Clinical efficacy of subgingival debridement with adjunctive erbium:yttrium-aluminum-garnet laser treatment in patients with chronic periodontitis: a randomized clinical trial.

BACKGROUND: The efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser application as an adjunct to subgingival debridement in the treatment of chronic periodontitis (CP) is controversial. This study assesses the efficacy of combining full-mouth subgingival debridement with Er:YAG laser application in the treatment of patients with CP. METHODS: In this 12-month, single-masked, parallel-group clinical trial, 40 patients with moderate CP were selected and randomly assigned to a test group (one session of full-mouth ultrasonic subgingival debridement followed 1 week later by Er:YAG application in sites with initial probing depths [PDs] of >/=4.5 mm) and a control group (two sessions of ultrasonic debridement within 1 week). The main outcome variable was change in PD; the secondary outcomes were change in clinical attachment level and proportion of sites with bleeding on probing. Outcomes were assessed at baseline and after 3, 6, and 12 months. Data were analyzed as intention to treat using analysis of variance to assess intergroup differences. RESULTS: Both treatments resulted in significant clinical improvements. The test group achieved, in comparison with the control, a significantly lower percentage of sites with PD >/=4.5 mm (17.44% versus 22.83%, respectively; P = 0.004) and a tendency for a lower percentage of sites with PD >/=4.5 mm and bleeding on probing (9.78% versus 12.69%; P = 0.052). CONCLUSION: This limited added clinical effect may justify the use of a protocol combining full-mouth ultrasonic debridement with laser therapy in the treatment of initial moderate CP.