Efficacy of the Er,Cr:YSGG Laser Application Versus the Conventional Method in Periodontal Flap Surgery: A Split-Mouth Randomized Control Trial

Abstract

Introduction: the Er,Cr:YSGG laser has a suitable wavelength for the ablation of both hard and soft tissues of the periodontium and can be considered as a potential tool in periodontal surgeries. The current study aimed at evaluating the application of this laser versus conventional instruments in periodontal pocket reduction flap surgery. Methods: Eight patients (16 dental arches) requiring periodontal surgery were included (Trial registration number: IRCT201711129014N199). Using a split-mouth study design, two posterior sextants of a dental arch were randomly allocated into either a test group, open flap debridement periodontal surgery using the Er,Cr:YSGG laser or a control group using the conventional method. Laser parameter settings of a 2780 nm wavelength, H mode (60 µs pulse duration), 25-50 Hz, 2-3.5 W output powers and Air-20%, Water-60-80% were applied and adjusted individually for each step of the flap surgery procedure. Baseline, 1 and 3-month measurements of plaque index (PI), Gingival Index (GI), gingival recession (GR), probing depth (PD) and clinical attachment level (CAL) were recorded for comparisons. Data were analyzed by a linear model for correlated data using the generalized estimating equations (GEE) method and the least significant difference (LSD). Results: In both treatment groups, reductions in PI and GI were observed in the 3-month follow-up period. These indices were significantly lower in the laser-treated sides compared to the conventional group (P<0.05). The Mean PD and CAL were lower at 1 month and 3 months compared to the baseline in both groups (P<0.05). However, these parameters were not statistically different in the treatment groups during these follow-up timelines. An increase in GR was observed from the baseline to 1 month and 3 months with less recession in the laser-treated sides (P=0.016). Conclusion: Based on the results of the present study, the Er,Cr:YSGG laser assisted periodontal flap surgery resulted in similar treatment outcomes to the conventional method and may be considered as a safe and effective treatment modality.