Laser-Assisted Minimally Invasive Non-Surgical Therapy in Treating Severe Periodontal Compromised Teeth-A Case series.

Background: The idea of minimally invasive non-surgical treatment (MINST) is to remove the etiology with minimal damage to the healthy periodontium and provide the ideal healing environment. In this case series, the novel protocol of laser-assisted minimally invasive non-surgical therapy (LAMINST) is introduced that combines the benefit of minimally invasive and the dental laser to maximize the therapeutic potential.

Method: 25 patients (32 teeth) with advanced periodontal disease have enrolled in the study. All the patients have received periodontal treatment by following the laser-assisted minimally invasive non-surgical therapy protocol. Treated sites were evaluated by comprehensive Periodontal examination at the baseline and 6-month re-evaluation, including probing depth (PD), Recession, clinical attachment level (CAL), bleeding on probing (BOP), presence of plaque, and mobility. The diagnosis and prognosis of each tooth were assigned based on the Periodontal evaluation.

Result: All the cases were diagnosed as Stage III and Grade C Periodontitis according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The average probing depth reduction 6 months after completion of LAMINST was 4.44 mm and improved clinical attachment level by 4.38mm. There was the mobility of 1 (6 teeth), 2 (9 teeth), and 3 (3 teeth) in the beginning, and all of them decreased to 1 (5 teeth) or none (13 teeth). The prognosis was assigned based on McGuire and Nunn's system. The initial prognosis for teeth was assigned to hopeless (5) (15 teeth), questionable (4) (13 teeth), poor (3) (4 teeth), and it has improved to questionable (5 teeth), poor (12 teeth), fair (13 teeth), and good (2 teeth). Initially, there were 179 BOP sites. After treatment, it decreased to 12 sites. The plaque was found in 173 sites before the treatment and has reduced to 9 sites after the treatment.

Conclusion: All clinical parameters such as PD, CAL, BOP, presence of plaque, and mobility are improved by receiving the laser-assisted minimally invasive non-surgical therapy protocol. The application of LAMINST may overcome the traditional limitation of non-surgical treatment, such as poor accessibility.