Effect of Er:YAG Laser on Scaling and Root Planning and Usage of i-Platelet Rich Fibrin as a Biomodifier

Objectives: The purpose of this study was to compare scaling and root planning (SRP) with Er:YAG laser and Gracey curettes and the effectiveness of using injectable platelet-rich fibrin (i-PRF) as a biomodifier was also investigated. Materials and Methods: There were 4 groups of extracted human teeth: Gracey Group (n=9): SRP with Gracey curettes; Gracey + i-PRF Group (n=9): SRP with Gracey curettes followed by application of i-PRF to the root surface; Er:YAG Group (n=9): SRP with Er:YAG laser; Er:YAG + i-PRF Group (n=9): SRP with Er:YAG laser followed by application of i-PRF to the root surface. The width of dentin tubules and the presence/absence of smear layer were examined using scanning electron microscopy (SEM). Results: There was significantly less smear layer in the Er:YAG group compared to the Gracey group (p=0.001). The width of dentin tubules was found to be significantly higher in the Er:YAG and Er:YAG+i-PRF groups compared to the Gracey group (respectively;p=0.015;p<0.001). The width of dentin tubules in the Er:YAG+i-PRF group was profoundly higher than in the Gracey+i-PRF group (p=0.026). Conclusions: Er:YAG laser was found to be more effective than Gracey curettes, which are the gold standard in root surface cleaning. Especially when combined with Er:YAG laser, i-PRF resulted in wider dentin tubules.