Use of Laser in Periodontal Tissue Regeneration: A Scoping Review of Clinical and Experimental Evidence

激光在牙周组织再生中的应用:临床和实验证据的范围综述

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Abstract

Background and Objectives: Periodontitis leads to progressive destruction of periodontal tissues and, despite advances in regenerative approaches, clinical outcomes remain inconsistent. Lasers have been proposed as adjuncts in regenerative periodontology because of their antimicrobial, hemostatic, and photobiomodulatory properties. However, available evidence remains heterogeneous. This scoping review aims to systematically map clinical and experimental evidence on the role of lasers in periodontal tissue regeneration. Materials and Methods: The review was conducted in accordance with the PRISMA-ScR guidelines. PubMed, Scopus, and Web of Science were searched up to September 2025 without time restrictions. Eligible studies included in vitro, ex vivo, in vivo and clinical research assessing the application of lasers for periodontal healing. Reviews, conference abstracts and studies unrelated to regeneration were excluded. Results: The electronic search retrieved 314 records, of which 193 unique articles were screened after duplicates removal and 17 full texts were assessed. A total of 15 studies met the eligibility criteria and were included in the review. Included studies comprised 5 in vitro investigations, 2 ex vivo studies, 1 in vivo animal study, 4 case reports and 3 RCTs, published between 2015 and 2025. In vitro and ex vivo evidence demonstrated that laser irradiation enhanced cell proliferation, differentiation, growth factor release, and root surface conditioning. The in vivo study confirmed increased angiogenesis and bone formation after Er:YAG PBM. Clinical studies, including RCTs and case reports, reported improvements in PD reduction, clinical attachment gain, and radiographic bone fill, particularly when lasers were applied as adjuncts to regenerative techniques or biomaterials. Conclusions: Available evidence suggests that lasers can positively modulate biological processes and enhance the outcomes of regenerative periodontal procedures. However, the limited number of high-quality clinical trials, variability in laser types and parameters, and heterogeneity in protocols limit the strength of current conclusions. Further standardized RCTs with long-term follow-up are needed to clarify the clinical relevance of lasers in periodontal regenerative outcomes.

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