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Review Article
5 (
1
); 50-58
doi:
10.25259/DJIGIMS_24_2025

Precision Periodontics: Unlocking New Potential with Laser Patterned Micro Coagulation

1MDS Department of Periodontology, Fleet Dental Centre, Naval Dockyard, SBS Road, Fort, Mumbai, Maharashtra, India.
Author image

*Corresponding author: Muneesh Joshi, HOD & Officer - In- Charge Department of Periodontology, Fleet Dental Centre, Naval Dockyard, SBS Road, Fort, Mumbai, 400088, Maharashtra, India. muneeshjoshi@gmail.com

Received: , Accepted: ,
© 2026 Published by Scientific Scholar on behalf of Dental Journal of Indira Gandhi Institute of Medical Sciences
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Joshi M. Precision Periodontics: Unlocking New Potential with Laser Patterned Micro Coagulation. Dent J Indira Gandhi Int Med Sci. 2026;5:50-8. doi: 10.25259/DJIGIMS_24_2025

Abstract

Periodontal diseases represent chronic inflammatory conditions that progressively compromise the supporting structures of the dentition, leading to attachment loss and tooth mobility when left untreated. Conventional treatment modalities, including mechanical debridement, adjunctive pharmacotherapy, and surgical interventions, remain effective but often present limitations such as post-operative discomfort, soft tissue recession, and unpredictable healing outcomes. Recent developments in laser technology have introduced alternative, minimally invasive strategies within periodontal therapy, offering potential improvements in clinical precision, patient comfort, and biological response.

Among emerging approaches, laser patterned micro coagulation (LPMC) has gained attention due to its controlled, tissue-sparing mechanism that has demonstrated promise in other medical disciplines. LPMC employs pulsed or scanned laser energy to generate discrete, microscopic zones of thermal coagulation within soft tissues, thereby facilitating precise modulation of biological responses while minimizing collateral thermal injury. The underlying mechanism is primarily photo-thermal, leading to localized protein denaturation and collagen shrinkage, with possible photo-mechanical contributions that support microstructural remodeling.

Within a periodontal context, these interactions may promote bacterial reduction, removal of inflamed pocket epithelium, modulation of inflammatory mediators, hemostasis, and subsequent stimulation of reparative processes. Such photo-thermal selectivity confers several potential clinical advantages, including decreased postoperative pain, minimized gingival recession, accelerated healing, and enhanced control over surgical margins. The potential applications of LPMC in periodontology extend across adjunctive use in non-surgical therapy, management of periodontal pockets, gingival depigmentation, treatment of peri-implantitis, and as a facilitative tool in regenerative procedures.

Distinct from other laser-assisted approaches, LPMC allows patterned energy delivery that yields spatially controlled microthermal lesions, maintaining the integrity of intervening tissue and enabling more favorable healing kinetics. These characteristics suggest that LPMC could bridge the gap between conventional mechanical debridement and traditional flap surgery, particularly in cases requiring precision and tissue preservation. However, despite its compelling theoretical rationale and promising ex vivo findings, scientific validation within the periodontal domain remains scarce. Current evidence is largely extrapolated from preliminary medical data and pilot dental reports, underscoring the need for well-designed randomized controlled trials to substantiate its safety, efficacy, and long-term outcomes. Establishing standardized parameters for wavelength, fluence, and tissue interaction dynamics will be essential to integrate LPMC into evidence-based periodontal practice. Consequently, LPMC may represent a significant advancement in minimally invasive periodontal therapy pending further translational and clinical research to define its optimal clinical indications and therapeutic effectiveness.

Keywords

Diode laser
Laser patterned micro coagulation
Periodontal therapy
Photobiomodulation
Photo-mechanical effects
Photo-thermal interactions

INTRODUCTION

Periodontal diseases, primarily gingivitis and periodontitis, represent a significant global health burden. These inflammatory conditions are initiated by bacterial biofilms accumulating on tooth surfaces, leading to inflammation of the gingiva (gingivitis) and, in susceptible individuals, progressing to destruction of the periodontal ligament, alveolar bone, and cementum (periodontitis). The ultimate consequence of untreated periodontitis is tooth loss.[1-5]

The primary goal of periodontal therapy is to eliminate the bacterial infection, reduce inflammation, and halt disease progression, thereby preserving the dentition and its supporting structures. Conventional non-surgical periodontal therapy involves scaling and root planning (SRP), a mechanical process to remove plaque, calculus, and bacterial toxins from tooth surfaces and root pockets.[6,7] Surgical interventions may be necessary for advanced cases to access deeper defects, reduce pocket depth, and regenerate lost tissues. While effective, these traditional methods can be invasive, leading to post-operative pain, swelling, gingival recession, and root sensitivity.[8]

