Applications of lasers in refractory periodontitis: A narrative review

The purpose of the study is to evaluate the various lasers in dentistry and to investigate if it can be used for treatment of refractory periodontitis. Methods: The study followed partially the PRISMA guidelines as it is a narrative review. A number of articles were selected from a period of 1980 to 2020 from databases, PubMed, PubMed central, Cochrane and Scopus. Articles related to the effects of lasers on periodontitis both refractory and aggressive were investigated. Results: After reviewing the literature, 70 articles were found, related to application of lasers in periodontal diseases. Out of the 70, 11 articles pertained to the effect of laser for the treatment of Refractory and inflammatory periodontitis. 5 articles related to experimental animal models, one pertaining to in-vitro and six studies related to in-vivo in human cohorts. Discussion: It was found that lasers if used in controlled parameters by incorporating laser assisted treatment such as Photodynamic therapy and low level laser therapy can be of use as an adjunct therapy for treatment of refractory periodontitis. The use of different wavelengths in the initial and maintenance phase of periodontal disease plays a positive role. The presence of in-vitro and animal model studies is one of the limitation to this study. The available studies have shown marked reduction in inflammation and better clinical and microbiological parameters. The drawback of this study is the limited literature involving laser management for refractory periodontitis in human cohorts. Conclusion: Different wavelengths of laser and choice of laser assisted periodontal treatment plays an important role in the overall progress and prognosis of periodontal disease activity.