• Logo
  • SBMUJournals

Adjunct Use of Low-Level Laser Therapy on the Treatment of Necrotizing Ulcerative Gingivitis: A Case Report





Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the gingiva in the context of an impaired host response. This form of gingivitis is relatively rare. NUG is an infection characterized by gingival necrosis presenting as “punched-out” papillae, spontaneous bleeding, pain, oral malodor, and pseudomembrane formation. The primary predisposing factors are bacterial plaque and an inadequate diet, but smoking and psychological stress may also affect the disease severity. NUG is associated with a characteristic bacterial flora, which includes fusiform bacteria, spirochetes, and Prevotella intermedia. Conventional treatment includes control of both the bacterial plaque and the secondary factors, as well as topical or systemic treatment biostimulative effect on wound healing, pain control, and inflammatory processes. Patients with NUG were treated using adjunct use of a diode laser (980 nm) for the control of pain and to accelerate the wound healing at day 2. 3. 5. 9, energy density was 9 J/cm2. After treatment, the patients’ quality of life improved faster than with conventional treatment. These results suggest that low-level laser therapy (LLLT) is an effective treatment for the reduction of pain levels and healing times. As a result, our case report shows that LLTT has a positive effect in relieving the symptoms of NUG.


Low level laser therapy; Necrotizing ulcerative gingivitis; Non-surgical periodontal treatment.


Rowland RW. Necrotizing ulcerative gingivitis. Ann Periodontol. 1999;4(1):65-73; discussion 78. doi:10.1902/ annals.1999.4.1.65

Sangani I, Watt E, Cross D. Necrotizing ulcerative gingivitis and the orthodontic patient: a case series. J Orthod. 2013;40(1):77-80. doi:10.1179/1465313312y.0000000037

Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza’s Clinical Periodontology. 12th ed. Philadelphia, PA: Elsevier; 2014.

Shannon IL, Kilgore WG, O’Leary TJ. Stress as a Predisposing Factor in Necrotizing Ulcerative Gingivitis. J Periodontol. 1969;40(4):240-242. doi:10.1902/ jop.1969.40.4.240

Carroll JD, Milward MR, Cooper PR, Hadis M, Palin WM. Developments in low level light therapy (LLLT) for dentistry. Dent Mater. 2014;30(5):465-475. doi:10.1016/j. dental.2014.02.006

Misra N, Chittoria N, Umapathy D, Misra P. Efficacy of diode laser in the management of oral lichen planus. BMJ Case Rep. 2013;2013. doi:10.1136/bcr-2012-007609

Gasperini G, Rodrigues de Siqueira IC, Rezende Costa L. Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg. 2014;43(7):868-873. doi:10.1016/j.ijom.2014.02.015

Vallone F, Benedicenti S, Sorrenti E, Schiavetti I, Angiero F. Effect of diode laser in the treatment of patients with nonspecific chronic low back pain: a randomized controlled trial. Photomed Laser Surg. 2014;32(9):490-494. doi:10.1089/pho.2014.3715

Ren C, McGrath C, Yang Y. The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis. Lasers Med Sci. 2015;30(7):1881-1893. doi:10.1007/s10103-015-1743-4

Minicucci EM, Miot HA, Barraviera SR, Almeida-Lopes L. Low-level laser therapy on the treatment of oral and cutaneous pemphigus vulgaris: case report. Lasers Med Sci. 2012;27(5):1103-1106. doi:10.1007/s10103-012-1101-8

Sanz-Moliner JD, Nart J, Cohen RE, Ciancio SG. The effect of an 810-nm diode laser on postoperative pain and tissue response after modified Widman flap surgery: a pilot study in humans. J Periodontol. 2013;84(2):152-158. doi:10.1902/ jop.2012.110660

Masse JF, Landry RG, Rochette C, Dufour L, Morency R, D’Aoust P. Effectiveness of soft laser treatment in periodontal surgery. Int Dent J. 1993;43(2):121-127.

Tomasi C, Schander K, Dahlen G, Wennstrom JL. Short-term clinical and microbiologic effects of pocket debridement with an Er:YAG laser during periodontal maintenance. J Periodontol. 2006;77(1):111-118. doi:10.1902/jop.2006.77.1.111

Artes-Ribas M, Arnabat-Dominguez J, Puigdollers A. Analgesic effect of a low-level laser therapy (830 nm) in early orthodontic treatment. Lasers Med Sci. 2013;28(1):335-341. doi:10.1007/s10103-012-1135-y