The application of lasers in periodontology has gained traction over the past few decades, offering potential benefits such as bacterial reduction.[9], debridement, hemostasis, and biostimulation. Various lasers, including Nd: YAG (Neodymium-doped Yttrium Aluminum Garnet), Er: YAG (Erbium-doped Yttrium Aluminum Garnet), diode, and CO2 (Carbon dioxide) lasers, have been investigated for use in periodontal procedures.[5,10] However, the use of continuous-wave or conventional pulsed lasers in a non-patterned manner can sometimes lead to excessive thermal damage, charring, and unpredictable tissue response, particularly in delicate periodontal tissues.

Laser patterned micro coagulation (LPMC), a technique that has demonstrated success in other medical disciplines by creating precise, discrete thermal lesions, presents an intriguing possibility for application in periodontology. By delivering laser energy in controlled patterns of micro-coagulation spots, LPMC aims to achieve therapeutic effects at a microscopic level while preserving the vitality and integrity of surrounding healthy periodontal tissues.[11] This approach could potentially mitigate some of the drawbacks associated with conventional periodontal lasers and mechanical treatments, offering a more targeted, less invasive, and potentially regenerative approach to periodontal management.

This review aims to explore the theoretical underpinnings and potential applications of LPMC in the context of periodontal therapy. We will examine how the unique characteristics of LPMC might interact with the complex anatomy and biology of the periodontium, discuss potential clinical uses ranging from pocket debridement to tissue regeneration, evaluate the potential advantages and limitations, and highlight areas for future research to establish the role of LPMC in modern periodontics.[12]

Mechanisms of LPMC relevant to periodontal tissues

The therapeutic effects of LPMC in periodontology would primarily rely on controlled photo-thermal interactions with the various components of the periodontal tissues: the gingiva, periodontal ligament, cementum, and alveolar bone.[13] While photo-mechanical effects are less dominant in the typical LPMC parameters used for coagulation, they could play a role depending on the specific laser system and settings.

Photo-thermal interaction with periodontal tissues

The principle of selective photothermolysis is central to understanding how LPMC could work in periodontology. Different periodontal tissues and structures contain varying concentrations of chromophores, such as water, hemoglobin, and melanin. By selecting an appropriate laser wavelength, LPMC can target specific structures.

Bacterial reduction

Periodontal pockets are colonized by complex bacterial biofilms.[14] Many periodontal pathogens contain endogenous chromophores or can be targeted by specific wavelengths. The rapid, localized temperature rise within the micro-coagulation spots can lead to thermal destruction of bacteria within the biofilm and the pocket epithelium.[15] The patterned delivery allows for treating a significant surface area of the pocket wall while potentially minimizing damage to the underlying connective tissue and root surface. The discrete nature of the lesions may also disrupt the biofilm structure, making it more susceptible to removal.

Pocket epithelium debridement

The inflamed pocket epithelium is often ulcerated and contains inflammatory cells and bacteria. LPMC can be used to selectively ablate or coagulate this diseased epithelial lining. The precise micro-lesions allow for the removal of the pathological tissue with minimal damage to the underlying connective tissue and attachment fibers. This could facilitate reattachment of healthy tissue to the root surface.

Inflammation modulation

The controlled thermal micro-injury induced by LPMC can trigger a localized inflammatory response followed by a healing cascade.[16-18] This biological response involves the release of cytokines and growth factors that can influence tissue repair and regeneration. The patterned approach, with intervening healthy tissue, is hypothesized to promote a more organized and efficient healing process compared to widespread thermal damage.

Hemostasis

The thermal effect of LPMC can coagulate small blood vessels, providing hemostasis during periodontal procedures. This can improve visibility and reduce bleeding.

Tissue contouring (Gingiva)

For procedures like gingival depigmentation or minor gingival recontouring, LPMC can be used to precisely remove or modify superficial gingival tissue containing excess melanin or requiring reshaping.[19,20] The micro-lesions allow for controlled tissue removal with potentially less post-operative pain and faster healing compared to scalpel or conventional laser excision.[21] The discrete micro-lesions would facilitate re-epithelialization from the surrounding untreated tissue.[22]

Potential photo-mechanical effects

While less prominent than in ablative or ultra-short pulse lasers, photo-mechanical effects could contribute to LPMC's action in periodontology, particularly with shorter pulse durations. The rapid expansion of heated tissue or potential micro-cavitation bubbles could aid in disrupting bacterial biofilms and removing debris from the root surface or pocket wall. However, parameters must be carefully controlled to avoid unintended mechanical damage to delicate structures like the periodontal ligament.

