Comparative clinical evaluation of two diode laser wavelengths as adjunctive therapy to subgingival curettage in the treatment of chronic periodontitis

Sažetak

Background: Chronic periodontitis is a biofilm-induced inflammatory disease leading to progressive destruction of periodontal supporting tissues. Mechanical debridement by scaling and root planing (SRP) remains the gold standard of therapy; however, complete elimination of pathogenic microorganisms from deep periodontal pockets is challenging. Adjunctive laser therapy has been proposed to enhance clinical outcomes. Objective: To compare the clinical effectiveness of two diode laser wavelengths (980 nm and 445 nm) as adjuncts to subgingival curettage/SRP in the treatment of periodontal pockets, and to evaluate their outcomes relative to SRP alone. Materials and Methods: Comparative analysis of two independent prospective studies with identical methodology were analyzed. The first study included 24 subjects (1,164 periodontal pockets) treated with SRP + 980 nm diode laser (SmilePro 980, Biolitec, Germany). The second study included a same number of subjects and a comparable number of periodontal pockets were treated (862 periodontal pockets) with SRP + 445 nm diode laser (SiroLaser Blue, Dentsply Sirona, Germany). Control groups received SRP alone. Clinical parameters included Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL), assessed at baseline and 1 month post-therapy. Results: Both laser groups demonstrated statistically significant reductions in PI, GI, BOP, and PPD compared with baseline (p < 0.05). When compared to SRP alone, both adjunctive laser therapies showed significantly greater improvement in PPD reduction and CAL gain (p < 0.05). No statistically significant difference was observed between the 980 nm and 445 nm laser groups in overall clinical outcomes (p > 0.05). Conclusion: Both diode laser wavelengths (980 nm and 445 nm) significantly enhance short-term clinical outcomes when used adjunctively with SRP compared to SRP alone. No clear superiority of one wavelength over the other was demonstrated under the applied clinical conditions.