Effectiveness of 980 nm Diode Laser in Enhancing Periodontal Treatment Outcomes in Tobacco Users: A Randomized Controlled Trial

Abstract

Background: Periodontal disease is a significant public health concern influenced by multiple local and systemic risk factors. Tobacco chewing adversely affects periodontal tissues by altering inflammatory responses and impairing healing, which may compromise outcomes of conventional non-surgical therapy. Scaling and root planing (SRP) remains the standard treatment for periodontitis; however, adjunctive diode laser therapy using Laser-Assisted New Attachment Procedure (LANAP) has been proposed to enhance clinical outcomes. Evidence regarding its effectiveness in tobacco chewers with Stage II Grade B periodontitis is limited. Materials and Methods: This randomized split-mouth clinical study included eight tobacco chewers aged 30–60 years diagnosed with Stage II Grade B periodontitis. Each participant received SRP alone in one quadrant and SRP followed by LANAP using a 980-nm diode laser in another quadrant. Clinical parameters assessed were Plaque Index, Gingival Index, Probing Pocket Depth, Clinical Attachment Level, Sulcus Bleeding Index, and the Fagerström Nicotine Dependence Scale for Smokeless Tobacco. Measurements were recorded at baseline, one month, and three months post-treatment. Statistical analysis was performed using paired tests with significance set at p < 0.05. Results: Both treatment modalities showed significant improvements in plaque accumulation, gingival inflammation, bleeding scores, probing depth, and attachment levels over three months. Adjunctive diode laser therapy demonstrated superior outcomes. Conclusion: Within study limitations, adjunctive 980-nm diode laser therapy with SRP provides additional clinical benefits over SRP alone for managing Stage II Grade B periodontitis among tobacco chewers. Larger studies with longer follow-up are recommended, clinically meaningful.