Background: Chronic periodontitis is an inflammatory disease caused by microbial biofilm and is traditionally treated with a nonsurgical intervention consisting of scaling and root planing (SRP). Low-level laser therapy (LLLT) has become a popular adjunct to SRP for the treatment of chronic periodontitis.
Clinical question: In patients with chronic periodontitis, what is the effect of LLLT as an adjunct to conventional SRP on probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), and biochemical markers of periodontal inflammation when compared to conventional mechanical debridement?
Summary of methods: A literature search was conducted in three databases followed by manually searching the references of the included studies within the specific date parameter but without language restrictions. Only randomized controlled trials (RCTs) were included in this review. Two authors independently screened titles, abstracts, and full-text articles. Outcomes were presented in a tabular format along with the characteristics, parameters, and regimens of the diode laser utilization for each study. PPD was significantly lower in the LLLT group at 1 month, but no difference was noted at subsequent evaluation intervals.
Critical appraisal: This systematic review included only RCTs, which are the highest level of research design. However, there was high clinical heterogeneity and a small number of studies were included with moderate to high bias. The overall evidence is of low quality. Although LLLTs used in conjunction with SRP had a significant effect on reducing PPD, this reduction was demonstrated for only 1 month following the treatment and therefore demonstrates questionable clinical relevance.
Practical implications: Although the findings from the seven included studies demonstrated short-term effectiveness of adjunctive LLLT when compared to SRP alone at 1 month posttreatment, there were relatively nonsignificant overall clinical results past 1 month. Therefore, the results of this systematic review should be interpreted with caution. More research is needed with consistent research methodologies, larger sample sizes, and longer posttreatment follow-up prior to the inclusion of LLLT as an adjunct treatment modality into clinical practice.