Comparison of Nd : YAG laser versus scaling and root planing in periodontal therapy

Background: The Nd:YAG laser has recently been used in the treatment of per iodontal disease. However, although a clinical reduction of probing depth a nd gingival inflammation to this new approach has been reported, it has not been fully evaluated, Interleukin-1 beta (IL-1 beta), a potent stimulator of bone resorption, has been identified in gingival crevicular fluid (GCF), which is closely associated with periodontal destruction. The aim of this study was to compare the effects of Nd:YAG laser treatment versus scaling/r oot planing (SRP) treatment on crevicular IL-1 beta levels in 52 sampled si tes obtained from 8 periodontitis patients. Methods: One or 2 periodontitis-affected sites with a 4 to 6 mm probing dep th and horizontal bone loss from 3 adjacent single-root teeth in each of 4 separate quadrants were selected from patients for clinical documentation a nd IL-1 beta assay. Sampling site(s) from each diseased quadrant was random ly assigned to one of the following groups: 1) subgingival laser treatment (20 pps, 150 mJ) only; 2) SRP only; 3) laser treatment first, followed by S RP 6 weeks later; or 4) SRP first, followed by laser therapy 6 weeks later. The GCF was collected and the amount of IL-1 beta was assayed by enzyme-li nked immunosorbent assay (ELISA). Clinical parameters and GCF were measured at baseline and biweekly after therapy for 12 weeks. Results: An obvious clinical improvement (marked decrease in the number of diseased sites with gingival index greater than or equal to 2) and reductio n of crevicular IL-1 beta were found in all groups. The level of IL-1 beta was significantly lower in the SRP group (P = 0.035) than in the laser ther apy group for the duration of the 12 weeks. The laser combined SRP therapy group showed a further reduction of IL-1 beta (6 to 12 weeks after treatmen t) than either laser therapy alone or SRP combined laser therapy. Conclusions: Our data suggest that laser therapy appeared to be less effect ive than traditional SRP treatment. Of the 4 treatment modalities, inclusio n of SRP was found to have a superior IL-1 beta response, when compared to other therapies without it. In addition, no additional benefit was found wh en laser treatment was used secondary to traditional SRP therapy.