Interaction with the root surface and bone

The interaction of LPMC with the root surface (cementum) and alveolar bone requires careful consideration.[23,24] The goal is typically to remove calculus and toxins from the root surface without causing excessive thermal damage that could impair healing or lead to ankylosis. Similarly, when used near bone, parameters must be controlled to avoid osteonecrosis. The wavelength, pulse duration, and energy density are critical in determining the depth and nature of the thermal effect on these hard tissues.

Lasers with high absorption in water, like Er:YAG, are typically preferred for hard tissue ablation, while LPMC for coagulation often uses wavelengths targeting melanin or hemoglobin. Therefore, the application of LPMC directly to the root surface or bone for debridement would likely be limited, with its primary role being on the soft tissue walls of the pocket and potentially stimulating bone regeneration indirectly through the healing response.[25]

The discrete nature of the micro-lesions in LPMC is key in periodontology. By leaving islands of healthy tissue between the treated spots, the technique aims to preserve the regenerative potential of the periodontium. Fibroblasts, osteoblasts, and cementoblasts residing in the untreated areas can migrate into the micro-lesions, facilitating repair and potentially regeneration of lost periodontal tissues.[26,27]

Instrumentation and technology for periodontal IPMC

The LPMC systems used in periodontology would share core components with those used in other fields, but with specific adaptations for oral and periodontal applications.

Laser source

Diode lasers (e.g., 810 nm, 940 nm, 980 nm) and Nd: YAG lasers (1064 nm) are commonly used in periodontology for their absorption in hemoglobin and melanin and their ability to be delivered through flexible optical fibers, which is advantageous for accessing periodontal pockets.[5,10] Frequency-doubled Nd: YAG or DPSS green lasers (532 nm) could also be considered for targeting pigmented bacteria or vascular lesions in the gingiva. The choice of laser source and wavelength is critical for achieving the desired selective absorption in periodontal tissues.

Pattern generation system

Similar to other LPMC applications, scanning mirror systems or digital micromirror devices (DMDs) would be employed to generate the micro-lesion patterns. For periodontal use, the delivery system would need to be adapted for intraoral access. This could involve specialized handpieces with scanning optics or fiber optic delivery systems integrated with scanning mechanisms. The ability to generate patterns on curved root surfaces and within confined periodontal pockets is a key technological requirement.[28]

Beam delivery system

Flexible optical fibers are the preferred method for delivering laser energy into periodontal pockets. The fiber tip would need to be designed to allow for the formation of the desired spot size and pattern on the pocket wall or root surface. Specialized handpieces or probes that can be inserted into the pocket and deliver the patterned laser energy are necessary.

Control software

The software would need to allow for the design and selection of patterns appropriate for different periodontal applications (e.g., patterns for pocket debridement, patterns for gingival depigmentation). Control over parameters such as spot size, pulse duration, energy per spot, spacing between spots, and pattern size and shape would be essential. The software should also ideally provide feedback on treatment delivery and potentially integrate with imaging.[29]

Integrated imaging/guidance

Real-time imaging is crucial for precise LPMC delivery in periodontology. Integration with intraoral cameras, periodontal probes with depth sensing, or even miniaturized OCT systems could help guide the clinician in placing the patterns accurately within the periodontal pocket or on the target tissue. This would ensure that micro-lesions are placed in diseased areas while avoiding critical structures.

The development of LPMC systems specifically tailored for periodontal use would require miniaturization of scanning components, flexible and durable fiber optic delivery, and intuitive software interfaces designed for the unique challenges of the oral environment.[30]

Clinical applications of LPMC in periodontology

The application of LPMC in periodontology is an emerging area, with much of the current understanding based on theoretical advantages and extrapolation from its use in other fields. However, several potential clinical applications can be envisioned:

Non-surgical periodontal therapy (Adjunct to SRP)

LPMC could be used as an adjunct to traditional SRP.[5,29] After mechanical debridement to remove gross deposits, LPMC could be applied to the pocket epithelium and potentially the root surface to achieve further bacterial reduction.[10,11,24], remove residual diseased tissue, and stimulate healing. The patterned delivery could treat the entire inner surface of the pocket more uniformly than a single-spot laser application. The tissue-sparing nature of LPMC might lead to less postoperative discomfort and recession compared to aggressive mechanical or conventional laser debridement.[2,3]

Management of periodontal pockets

For persistent periodontal pockets after initial therapy, LPMC could be used for targeted debridement and bacterial inactivation within the pocket.[28] The ability to control the depth and lateral spread of thermal damage with micro-lesions is crucial in avoiding damage to the underlying bone and periodontal ligament.

