefulness in the clinic.
Laser treatment of
peri-implantitis is not recommended.