Comparative Clinical Outcomes of Laser-Assisted Periodontal Therapy Versus Conventional Scaling and Root Planing in Patients With Chronic Periodontitis: A Prospective Nonrandomized Study
TL;DR
Adjunctive 940-nm diode laser therapy was associated with additional clinical benefits over conventional SRP, including enhanced periodontal pocket reduction and attachment gain, without compromising safety, and these findings support its use as a complementary nonsurgical treatment modality.
Abstract
Background Scaling and root planing (SRP) is the standard nonsurgical treatment for chronic periodontitis; however, complete mechanical debridement may be limited in deep periodontal pockets, prompting interest in adjunctive laser therapy to enhance clinical outcomes. Objective To compare the clinical effectiveness and safety of adjunctive 940-nm diode laser therapy combined with SRP versus SRP alone in patients with chronic periodontitis. Methods This prospective nonrandomized comparative clinical study included 60 patients with Stage II-III, Grade B periodontitis who were allocated to receive either SRP alone (n = 30) or SRP with adjunctive 940-nm diode laser therapy (n = 30) based on participant preference following an informed discussion at a single tertiary care center. Clinical attachment level (CAL) was the primary outcome. Secondary outcomes included probing pocket depth (PPD), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and treatment-related safety. Clinical assessments were performed at baseline and at 4, 12, and 24 weeks by a blinded, calibrated examiner who was not involved in treatment delivery. Within-group comparisons were analyzed using paired t-tests, between-group comparisons using independent t-tests, and longitudinal changes using repeated-measures ANOVA. Multivariable linear regression was used to identify independent predictors of CAL gain. Results Both treatment groups demonstrated significant improvements in all clinical parameters over 24 weeks (p < 0.001). Compared with SRP alone, adjunctive diode laser therapy produced significantly greater PPD reduction (3.58 ± 0.64 vs. 3.22 ± 0.58 mm; p = 0.026) and CAL gain (3.42 ± 0.78 vs. 3.01 ± 0.69 mm; p = 0.034) at 24 weeks. Significant time × treatment interactions were observed for PPD and CAL (p < 0.05). Multivariable regression confirmed adjunctive laser therapy as an independent predictor of CAL gain. No significant between-group differences were observed in PI, GI, BOP, or adverse events. Conclusions Adjunctive 940-nm diode laser therapy was associated with additional clinical benefits over conventional SRP, including enhanced periodontal pocket reduction and attachment gain, without compromising safety. These findings support its use as a complementary nonsurgical treatment modality for appropriately selected patients with chronic periodontitis and provide prospective clinical evidence to guide periodontal practice.