Management

One Year Clinical Results of Er Cr YSGG Laser Application in Addition to Scaling and Root Planning with Early to Moderate Periodontitis

it to a consortium of bacteria rather than by a single microorganism [2], with bacterial plaque gradually accumulating with time causing secondary tissue inflammation known as gingivitis, chronic periodontitis is usually treated by removing subgingival deposits, bacterial biofilm, and smear layer [3,4]. This strategy is aimed at abating, if not eliminating, etiologic agents of the disease, like microbial film and subgingival calculus [2], and restoring the periodontal attachment level through the reconnection of periodontal fibers with newly formed cementum [5,6].For nonsurgical management of early to moderate chronic periodontitis, scaling and root planing (SRP) remains the traditional initial approach of treatment. Scaling removes plaque, calculus, and stain from the crown and root surfaces while root planing entails the complete debridement of cementum or dentin from the root surface for the purpose of smoothing it and displacing it calculus [7]. The procedure also extends to adjacent periodontal tissues [8]. Although the positive effects of SRP in chronic periodontitis have been, time and again, validated, i.e., “reduction of clinical inflammation, microbial shifts to a less pathogenic subgingival flora, decreased probing depth, gain of clinical attachment, and less disease progression,”[5] This procedure has known drawbacks.The use of manual instruments and ultrasonic scalers commonly forming part of the SRP procedure makes it more time consuming and often incomplete due to tooth topography, and often painful [9]. Cobb (2008), for example, observes that in university-administered clinical trials, a quadrant of SRP often takes about 70 minutes, or 10 minutes per tooth with 10 minutes allowed for patient setting and anesthesia administration. In private practice, however, this time is deliberately trimmed down engendering reduced results often observed in recent clinical trials [5]. In cases where gingival recession exists, opened root surfaces may remain.

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