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This study evaluated the effects of diode and erbium lasers, as an adjunct to scaling and root planing (SRP), on clinical and immunological parameters in non-surgical periodontal therapy. In this split-mouth randomized controlled clinical trial, 17 participants with at least one periodontally involved tooth in each quadrant received oral hygiene instruction and full-mouth SRP. At baseline, probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and full-mouth plaque index (FMPI) were measured, and gingival crevicular fluid (GCF) sampling was performed. Next, one random quadrant in each participant received 940 nm diode laser (1 W, continuous-wave), and another quadrant received 2780 nm Er,Cr:YSGG laser (1.5 W, 30 Hz) irradiation. The GCF levels of interleukin (IL)-10 and matrix metalloproteinase (MMP)-13 were measured at baseline, and after 2 and 6 months using ELISA. The clinical parameters were also measured. Data were analyzed by repeated measures ANOVA. Significant clinical improvement was noted in all groups (P < 0.05). CAL in the control group was higher at 6 months than 2 months. The increase in IL-10 in erbium group was significantly greater than that in other groups (P < 0.001). The MMP-13 level was significantly lower in laser groups with greater reduction in erbium group (P < 0.001). Application of 940 nm diode and 2780 nm Er,Cr:YSGG lasers as an adjunct to SRP significantly decreased the GCF level of MMP-13, with no significant clinical advantage over SRP monotherapy. Application of 2780 nm Er,Cr:YSGG laser in addition to SRP increased the GCF level of IL-10. Trial registration numbers: IRCT20140318017053N11 and IRCT20140318017053N9. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the clinical, anti-inflammatory, and osteoimmunological benefits of the single (PT) and repeated laser phototherapy (rPT) as an adjunctive treatment of inflamed periodontal tissue. Twenty-seven patients with chronic periodontitis were randomly divided into three groups of nine patients each in order to undergo scaling and root planing (SRP), SRP followed by one session of adjunctive PT (Day 1; SRP + PT), or SRP followed by adjunctive repeated PT five times in 2 weeks (Days 1, 2, 4, 7, and 11; SRP + rPT). For phototherapy session, a diode laser ( λ = 670 nm, 200 mW, 60 s/tooth) was applied into the sulcus. Clinical parameters, including full-mouth plaque score, full-mouth bleeding score, probing pocket depth, and clinical attachment level were recorded. Samples of gingival crevicular fluid (GCF) were taken at baseline, 4, and 8 weeks after treatment. Interleukin 1beta (IL-1β), tumor necrosis factor alpha (TNF-α), receptor activator of nuclear factor κΒ ligand (RANKL), and osteoprotegerin (OPG) levels in the collected GCF were measured. PT used in a single or repeated doses, does not produce a significant reduction in the clinical parameters essayed ( p > 0.05). Levels of IL-1β in GCF were significantly reduced in SRP + PT and SRP + rPT groups compared with the SRP group ( p < 0.05). However, the SRP + rPT group showed a significant reduction of pro-inflammatory cytokine TNF-α and RANKL/OPG ratio at 4 weeks post-treatment compared with the SRP + PT and SRP groups ( p < 0.05). SRP + PT group also showed a significant reduction in TNF-α and RANKL/OPG ratio at 8 weeks post-treatment compared with the SRP group ( p < 0.05). PT exerts a biostimulative effect on the periodontal tissue. Multiple sessions of PT showed a faster and greater tendency to reduce proinflammatory mediators and RANKL/OPG ratio. [ABSTRACT FROM AUTHOR]