The clinical efficacy of laser-assisted open flap debridement in patients with periodontitis: a systematic review and meta-analysis

The aim of this meta-analysis was to assess the quality of evidence and efficacy of laser-assisted open flap debridement (OFD) in the treatment of periodontitis.

This systematic review and meta-analysis followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in the PROSPERO (CRD42024613819). We searched PubMed, Web of Science, Cochrane Library for studies up to September 15,2024 that compared of laser-assisted OFD with OFD alone. The primary outcome indicator was clinical attachment level (CAL) and the secondary outcome indicators were PD, PI, BI. Random or fixed-effects meta-analytical models were used, depending on the results of the heterogeneity assessment.

A total of 69 titles and abstracts are searched, and 12 RCTs are included in this Meta-analysis. The Meta-analysis shows that, at the 6-month postoperative follow-up, patients in the laser-assisted OFD experimental group exhibit a reduction in CAL [MD = -0.57, 95%CI: (-0.88, -0.25), P = 0.0004] and a decrease in probing depth (PD) [MD = -0.31, 95%CI (-0.57, -0.05), P = 0.02], with these differences being significant. However, the declines in plaque index (PI) [MD = -0.03, 95%CI (-0.17, 0.11), P = 0.66] and gingival index (GI) [MD = 0.01, 95%CI: (-0.05, 0.07), P = 0.77] do not manifest statistically significant differences.

With the limited data available, compared with OFD, laser-assisted OFD can achieve better therapeutic effects in the treatment of periodontitis. Moreover, since the laser parameters and treatment protocols of the included studies were unstandardized and have no direct comparability, further RCTs are required to draw a more realistic and reliable conclusion.