In orthodontic therapy, the periodontal ligament plays a critical role in the bone remodeling process by stimulating osteoblasts in tension zones and promoting bone resorption through osteoclasts in compression zones in response to mechanical stress. These processes are regulated by key cytokines, such as RANKL and IL-1, which are influenced by factors such as patient age and force application. This work evaluates the effectiveness of clear aligners versus traditional braces on periodontal health in patients with periodontitis, following PRISMA guidelines and utilizing specific inclusion and exclusion criteria.

A systematic review of 1664 records was conducted, leading to the inclusion of eight studies that focus on the impact of orthodontic treatments on periodontal health. The review identifies various biases present in the literature.

The findings reveal that clear aligners, in contrast to fixed appliances, improve oral hygiene and reduce inflammation, leading to better periodontal outcomes. Fixed appliances, on the other hand, may exacerbate plaque accumulation and inflammation, which can worsen periodontal health.

Clear aligners offer advantages over fixed appliances in terms of enhancing periodontal health, improving patient compliance, and providing long-term benefits, particularly in patients with severe periodontitis. The effectiveness of clear aligners is linked to better management of periodontal complications and overall oral hygiene. Treatment decisions should be based on patient-specific criteria to optimize outcomes.

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.

Within a general practice setting, there are few benign pathological conditions of the attached or keratinised gingival complex that are not amenable to simple surgical intervention. The majority of surgical procedures are adjunctive to the delivery of restorative dentistry. There is an understandable dogma worldwide towards the management of soft tissues as they interface with restorative procedures. Contemporary teaching, both at undergraduate and postgraduate level, would recognise the need for a period of wound healing and stability, based on scalpel-induced incisional therapy. The use of laser wavelengths, based on predictable evidence-based protocols, has re-defined the surgical management of keratinised mucosa that is bound to the underlying periosteum and bone. This can be seen as being of benefit to the clinician in determining the outcome, and the patient in achieving quality results.

Surgical lasers rapidly are becoming part of the periodontal armamentarium. This article discusses the different lasers that are suitable for use on the soft tissues of the periodontium. Various laser-assisted periodontal surgical procedures and laser treatment of diseases of the oral mucosa are discussed.

Publicity about the use of lasers in dentistry has generated considerable interest in both professional and lay audiences. The purpose of this report is to provide information for members of the dental profession about the current and potential application of laser technology to periodontal practice. This report was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology.

Free gingival grafts are a reliable method for treatment of gingival recessions: An autograft is taken from the palate as replacement for the lost keratinized gingiva. A technique using the CO2 laser and results from a clinical study are presented. The receptor beds for 23 free gingival grafts were prepared with a CO2 laser. After a trapezoid incision in the epithelium, the connective tissue fibers were cut parallel to the periosteum avoiding coagulation of this delicate tissue. The grafts from the palate were taken conventionally. In all cases wound healing and incorporation of the grafts were good; no delay could be seen. Controls after 1 year revealed good results of the treatment. The CO2 laser can be useful for the free gingival graft procedure. Good hemostasis and low mechanical stress of the receptor bed can be achieved without affecting wound healing or incorporation of the delicate free gingival grafts.

The effect of a continuous wave carbon dioxide laser on dentin was observed as a function of power density and exposure time utilizing a wet scanning electron microscope. Visible charring occurred for all conditions studied. Surface cratering and flaking were followed by melting of the dentin. Melting resulted in a porous layer or porous globules of resolidified material and partial sealing of the tubules. Beneath the melted zone is an area of altered dentin where the tubules appear to be filled by solidification of the melted dentin.

This study evaluated a coaxial CO2/Nd:YAG laser used during periodontal surgery in mongrel dogs for the purpose of ablating the osseous portions of root surfaces to increase reattachment of soft tissue. Periodontal defects were produced with ligatures of orthodontic wire and elastics. The left mandibular osseous root surfaces were irradiated with a defocused, CW laser beam [power density (PD) = 42.46 W/cm2, energy density (ED) = 424.63 J/cm2]. The left maxillary osseous root surfaces were treated with a beam at twice the energy density [PD = 84.93 W/cm2, ED = 849.3 J/cm2]. The mandibular right quadrant received conventional surgery and the maxillary right quadrant served as the untreated control. Fourteen days after treatment, facial/lingual attached gingivae were scored for soft tissue adherence to bone. Laser irradiation at low ED did not improve soft tissue attachment when compared to conventional treatment. Higher ED irradiation produced significantly less attachment and increased tissue necrosis.

The purpose of this study was to evaluate the effect of a coaxial carbon dioxide/neodymium:yttrium aluminium garnet laser beam on enamel surface roughness and the dental pulps of mongrel dogs. In four dogs, four maxillary left posterior teeth were irradiated at 16 cm source-tooth distances. Two teeth were irradiated with 16 W CO2/16 W Nd:YAG and the remaining two with 16 W CO2/40 W Nd:YAG. Two maxillary right teeth were untreated controls. In addition, mandibular premolars were irradiated at the same distance and power levels, extracted, and analysed for surface roughness. Significant differences in surface roughness were found between control samples and either power level, but not between enamel surfaces at the two power levels. Maxillary teeth were removed at 10 days postoperatively, sectioned and stained (H & E). The reaction of pulpal cells to irradiation was scored. Data analysis revealed statistically significant differences between the control and lower power Nd:YAG groups and between the control and higher power Nd:YAG groups. The difference in pulpal response between both laser groups approached significance.

A review was conducted to determine specific areas of application of the argon laser to dentistry. When appropriate, comparisons between the argon laser and other treatment methods were made. It was concluded that the argon laser has applicability in composite resin placement, in enamel and dentin bonding procedures, in preventive dental therapies, and in endodontic procedures.

The carbon dioxide laser is used in the oral cavity for a variety of procedures. Although the procedures may not involve the teeth directly, precaution should be exercised to preserve their integrity. The results of this study indicate that the most limiting parameter for oral use of the CO2 laser is damage to the enamel surface, which could be inflicted with as little as 5 W for 0.2 second and a 1 mm beam. Care should be exercised to prevent inadvertent damage to the surface enamel of teeth even at very low energy levels.

Up to now lasers have not achieved any practical importance in dentistry for drilling teeth because of considerable damage to the surrounding tissue. We studied the application of pulsed 2.94 microns Er:YAG laser radiation in vitro on extracted teeth to remove enamel, dentin, and carious lesions. The depth and diameter of laser-drilled holes were measured as a function of pulse number and radiant exposure. The tissue removal is very effective both for dentin and enamel.