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| Format: | Recurso digital |
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Zenodo
2025
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| Online Access: | https://doi.org/10.5281/zenodo.17435217 |
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Table of Contents:
- <p>Abstract:<br>Background: Scaling and root-planing (SRP) remains the foundational non-surgical treatment<br>for periodontitis, but residual pockets, incomplete bacterial removal and patient discomfort<br>motivate adjunctive approaches. Laser-assisted periodontal therapy (LAPT) — including<br>Er:YAG, diode, Nd:YAG, CO₂, LANAP and photodynamic therapy (PDT) — is proposed to<br>improve microbial decontamination, tissue management and healing.<br>Objective: To systematically review clinical, microbiological and patient-centred outcomes<br>comparing LAPT (monotherapy or adjunctive) with conventional SRP in adult periodontitis<br>patients, emphasizing studies from 2018–2025.<br>Methods: Searches of PubMed/MEDLINE, Cochrane Central and open access journals (through<br>Oct 2025) identified randomized controlled trials (RCTs), controlled clinical trials and<br>systematic reviews comparing any LAPT versus SRP. Primary outcomes: probing pocket depth<br>(PPD) reduction and clinical attachment level (CAL) gain. Secondary outcomes: bleeding on<br>probing (BOP), plaque/gingival indices, microbiological/inflammatory markers, patient-reported<br>outcomes and adverse events. Data were extracted by two reviewers and synthesized<br>qualitatively due to heterogeneity in laser types and protocols.<br>Results: Thirteen RCTs/controlled trials and multiple systematic reviews/meta-analyses were<br>identified. Adjunctive laser therapy (particularly Er:YAG or diode lasers used in well-specified<br>protocols) often produced modest additional short-term improvements in PPD, CAL and BOP<br>versus SRP alone; effect sizes were commonly <1 mm and declined over time in many studies.<br>Photodynamic therapy (PDT) adjuncts and some LANAP/ Nd:YAG protocols show promising<br>reductions in pathogens and early clinical markers [7,17,22]. Evidence quality is variable;<br>heterogeneity of laser parameters, operator skill and follow-up durations limit generalizability.<br>Conclusions: LAPT can provide modest incremental clinical benefits as an adjunct to SRP in<br>selected protocols and patient subsets (e.g., residual deep pockets), especially in the short term.<br>There is insufficient robust evidence to support routine replacement of SRP by lasers.<br>Standardized laser protocols, larger multicentre RCTs and ≥12-month follow-up studies<br>(including cost-effectiveness) are needed.</p>