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Introduction: Within the field of periodontology, there has been a proposal for the utilization of noninvasive laser therapy as a potential treatment for persistent periodontitis. The Laser-Assisted New Attachment Procedure (LANAP) employs an Nd:YAG laser as a specific technique. Through its interaction with endogenous chromophores, the Nd: YAG laser exhibits a selective effect on the evaporation of granulation tissue, therefore establishing a correlation with reduced bleeding. The study also examined Oxygen High-Level Laser Therapy (OHLLT). The OHLLT technique employs a high-power diode laser in combination with hydrogen peroxide solutions to facilitate the liberation of singlet oxygen, which possesses antibacterial attributes, within the periodontal pockets. The existing literature indicates their potential to promote the regeneration of tooth support tissues. Objective: The aim of this study is to assess the subjective pain levels reported by patients who have undergone surgery using the OHLLT protocol versus those who have undergone surgery using the LANAP technique. Methods: A total of 20 individuals with a stage III–IV periodontitis diagnosis were recruited for the study. The participants were randomly divided into two groups, each consisting of 10 individuals: Group 1, comprising patients treated according to the LANAP protocol, and Group 2, comprising patients treated according to the OHLLT protocol. After their initial session of nonsurgical periodontal therapy, individuals provided feedback regarding their level of pain, utilizing a Numerical Rating Scale (NRS) comprising time intervals of 0 h (T0), 6 h (T1), 12 h (T2), 24 h (T3), 48 h (T4), and 7 days (T5). The Wilcoxon–Mann–Whitney statistical test was employed to assess the variations in NRS scores between Group 1 and Group 2 at each recording period. (p ≤ 0.05). In addition, a microbiological assessment of the bacterial load in the periodontal region was conducted on all subjects using real-time PCR testing at two time points: prior to treatment (T0) and seven days post-treatment (T5). Results: The findings of this study indicate that the OHLLT group exhibited significantly lower pain levels compared to the LANAP group at all time intervals, except for the preoperative period, where no significant difference was observed (p < 0.05). Group 2 exhibited a more rapid decrease in pain, as demonstrated by a score test approaching zero within 24 h. The quantity of periodontal bacteria seen seven days post-treatment was similar between the two groups and was found to be decreased compared to the pre-treatment levels. Conclusions: The OHLLT and LANAP regimens have demonstrated efficacy in the nonsurgical management of periodontal disease. Nevertheless, it should be noted that the OHLLT approach does not subject the patient to any thermal hazards, unlike the LANAP method. The postoperative discomfort experienced following the OHLLT procedure is indeed reduced, as this technique is characterized by lower invasiveness and reduced dependence on the operator. [ABSTRACT FROM AUTHOR]

In peri-implantitis, treatment lasers are effectively used to enhance implant surfaces' decontamination of bacteria. The type of lasers commonly used and tested in dentistry are Nd:YAG, Er:YAG and diodes. The Er:YAG laser is considered to be effective in removing biofilm from implant surfaces. Photodynamic therapy (PDT), realized with low-level laser therapy (LLLT) and a photosensitizer, seems to have limited efficacy in peri-implantitis management, while diode lasers used with high frequency and power (Wiser, Doctor Smile), performed with hydrogen peroxide 10 vol. 3% (OHLLT), seems to lead to a deep sanitization of implant surfaces, without any thermal effect. The aim of our retrospective controlled study is to compare an oxygen high-level laser therapy (OHLLT) protocol with OHLLT with an Er:YAG laser (Pluser, Doctor Smile) in order to maximize bacterial removal and to evaluate if an Er:YAG laser could improve hard tissue regeneration with respect to OHLLT alone. Two hundred and ten implants affected by peri-implantitis were divided into two groups: 88 implants were treated with OHLLT alone (control group) while 122 underwent OHLLT and Er:YAG treatment (test group). Mean bone loss before (T0) and after treatment (T1) (with a follow-up of 5 years) was registered for all implants. The collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 11.5. No statistically significant differences were found. In the OHLLT group, we noticed a mean bone loss after treatment of 2.1 mm in the upper arch and 2.4 mm in the mandible. In the OHLLT + Er:YAG group, the results indicate a mean bone loss of 2.0 mm in the upper arch and 2.5 mm in the mandible. Both groups showed a mean bone loss after treatment of 2.3 mm. According to the Kolmogorov–Smirnov test, overall, data followed a normal distribution (value of the K-S test statistic = 0.0912; p = 0.36112). OHLLT plays a central role in enhancing clinical results in peri-implantitis treatment, leading to an effective bacterial decontamination. Our results showed no statistically significant differences between OHLLT and OHLLT + Er:YAG laser; thus, the potential advantageous role of Er:YAG has been downgraded with the analysis of our study. [ABSTRACT FROM AUTHOR]