**5. Disadvantages of using lasers in periodontal therapy**

Relatively high cost of the devices. A need for additional education (especially in basic physics). Lasers do not eliminate the need for anesthesia. Every wavelength has different properties. The need for implementation of safety measures (i.e., goggle use, etc.) [68].

## **6. Healing following laser therapy**

Despite apparent benefits of lasers regarding patient compliance and clinical observation, there are no enough data to support that laser is associated with reduced scarring, which itself appears to be different according to the wavelength and extremely related to the energy density, and there are no enough data to support quicker healing associated with laser therapy [13]. Limited experimental animal studies [68, 69] involving CO2,Nd:YAG, diode lasers, or Er:YAG have evaluated the histological and immunohistochemical patterns of periodontal tissue healing following surgical and nonsurgical periodontal therapy. Sculean et al. [70] and Yukna et al. [71] reported healing response of intrabony defects after open flap surgery or treatment using a laser-assisted new attachment procedure in humans using Er:YAG and Nd:YAG lasers, respectively. Lippert et al. [72] claimed that CO2 laser-induced wounds in oral and oropharyngeal mucosa healed significantly faster (in 32.8 ± 9.2 days) than those created by Nd:YAG laser (in 40.4 ± 9.2). However, in contrast to conventional scalpel surgery, the histological findings showed that the beginning of wound healing was delayed after laser surgery, and it depends on the size of the initial defect. Due to the more pronounced zone of necrosis at the base of the wound ground, this effect is more evident using the Nd:YAG laser [72]. Although, as compared to conventional treatment, overall [72] as well as initial periodontal wound healing laser application [73] has been shown to be delayed, few studies have reported that laser-induced wounds show a reduced propensity of contraction of the scar in comparison to the usual surgeries of scalpel [13]. Low-level laser treatment by GaAIAs radiation in milliwatt range has been shown to be effective in recent studies, as it absolutely affects proliferation of fibroblasts in gingiva or periodontal ligament, so it consequently maintains peri-implant and periodontal wound healing [73].

**151**

*Laser Applications in Periodontology*

**7. Latest advances**

**8. Cost and safety**

**9. Conclusion**

**Author details**

Sura Dakhil Jassim

*DOI: http://dx.doi.org/10.5772/intechopen.88046*

Waterlase® system is a revolutionary dental device that uses laser-energized water to cut or ablate soft and hard tissues and provide periodontists with the opportunity to perform more procedures in fewer appointments with less need for anesthesia, scalpels, and drill [74]. Periowave™, a photodynamic disinfection system, utilizes nontoxic dye (photosensitizer) in combination with a low-intensity laser, enabling singlet oxygen molecules to destroy bacteria [75]. After applying a light-sensitive drug (photosensitizer), low-intensity laser is directed on the area treated with the drug resulting in phototoxic reactions. Although the use of photosensitizers for complete suppression of the anaerobic perio-pathogens has been

Laser safety officer (LSO) is an elected, well-trained individual who guides safety of laser performs and confirms a harmless surroundings for exhausting it, as an important part of giving dental treatment with laser device is protection and safety. All clinicians must be aware and take care of the prevention of accidental and hazardous irradiation. The patient, clinician, and assistant must wear a protective eyewear particular for the wavelength and the type of laser in use. Additionally, the clinician should follow laser safety rules and join certificate courses by dental laser organizations; however the size and the cost of laser device still create a dif-

Lasers have been suggested as an adjunctive or alternative to conventional techniques for various periodontal procedures and considered superior in respect to easy ablation, decontamination, and hemostasis besides less postoperative pain and less operative pain. Application of lasers with their different types in implant dentistry and the recent laser practical modalities had revolutionized the outcome of periodontal therapy with patient acceptance. But, procedural cost and patient

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

risk should be kept in mind and completely assumed before laser use.

suggested, the same is not true for facultative anaerobes [76].

ficulty and a struggle for its practical application [77].

College of Dentistry, University of Babylon, Iraq

provided the original work is properly cited.

\*Address all correspondence to: suradak85@yahoo.com
