The Effectiveness of 980nm Laser Therapy on Socket Preservation: A Preliminary Split Mouth Randomized Controlled Clinical Study

Research Article

J Dent & Oral Disord. 2019; 5(2): 1116.

The Effectiveness of 980nm Laser Therapy on Socket Preservation: A Preliminary Split Mouth Randomized Controlled Clinical Study

Abdel Mageed H1,2†, Hanna R2†* and Benedicenti S2

¹Laser Dental Center, Building 40A Baghdad Street, El Korba, Heliopolis, Egypt

²Laser Therapy Center, Department of Surgical and Diagnostic Sciences, University of Genoa, Italy †Joined first author

*Corresponding author: Hanna R, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy

Received: August 05, 2019; Accepted: September 12, 2019; Published: September 19, 2019


Background: The area of interest of laser beam profile and its clinical application have examined previously. However, utilization 980nm diode laser treatment in this concept remains unevaluated, in order to verify its potential in socket preservation. Our study’s objectives were to examine 980nm beam profile zones, high-level laser therapy and low-level laser therapy, in enhancing the haemostasis and accelerating bone healing in extraction socket respectively.

Methods: Ten recruited orthodontic patients required bilateral lower first premolars teeth extraction. Twenty sockets randomized into Laser Group (LG) and Control Group (CG). Two laser treatment protocols utilized as follows: contact stage (2 Watts, Continuous Wave (CW), 300 microns tip, 14 seconds exposure time) and non-contact stage (3 Watts, CW, 300 microns tip, 40 seconds exposure time). Cone Beam Computer Tomography (CBCT) immediately and 4 months postoperatively utilised to measure bone height, width, density, and a neoformed bone in extraction sockets.

Results: Four months CBCT values of bone density and newly formed bone were higher of mean values 498.61 mm ± 142.5 and 1.63 mm ± 0.22 respectively, and statistically significant differences P=0.04 and P=0.17 respectively, in LG compared to CG.

Conclusion: Our data, for the first time, prove the positive effects of 980nm laser beam profile zones in socket preservation.

Keywords: Bone regeneration; Bone repair; High-Level Laser Therapy (HLLT); Low-Level Laser Therapy (LLLT); Photobiomodulation; Tooth socket preservation


Physiological bone loss is one of the unavoidable complications, which is associated with tooth extraction. Most of the alveolar bone resorption occurs during the first 3 to 6 months after tooth extraction [1-3]. Therefore, the socket preservation has become the gold standard in recent years among clinicians. Several in-vivo studies, clinical case series and systematic reviews published in order, to establish the rationale in using socket preservation as a therapeutic therapy [4-7]. However, some of these techniques can incur some challenges. Photobiomodulation (PBM) therapy has been utilised to enhance bone healing for over the last 3 decades. Despite many studies examined the positive effects of PBM and HLLT on early bone healing [8-11], it still remains a fact that insignificant difference observed in bone regeneration between the control and irradiated groups [12].

When the extraction socket irradiated with 980nm, the photonic energy of its first zone beam profile (HLLT) absorbed by the Haemoglobin (Hb), which subsequently transformed into a thermal energy (Photothermolysis), in order to achieve photocoagulation [13]. The protein in the blood denatures at 60 to 65 degree Celsius (°C); due to the photothermolysis effect [14]. The bone of the extraction socket walls can gain the Low-Level Laser Therapy (LLLT) effect in the last zone of the beam profile [15,16]. This enhances the neovascularization, increases collagen synthesis, and promotes newly formed bone. This is due to the 980nm bio-stimulatory effect on gene expression up- regulation, growth factors increase and cell proliferation and differentiation [17,18]. The 980nm mechanism of action is different than any other wavelengths in the IR region, as the main chromophore for PBM is water [19].

Many studies showed the effectiveness of 980nm PBMT on tissue regeneration, as an adjunctive therapy to the non-surgical periodontal treatment [20,21]. Ohshiro et al.1996, stated that the effects of laser energy on the tissue varies, which mostly depending on the power density or on the photonic density of the incident beam on the target tissue [18]. This led to a progression of the photodestructive and photoactivation sides of the laser beam profile. The photoreactions are temperature specific. However, the range of changes in the temperature depends mostly on the laser wavelength and target tissue phenotype. Ohshiro et al.1996 identified two zones of photoreaction in the laser beam profile; first zone, the photodestruction associated with the laser surgery for which called HLLT, while the second one, the photobioactivation associated with laser therapy, subablative threshold, for which is LLLT [18]. The school of thought among various orthodontic researchers is prevention modality prior to orthodontic tooth movement to avert the possibility of bone resorption and dehiscence [22].

Therefore, our study, for the first time, examined the effect 980nm laser beam profile concept on extraction socket preservation. The objectives of the study were to investigate, whether using 980nm could enhance the hemostasis process, through its coagulation phenomena, and accelerate the bone healing (remodeling sage) through its LLLT effect.

Material and Methods

Inclusive and inclusive criteria

Ten healthy and non-smoking (6 females and 4 males) patients at age range between 17-30 year old, enrolled in a comparative split mouth randomised controlled clinical trial (Figure 1). All the recruited patients required extraction of bilateral lower first premolar teeth for orthodontic purposes and presented with a good oral hygiene with plaque index of “0” value, according to Silness and Loe classification [23]. The treatment side of each patient was allocated using a Google random number generator, leading to a right or left treatment side only (laser group). The un-selected site received a sham laser therapy (control group). The total data were 20 extraction sockets without socket preservations. The study was double blinded (patient and investigator). The exclusive criteria were opposite to the above, including pregnant women. This study conformed to CONSORT guidelines. All the subjects gave their informed consent for inclusion, before they participated in the study, which was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of October 6 University/Faculty of Dentistry/Egypt. The project identification code is 109, which was issued on the 02/05/2017.