Effects of dual-wavelength laser combined with periodontal flap surgery on periodontal parameters and inflammatory factors in patients with periodontic-endodontic lesions

Objective This study investigated the clinical effectiveness of dual-wavelength laser with periodontal flap surgery in managing periodontic-endodontic lesions (PEL) and its impact on periodontal parameters and inflammatory markers. Methods A total of 106 PEL patients were randomly assigned to a study group or a control group (53 each). All patients first received root canal treatment. The control group underwent conventional periodontal flap surgery, whereas the study group received adjunctive dual-wavelength laser treatment (Nd: YAG for root canal disinfection and Er: YAG for periodontal pocket debridement). Pain visual analogue scale (VAS) scores were recorded prior to treatment and at 1 and 7 days postoperatively. Periodontal parameters, gingival crevicular fluid (GCF) and serum inflammatory markers, and bacterial infection/clearance rates were assessed at baseline and 3 months post-treatment. Clinical efficacy and incidences of tooth mobility, periodontitis recurrence, and percussion pain were evaluated at 6 months. Results Ninety-nine patients completed follow-up (48 in the study group and 51 in the control group). On postoperative day 1, VAS scores increased in both groups but were significantly lower in the study group ( P < 0.05); by day 7, VAS scores declined with no between-group difference ( P > 0.05). At 3 months, PD, CAL, GI, PLI, and levels of IL-1β, IL-6, and MMP-8 decreased in both groups, with greater improvements in the study group ( P < 0.05). The study group also exhibited lower bacterial infection rates and higher bacterial clearance ( P < 0.05). At 6 months, the study group showed higher treatment success and lower rates of tooth mobility, recurrence, and percussion pain ( P < 0.05). Conclusion Dual-wavelength laser adjunctive therapy enhances the clinical efficacy of periodontal flap surgery in PEL, significantly improving periodontal healing, reducing inflammation, and promoting bacterial clearance.