Running head: LASER VS SRP 1

Laser Therapy vs. SRP

by

Abbey Marshall

Ngan Tran

Lake Washington Institute of Technology

In partial fulfillment

of the requirements for

DHYG 332: Research, spring quarter 2018

Agatha Stavnesli, RDH

June 4, 2018
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The use of laser therapy in dentistry is a new idea that is still being heavily researched.

The focus of this research paper was to determine the effectiveness of laser therapy, in treating

gum disease, compared to the gold standard, scaling and root planing (SRP). While conducting

the research, it was determined that the use of laser therapy alone has not been explored

thoroughly. Instead, it is being used in conjunction with SRP. On Laser-Assisted Non-Surgical

Periodontal Therapy, Everett and other authors stated that “the overall results of the study

suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for

the treatment of chronic periodontitist” (Everett, et al.,2017, abstract). Our PICO question is as

follows: For a patient with periodontitis, will laser therapy in conjunction with SRP, compared to

SRP alone, be more effective in treating disease?

What is laser therapy? According to Dr Blodgett at blodgettdentalcare.com, laser is an

acronym; it stands for light amplification by stimulated emission of radiation (2015). Laser

therapy has many different applications in dentistry. Some of them include wound healing,

recontouring and crown lengthening, and exposure of unerupted or partially erupted teeth. For

the purpose of this research study, the laser therapy application of disinfection and removal of

inflamed tissue will be the main focus. “In periodontal laser therapy, the provider uses a dental

laser to access and remove the inflamed gum tissue from around the root of the tooth. When the

infected tissue is removed and the root is exposed, the root scaling begins” (Sandilands, P5).

Once scaling and root planing is completed, the removal of diseased tissue allows the remaining

healthy tissue to reattach to tooth structure.

What is SRP? According to mouth healthy website, SRP includes two parts, scaling is

when biofilm and calculus are removed supra and subgingival, root planing is when the hygienist

or dentist smooths out the root to help gum reattach to the teeth (p 5). Research has shown
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statistically significant clinical parameters reduction including plague and probing depth, clinical

attachment level and bleeding on probing after SRP 6 to 8 weeks. This research was conducted

on patients with gingivitis, aggressive periodontitist and chronic periodontitist diseases (Singh,

Changel, Singh, Agrawal and Savita, 2017). Another research has also shown significantly

reduced clinical parameters only three months after SRP therapy (Muthuraj et al, 2017). The

research was conducted on both patients with and without type II diabetes. As a result, “based on

a review of the evidence, the ADA concluded that clinicians should consider SRP as the initial

treatment for patients with chronic periodontitist” (ADA, p.4).

One Randomized Control Trial, compares laser therapy in conjunction with SRP to SRP

alone. “To examine potential benefits of using laser therapy for secular decontamination in

conjunction with scaling and root planing in the treatment of chronic periodontitis. The study

was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and

root planing followed by laser therapy; the contralateral side received scaling and root planing

without laser (control group)” (Everett, et al., 2017, abstract). This study showed statistical

significance, however, no clinical significance was determined. “Sites receiving laser therapy

tended to show a greater decrease in probing depths, gain in clinical attachment level, and

reduced bacterial levels” (Everett, et al.,2017, abstract). This is helpful to clinicians who may

decide to use laser therapy during scaling and root planing procedures, however the patient won’t

notice any of the potential benefits.

Another article described the benefits of using lasers for photo activation dye (PAD)

disinfection: “Low power laser energy is useful for photochemical activation of oxygen-releasing

dyes, causing membrane and DNA damage to the microorganisms” (Verma, Maheshwari, Singh

and Chaudhari 2012, soft tissue application, p.3). PAD has been proven effective in killing gram-
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negative and gram-positive bacteria, along with fungi and viruses. All of which can be found in

complex biofilms and subgingival plaque. “The major clinical applications of PAD include

disinfection of root canals, periodontal pockets, deep carious lesions, and sites of peri-

implantitis” (Verma, et al., 2012) This application of lasers would be very beneficial to clinicians

when treating patients with chronic periodontitis.

There are many different types of lasers that are used in dentistry today. Some of them

are CO2 laser, Diode laser and PerioLase. The PerioLase laser is used in Laser Assisted New

Attachment Procedures, or LANAP. “In the LANAP procedure, a laser takes the place of a

scalpel. Using incredible precision, the laser removes only dead and infected tissue” (Dr

Bloggett, p. 18). The result is less bleeding, little pain and discomfort. Another application of

the PerioLase is for treating diseased tissue around dental implants, also known as peri-

implantitis termed Laser Assisted Peri-Implantitis Procedure, or LAPIP. Millions of Americans

dental implants fail due to gum disease. The LAPIP procedure doesn’t require removal or

replacement of the implant, laser can actually stimulate the growth of healthy bone and gum

tissue” (Dr Bloggett, 2015). Special instruments are required for implants, yet sometimes, the

implant still fails. The use of laser therapy could result in more successful dental implants.

The use of laser therapy seems futuristic and intimidating. However, it may very well

become the new face of modern dentistry. Although there is much more research that needs to be

done, it seems promising. According to the Academy of General Dentistry (AGD), there are

ample benefits to using lasers for excising diseased gum tissue (Sandilands, 2018). Lasers are

able to target the diseased area in an accurate and precise manner. In conclusion, the answer to

our PICO question is, yes. For a patient with periodontitis, laser therapy in conjunction with

SRP, compared to SRP alone, is more effective in treating disease.

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References

Dental Science: Laser Treatments for Your Teeth & Gums. (2017, June 14). Retrieved from

https://www.blodgettdentalcare.com/dental-science-laser-treatments-for-your-teeth-gums/

Everett, J. D., Rossmann, J. A., Kerns, D. G., & Al-Hashimi, I. (2017). Laser Assisted Non-

surgical Periodontal Therapy: A Double Blind, Randomized Clinical Trial. The Open

Dentistry Journal, 11, 79–90. http://doi.org/10.2174/1874210601711010079

How Laser Periodontal Therapy Treats Gum Disease Colgate. (2018, June 2). Retrieved from

https://www.colgate.com/en-us/oral-health/conditions/gum-disease/how-laser-

periodontal-therapy-treats-gums-disease-0315

MeSH - NCBI. (n.d.). Retrieved June 1, 2018, from

https://www.ncbi.nlm.nih.gov/mesh/?cmd=HistorySearch&querykey=2

Muthuraj, M. S., Janakiram, S., Chithresan, K., Maradi, A. P., Maddur, P. K., & Rangaraju, R.

(2017, May/June). Effect of scaling and root planing on levels of 8-

hydroxydeoxyguanosine in gingival crevicular fluid of chronic periodontitis patients with

and without Type II diabetes mellitus. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/29440786

The American Dental Association Releases Guideline on Gum Disease Treatment. (2015, July

1). Retrieved from https://www.ada.org/en/press-room/news-releases/2015-

archive/july/the-american-dental-association-releases-guideline-on-gum-disease-

treatment

Verma, S. K., Maheshwari, S., Singh, R. K., & Chaudhari, P. K. (2012). Laser in dentistry: An

innovative tool in modern dental practice. National Journal of Maxillofacial Surgery,

3(2), 124–132. http://doi.org/10.4103/0975-5950.111342