Evaluation of 940-nm Diode Laser Effectiveness on Pocket Depth, Clinical Attachment Level and Bleeding on Probing in Chronic Periodontitis

We intend to conduct this study with the laser treatment model of the RWTH University of Aachen, Germany. If we get favorable results, we will propose a more effective solution than conventional non-surgical treatment methods (SRP and antibiotic therapy).

Randomized, parallel-group trial with blinded outcome assessment. Randomization for choosing left or right was conducted by tossing a coin.

Patients referring to the Anzali campus dental school clinic and a specialized private practice in Rasht city in 1401-1402 are studied depending on the number calculated in the statistical survey. The person responsible for measuring clinical parameters and patients will not be aware of the laser-treated side.

1. Not receiving any periodontal treatment in the last 12 months 2. Not taking any type of antibiotic, anti-inflammatory, or oral contraceptive drugs during the last 3 months 3. Absence of any systemic disease that affects the periodontal treatment process such as uncontrolled diabetes 4. Absence of pregnancy 5. Not using any type of tobacco or drug addiction 6. No need for antibiotic prophylaxis 7. Having at least 1 point with a probe depth of more than 3 mm in each studied part

The number of 44 oral segments (first premolar, second premolar, and molar teeth of each quadrant) in 12 patients are equally and randomly placed in two treatment groups: Scaling & Root Planing (SRP) and Scaling & Root Planing + Laser (SRP+L).

Diode laser with wavelengths between 655 and 980 nm can accelerate wound healing and increase angiogenesis and growth factor release. If the positive effect of laser in improving periodontal parameters is determined, this method can be used as a routine method in non-surgical treatments.

In the first session, supragingival scaling of the whole mouth and hygiene education is performed, and then clinical parameters including pocket depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) are measured in 6 points of each tooth (mesiobuccal, buccal, distobuccal, mesiolingual, lingual and distolingual) and recorded in the corresponding form. It should be noted that the accuracy of the examiner's assessment will be checked and confirmed in several test sessions and cases under the supervision of a periodontist. Then, subgingival scaling and root planing (SRP) is performed under local anesthesia by a periodontist with a valid laser fellowship. Subsequently, one of the two left or right sides is chosen randomly by tossing a coin for the adjunctive laser treatment, and by the same periodontist undergoes laser therapy with the protocol approved by the Laser Center of RWTH University of Aachen, Germany. On the SRP side, the tip of the laser fiber is moved without being activated, similar to the method performed on the SRP+L side, so the patient does not know which side has undergone laser therapy. A week later, laser therapy is repeated without performing SRP according to the above method. It should be noted that the person responsible for measuring clinical parameters will not be aware of the laser-treated side.

On the SRP side, the tip of the laser fiber is moved without being activated, similar to the method performed on the SRP+L side, so the patient does not know which side has undergone laser therapy. A week later, laser therapy is repeated without performing SRP according to the above method. It should be noted that the person responsible for measuring clinical parameters will not be aware of the laser-treated side.