Abstract
Purpose: Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.
- diode laser
- scaling and root planing
- periodontal diseases
- periodontitis
- bacteria
- dental hygienists
- soft tissue laser
- non-surgical periodontal therapy
Footnotes
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Mary Sornborger Porteous, RDH, BS, MS, is a Clinical Dental Hygienist working in Private Practice. Dorothy J Rowe, RDH, MS, PhD, is an Associate Professor at the Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco.
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This study supports the NDHRA priority area, Clinical Dental Hygiene Care: Assess the use of evidence-based treatment recommendation in dental hygiene practice.
- Copyright © 2014 The American Dental Hygienists’ Association