Gingival depigmentation

Physiological melanin hyperpigmentation of the gingiva is a common aesthetic concern for some patients.[30] LPMC could offer a precise method for removing excess melanin from the gingival epithelium by targeting the melanin chromophore.[19] The patterned delivery would allow for controlled treatment of the pigmented areas with potentially faster healing and less risk of scarring or dyspigmentation compared to conventional methods like scalpel surgery, cryosurgery, or non-patterned lasers.[31] The discrete micro-lesions would facilitate reepithelialization from the surrounding untreated tissue.[32,33]

Peri-implantitis management

Peri-implantitis, an inflammatory condition affecting the tissues surrounding dental implants, is a significant challenge.[34] Bacterial biofilms on the implant surface and in the peri-implant pocket are key etiological factors. LPMC could potentially be used to debride the inflamed peri-implant pocket epithelium and reduce bacterial load on the exposed implant surface (depending on the implant surface characteristics and laser wavelength). However, careful consideration of the thermal effects on the implant surface and surrounding bone is paramount to avoid damaging the implant or compromising osseointegration. Research is needed to determine safe and effective parameters for this application.

Potential for periodontal regeneration

The controlled micro-injury induced by LPMC could potentially stimulate a regenerative response in the periodontium.[26] The release of growth factors and cytokines from the treated and surrounding healthy tissues could promote the migration and differentiation of cells involved in periodontal regeneration (fibroblasts, cementoblasts, osteoblasts).[35] This is a highly speculative application and would require significant research to validate, likely involving specific patterns and parameters designed to optimize the regenerative cascade.

Adjunct in periodontal surgery

LPMC could potentially be used during periodontal surgery for precise debridement of flap tissue, hemostasis, or surface modification of root surfaces or bone (with appropriate wavelengths and parameters).

Treatment of specific lesions

LPMC might be useful for the precise removal or modification of small, benign gingival lesions.

It is important to emphasize that the application of LPMC in periodontology is still in its nascent stages. While the theoretical benefits are compelling, robust clinical trials are needed to establish the safety and efficacy of LPMC for these potential applications, determine optimal treatment parameters, and compare outcomes to existing treatment modalities.

Advantages and disadvantages of LPMC in periodontology

Applying LPMC principles to periodontal therapy offers several potential advantages but also presents specific challenges.

Advantages

Reduced collateral damage

The primary advantage of LPMC is its ability to create discrete micro-lesions, minimizing thermal damage to surrounding healthy periodontal tissues (gingiva, periodontal ligament, bone).[36] This is crucial for preserving the delicate structures required for tooth support and potential regeneration.

Minimized pain and discomfort

Reduced thermal load and less extensive tissue damage are likely to result in less post-operative pain, swelling, and discomfort for patients compared to conventional surgical or aggressive laser treatments.[37]

Faster healing and recovery

The presence of intact healthy tissue between the micro-lesions facilitates rapid re-epithelialization and healing,[6,12] potentially leading to faster recovery times and reduced postoperative complications.[38]

Reduced gingival recession

By precisely targeting the pocket epithelium and minimizing damage to the underlying connective tissue, LPMC may lead to less post-operative gingival recession compared to mechanical debridement or conventional lasers that can cause significant tissue shrinkage.[39]

Precise tissue management

The ability to generate controlled patterns allows for highly precise treatment of specific areas within the periodontal pocket or on the gingiva, avoiding damage to adjacent critical structures.[37,38]

Targeted bacterial reduction

LPMC can target bacteria within the biofilm and pocket epithelium through thermal effects, potentially reducing bacterial load more effectively in specific areas than mechanical methods alone.[40]

Potential for enhanced healing/regeneration

The controlled micro-injury may stimulate a favorable biological response that promotes healing and potentially contributes to periodontal regeneration.[41]

Efficiency

Patterned delivery allows for treating a larger area of the pocket wall or gingival surface in a relatively short time compared to treating individual spots.

