Journal of Lasers in Medical Sciences

Abstract

Introduction: Endodontic-periodontal lesions (EPL) present a complex diagnostic and therapeutic challenge due to their dual involvement of pulpal and periodontal tissues, their diverse etiology, and overlapping clinical features. Traditional management strategies, including scaling and root planing (SRP), surface root debridement (SRD), and conventional endodontic therapy, often fail to achieve predictable outcomes because of persistent microbial contamination and the limitations of mechanical debridement.

Methods: To identify studies on laser therapy for managing endodontic-periodontal lesions, the PubMed database was searched, and articles published from 1988 to April 2022 were extracted and analyzed.

Results: This review provides a comprehensive evaluation of the clinical efficacy and therapeutic applications of diode laser therapy in the management of EPL. Evidence highlights the bactericidal effects of diode lasers in root canals and periodontal pockets, their ability to enhance decontamination through laser-activated irrigation (LAI) and antimicrobial photo-activated disinfection (aPAD), and their role in reducing probing depth (PD) and improving clinical attachment level (CAL). Additionally, diode lasers contribute to wound healing, photobiomodulation, and pain reduction, supporting their integration into both surgical and non-surgical treatment protocols. Limitations, however, include variability in laser parameters, absence of standardized protocols, and insufficient long-term clinical trials.

Conclusion: The findings suggest that diode lasers represent a valuable adjunct in EPL management, capable of improving microbial control, enhancing tissue regeneration, and supporting comprehensive endodontic-periodontal therapy. Further well-designed clinical studies are required to establish standardized guidelines and confirm long-term efficacy.