Low-level laser therapy has an additional effect with open flap debridement on the treatment of stage III periodontitis: a split-mouth randomized clinical trial

Quintessence Int. 2023 Apr 11;54(4):274-286. doi: 10.3290/j.qi.b3666941.


Objective: The purpose of this randomized, controlled, split-mouth trial was to clarify the clinical efficacy of using low-level laser therapy (LLLT) as an adjunct to open flap debridement in the treatment of periodontitis.

Method and materials: The study was conducted on 10 patients with stage III periodontitis. Clinical parameters were recorded for 70 sites of periodontal pockets at baseline and after 3 months and included Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), and relative attachment level (RAL), and evaluated postoperative pain and dental hypersensitivity. After open flap debridement, the sites were randomly divided into test sites receiving the low-level diode laser (wavelength 808 nm) and control sites treated with laser-off. The Wilcoxon test and Mann-Whitney U-test were used for intra- and inter-group comparisons, respectively, and the Friedman test to test between different periods.

Results: Both treatments produced a reduction in GI, BOP, and PD, an increased RGR, and a gain in RAL between baseline and 3 months after surgery. There were significant improvements in GI, PD, and RAL after 3 months; postoperative pain after 24 hours and after 3 days; and dental hypersensitivity after 1 week and 1 month of the surgery, which significantly decreased in the test group.

Conclusion: Both groups were clinically effective in treating stage III periodontitis, with a significant preference in reduction of GI and PD and gain of RAL, and decreased postoperative pain (after 24 hours and 3 days) and dentinal hypersensitivity (after 1 week and 1 month) for open flap debridement+LLLT.

Clinical relevance: The use of LLLT as an adjunct to open flap debridement improved the clinical indices, postoperative pain, and dentinal hypersensitivity better than open flap debridement alone in the treatment of stage III periodontitis.

Keywords: diode laser; low-level laser therapy; open flap debridement; periodontal pockets; periodontitis; stage III.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chronic Periodontitis* / radiotherapy
  • Chronic Periodontitis* / surgery
  • Debridement / methods
  • Dental Scaling / methods
  • Follow-Up Studies
  • Humans
  • Low-Level Light Therapy*
  • Pain, Postoperative
  • Periodontal Attachment Loss / radiotherapy
  • Periodontal Attachment Loss / surgery
  • Treatment Outcome