Disadvantages

Cost of equipment

LPMC systems are typically more expensive than traditional periodontal instruments or conventional single-spot dental lasers, which could limit their accessibility.

Learning curve

Operating LPMC systems and selecting appropriate parameters for different periodontal conditions and tissue types will require specialized training and expertise for dental professionals.

Limited penetration depth

The penetration depth of the laser energy is dependent on the wavelength and tissue optical properties. This could limit the effectiveness of LPMC for treating very deep periodontal pockets or lesions affecting the underlying bone.

Challenges in intraoral delivery

Adapting LPMC technology for precise and stable delivery within the confined and often moist environment of the oral cavity and periodontal pockets presents significant engineering challenges.[5,45]

Lack of robust clinical evidence

Currently, there is limited high-quality clinical evidence specifically on the efficacy and long-term outcomes of LPMC in periodontology. Most understanding is based on theoretical principles and extrapolation from other medical fields.

Risk of thermal damage to root surface/bone

While LPMC aims to minimize damage, incorrect parameter selection or imprecise delivery could still lead to unintended thermal damage to the root surface (cementum) or alveolar bone, potentially compromising healing or leading to complications.[23,24]

Need for specific periodontal parameters

Optimal LPMC parameters (wavelength, pulse duration, spot size, spacing, and energy) for various periodontal applications need to be determined through rigorous research.[58,59] Parameters effective in ophthalmology or dermatology may not be suitable for the unique characteristics of periodontal tissues.[42,43]

Clinical efficacy of laser-assisted periodontal therapy: Evidence from recent literature

Recent randomized controlled trials have demonstrated significant benefits of adjunctive laser therapy in periodontal treatment. A landmark study by Manjunath et al. evaluating the diode laser as an adjunct to scaling and root planing in chronic periodontitis reported statistically significant improvements in clinical parameters. The study demonstrated that SRP combined with 980-nm diode laser achieved greater reductions in probing pocket depth (PPD), improved clinical attachment level (CAL) gains, and reduced bleeding on probing (BOP) compared to SRP alone at 3-month follow-up. Bacterial colony-forming unit (CFU) counts were also significantly reduced in the test group at 1 week post-treatment.[29]

Similarly, AlAhmari et al.[7] Conducted a randomized controlled trial assessing scaling and root planing with and without adjunct antimicrobial photodynamic therapy (aPDT) in chronic periodontitis patients among both smokers and never-smokers. While outcomes were compromised in cigarette-smokers, never-smokers demonstrated significant improvements in PI, BOP, PPD, and clinical AL with both treatment modalities. Qureshi et al.[8] Further substantiated these findings in a three-arm randomized controlled trial involving type-2 diabetic patients with moderate to severe periodontitis, showing that SRP with or without metronidazole adjunct significantly improved periodontal parameters and glycemic control compared to oral hygiene instructions alone.

Furthermore, a high-quality systematic review on adjunctive diode laser treatment in non-surgical periodontal therapy concluded that while efficacy remains debatable, evidence supports the clinical benefits of diode laser (808-980 nm) combined with SRP, particularly in terms of pocket depth reduction, CAL gain, and bacterial load reduction. These clinical outcomes align with the theoretical principles underlying LPMC technology and support the rationale for further investigation of patterned micro-coagulation in periodontal applications.[8,11]

Laser patterned microcoagulation for oral tissue applications

LPMC has demonstrated promising results when applied to oral mucosal tissues. Romanos et al.[11] conducted a seminal animal study examining oral mucosa response to laser-patterned microcoagulation treatment using a 980-nm diode laser. The histological analysis revealed complete epithelial regeneration within 7-12 days of LPM treatment, with pronounced fibroblast activity and new collagen formation observed within 1 day. By day 28, tissue structure was nearly completely restored with increased vascularity and no scarring evident. Complete healing occurred by day 90 with no keratinization changes or scar tissue formation. This study provides strong mechanistic evidence supporting LPMC's potential in periodontal regeneration.

More recently, a randomized controlled pilot clinical trial (LPM TRIAL) by Reddy et al.[36] investigated laser patterned microcoagulation in the management of desquamative gingivitis secondary to oral lichen planus. Using a 940-nm diode laser with specific pulsed parameters (250 ms pulses, 5 joules of energy at 4 kJ/cm2 fluence), LPM resulted in a significant reduction in lesion number and size in the test group. Pain reduction was significantly greater in the LPM-treated group (6.4 ± 0.51) compared to controls (4.07 ± 0.80, p = 0.000). Oral disease severity score for pain at three months was significantly lower in the test group (1.87 ± 0.64) versus the control (2.47 ± 0.64, p = 0.021). Thongprasom's score at six months showed superior outcomes in the LPM group (0.33 ± 0.49) compared to controls (1.33 ± 0.49, p = 0.000). Notably, LPM was well-tolerated with no significant adverse effects, providing direct clinical evidence of LPMC's effectiveness and safety as a novel therapeutic modality for oral mucosal lesions.

