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Lasers in Periodontal and Peri-implant Therapy: Challenges and Opportunities

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Emerging Therapies in Periodontics

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Abstract

Lasers are increasingly being applied as a monotherapy or adjunct to surgical and nonsurgical therapy in the treatment of periodontitis and peri-implantitis. Numerous clinical studies evaluating the effectiveness of lasers in periodontal therapy as well as critical and systematic reviews of this research have been reported in the literature. The therapeutic goals of using lasers, or specific laser wavelengths, as a monotherapy or adjunct to traditional therapies, include root surface debridement and detoxification, reduction in specific or overall subgingival bacterial composition, subgingival curettage, suppression of inflammation, biostimulation, and periodontal regeneration. Low-level lasers have been used in conjunction with photosensitizers, such as toluidine blue, which adhere to the bacterial membrane, to induce a photochemical cytotoxic reaction intended to eradicate periodontopathic bacteria (i.e., antimicrobial photodynamic therapy). The conclusions of current systematic reviews are inconsistent, reflecting, in part, inconsistencies in clinical protocols, therapeutic and biological endpoints, procedural heterogeneity, and inadequate description of interventions. Nevertheless, systematic reviews conclude that clinical outcomes of laser treatment are similar or slightly better than reference nonsurgical or surgical therapies; however, any differential benefits remain short term. Moreover, there is limited human histologic evidence that is consistent with the potential for periodontal regeneration following laser-assisted therapy in patients with moderate to severe periodontitis. To capitalize on cellular and molecular changes incurred by laser interactions with hard and soft tissues of the periodontium and peri-implant tissues, laser treatment protocols should be refined to optimize lasers as a tool in our dental armamentarium. There is much promise for improved treatment outcomes with inclusion of dental lasers in the treatment of periodontal and peri-implant disease.

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  1. Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA

    M. A. Reynolds, M. E. Aichelmann-Reidy & P. S. Rosen

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    Sinem Esra Sahingur

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Reynolds, M.A., Aichelmann-Reidy, M.E., Rosen, P.S. (2020). Lasers in Periodontal and Peri-implant Therapy: Challenges and Opportunities. In: Sahingur, S. (eds) Emerging Therapies in Periodontics. Springer, Cham. https://doi.org/10.1007/978-3-030-42990-4_15

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