Periodontol 2000. 2015 Jun;68(1):217-69. doi: 10.1111/prd.12080.
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.
激光照射具有多种有利特性，如消融或蒸发、止血、生物刺激（光生物调节）和微生物抑制与破坏，从而引起各种有益的治疗效果和生物学反应。因此，激光的应用被认为是有效且适合治疗各种炎症和感染性口腔疾病的方法。二氧化碳（CO2）、掺钕钇铝石榴石（Nd:YAG）和二极管激光器主要用于牙周软组织管理。随着掺铒钇铝石榴石（Er:YAG）和掺铒、铬钇钪镓石榴石（Er,Cr:YSGG）激光器的发展，这些激光器不仅可应用于软组织，还可应用于牙体硬组织，激光的应用范围从牙周软组织管理迅速扩展到硬组织治疗。目前，各种牙周组织（如牙龈、牙根和骨组织）以及钛种植体表面都可以用激光进行治疗，各种牙科激光系统也被用于牙周病和种植体周围病的治疗。在牙周病学中，机械疗法一直是主流治疗方法；然而，仅靠传统的机械疗法可能无法完全清除细菌和/或实现最佳的伤口愈合。因此，除了包括抗生素和抗炎药物的化学疗法外，激光和发光二极管的光疗也逐渐与机械疗法结合，通过彻底清创、去污和组织刺激来增强后续的伤口愈合。随着低水平和高水平激光疗法益处的证据不断增加，这些疗法在牙周病和种植体周围病的治疗中对伤口愈合/组织再生起着重要作用。本文根据目前基础和临床研究以及病例报告中的科学证据，讨论了激光疗法在软组织管理、牙周非手术和手术治疗、骨手术和种植体周围治疗中的应用效果，重点关注牙周和种植体周围组织的术后伤口愈合情况。
