Review The Clinical Efficacy And Safety Of Er: YAG And Er, Cr: YSGG Laser In Therapy Of Periodontitis

Objective: To systematically evaluate the efficacy and safety of Er,Cr: YSGG laser and Er: YAG laser alone or laser-assisted SRP by comparing them with SRP seperately in initial therapy of periodontitis and provide evidence for clinical treatment of periodontitis.Methods: We collected all relevant RCT studies using the combination of subject words and free words about Er,Cr: YSGG laser and Er: YAG laser for periodontitis in Cochrane Library,Pubmed,Embase,Web of Science,CNKI,VIP,Wanfang,CBM,Chinese clinical trial registry(Chi-CTR),WHO International Clinical Trials Registry Platform(WHO-ICTRP),and US-clinical trials.We chose and evaluated all included-studies according to the inclusion and exclusion criteria and Cochrane evaluation handbook of RCT(5.1.0),extracted data following the pre-designed data extraction table and synthesized the data using Meta analysis.Results:1.17 RCTs about Er: YAG laser alone for periodontitis were included.(1)There w ere statistically significant differences between the two groups as following:PLI after3 months and 6 months([MD=0.03,95%CI(0.00,0.06),P=0.04],[MD=0.02,95%CI(0.01,0.03),P=0.003]);BOP and CAL after 2 years([RR=0.72,95%CI(0.54,0.95),P=0.02],[MD=-1.57,95%CI(-2.87,-0.26),P=0.02]).(2)There were no statistically significan t differences between the two groups as following:PD within 3 months,3 months,3 months to 6 months,6 months to 1 year,2 year;CAL within 3 months,3 month s,3 months to 6 months,6 months to 1year;BOP within 1 month,1 month to 1.5 month,3 months,6 months and 1 year;PLI within 3 months,1 year and 2 years.,V AS(0-10mm)and VAS(0-100mm)after treafterment.2.12 RCTs about Er: YAG laser-assisted SRP for periodontitis were included..(1)There were statistically significant differences between the two groups as following: PD after 3months and 1 year,PLI after 1.5 months([MD=-0.30,95%CI(-0.52,-0.08),P=0.008];[MD=-0.27,95%CI(-0.48,-0.05),P=0.01];[MD=-0.19,95%CI(-0.28,-0.10),P <0.0001]).(2)There were no statistically significant differences between the two groups asfollowing:PD after 1 month and 6 months,CAL within 1 month and after 1 month,1.5month,3 months,6 months and 1 year;BOP within 1 month and after 1 month,3 months,6months and 1 year;PLI within 1 month and after 3 months,6 months,1 year;VAS(0-100mm)after treatment,1 week and 6 months.3.9 RCTs about Er,Cr: YSGG laser-assisted SRP for periodontitis were included.(1)There were statistically significant differences between the two groups for VAS and PD within and after 3 months as follows:([MD=-3.19,95%CI(-4.03,-2.34),P <0.00001],[MD=-0.33,95%CI(-0.63,-0.02),P=0.04] and [MD=-0.28,95%CI(-0.41,-0.14),P<0.0001]).(2)There were no statistically significant differences between the two groups for PD after 6 months,CAL?BOP and PLI within and after 3 months and 6 months.Conclusion:1.Compared with the SRP group,after Er: YAG laser alone operation about 1 month to2 years,comfortable level and the efficacy of PD,CAL,BOP and PLI are almost the same.But it shows the possibility of improving PLI after 3 months and 6 months,and BOP after 2 years.2.Compared with the SRP group,after Er: YAG laser-assisted SRP operation about within 1 month to 1 year,comfortable level and the efficacy of PD,CAL,BOP and PLI are almost the same.But it shows the possibility of improving the PLI after 1.5 months and PD after 3 months and 1 year.3.Compared with the SRP group,after Er,Cr: YSGG laser-assisted SRP operation about within 3 to 6 months,the efficacy of PD,CAL,BOP and PLI are almost the same.But it may improve the PD within and after 3 months and it is more comfortable.4.Because of the shortage in quantity of study and samples in each study,the low-connected relationship of these studies,the absence of standard operating manual,evaluation system and safety evaluation,this study is just a start to this question.It is hoped that there are more studies and samples,more high-level and standardized randomized controlled trials that can be used to prove the curative effect and safety of Er,Cr: YSGG laser and Er: YAG laser in initial therapy of periodontitis.