Meta-analysis of laser-assisted periodontal therapy (2015–2025)

This systematic review and meta-analysis evaluated the adjunctive clinical efficacy of laser-assisted periodontal therapy compared with conventional scaling and root planing (SRP). The primary research question was whether laser systems provide additional improvements in clinical attachment level (CAL) and probing depth (PD) in patients with periodontitis. PubMed, Scopus, and Web of Science were searched for studies published between January 2015 and October 2025 following PRISMA 2020 guidelines. Randomized controlled trials and prospective clinical studies comparing laser-assisted periodontal therapy with SRP alone were included. Primary outcomes were changes in CAL and PD with a minimum follow-up of 3 months. Meta-analysis was performed using a random-effects model when sufficient quantitative data were available. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and evidence certainty was evaluated using GRADE. Twenty-six studies were included in the qualitative synthesis, and quantitative meta-analysis was feasible only for Er: YAG lasers. The pooled mean difference in CAL gain favored Er: YAG adjunctive therapy (MD = 0.319 mm; 95% CI: −0.097 to 0.735 mm), without statistical significance. Moderate heterogeneity was observed (I² ≈ 54%). Evidence for diode lasers, Nd: YAG lasers, and antimicrobial photodynamic therapy showed modest short-term effects but lacked standardized data for quantitative pooling. Laser-assisted periodontal therapy may provide small adjunctive benefits over SRP alone. Er: YAG lasers showed the most consistent, though clinically limited, effects and should be considered supplementary rather than routine adjuncts.