Gingival depigmentation: Comparative evidence with diode laser

Gingival hyperpigmentation represents a significant aesthetic concern in patients with high lip lines or gummy smiles. Suragimath et al.[20] conducted a split-mouth randomized clinical comparative study evaluating the efficacy of gingival depigmentation using the conventional scalpel technique versus the 980-nm diode laser. The study involved 12 subjects (aged 18-40 years) with melanin hyperpigmentation of the gingiva. Bleeding during surgery, pain scores, and procedure difficulty were statistically greater for the scalpel technique compared to the laser technique. Wound healing parameters showed no significant differences between techniques. However, laser-treated sites demonstrated reduced patient pain experience and better operator comfort. Although gingival depigmentation procedures with both scalpel and laser were effective in removing melanin, slight melanin repigmentation occurred in 3 of 12 subjects (25%) treated with scalpel depigmentation at one-year follow-up, compared to none in the laser-treated sites. These findings support the superior clinical outcomes and patient satisfaction associated with laser-assisted gingival depigmentation over conventional scalpel approaches, providing a strong clinical rationale for LPMC application in this indication.[15,38,39]

Future directions in periodontal LPMC research

The application of LPMC in periodontology is a promising but still largely unexplored area. Significant research is needed to translate the theoretical benefits into established clinical practice. Future directions should focus on:

Pre-clinical studies

In vitro and in vivo studies using animal models are essential to precisely characterize the interaction of LPMC with different periodontal tissues (gingiva, PDL, cementum, bone) at various parameters.[44] This includes evaluating thermal effects, cellular responses, and the impact on bacterial biofilms.[43,44]

Development of periodontology-specific LPMC systems

Engineering efforts are needed to develop LPMC delivery systems specifically designed for intraoral use, with features like flexible fiber optics, maneuverable handpieces, and integrated guidance systems suitable for accessing and treating periodontal pockets and complex tooth/implant surfaces.[45]

Optimization of treatment parameters

Rigorous research is required to determine the optimal LPMC parameters (wavelength, pulse duration, spot size, spacing, energy, pattern geometry) for specific periodontal applications (e.g., pocket debridement, gingival depigmentation, potential regeneration).[46] This will likely involve dose-response studies and evaluation of biological outcomes.

Clinical trials

Well-designed, randomized controlled clinical trials are crucial to evaluate the safety and efficacy of LPMC for various periodontal conditions. These trials should compare LPMC as a monotherapy or adjunct to conventional treatments (SRP).[29,36] and assess outcomes such as probing depth reduction, clinical attachment level gain, bleeding on probing, pain levels, recession, and radiographic bone changes.

Understanding biological mechanisms

Further research is needed to elucidate the precise cellular and molecular mechanisms by which LPMC influences healing and potentially regeneration in periodontal tissues.[47,48] This could involve studying the release of growth factors, cytokine profiles, and the behavior of periodontal cells in response to LPMC treatment.

Peri-implantitis research

Dedicated research is necessary to determine if LPMC can be safely and effectively used for the debridement and decontamination of peri-implant pockets and implant surfaces without causing damage to the implant or surrounding bone.[49,50] This would require careful material interaction studies and clinical evaluation.

Long-term outcomes

Longitudinal studies are needed to assess the long-term stability of outcomes following LPMC treatment in periodontology, including recurrence rates and the need for retreatment.[51-58]

Cost-effectiveness analysis

Evaluating the cost-effectiveness of LPMC compared to existing periodontal therapies is important for its potential adoption in clinical practice.

Addressing these research questions will be critical in determining the true potential and optimal role of LPMC within the field of periodontology.[59-62]

CONCLUSION

Laser-patterned micro coagulation represents a promising technological advancement with potential applications in periodontology. By enabling the precise delivery of laser energy in controlled patterns of microscopic thermal lesions, LPMC offers a tissue-sparing approach that could overcome some of the limitations of traditional mechanical and conventional laser therapies in managing periodontal diseases.

The theoretical advantages of LPMC in periodontology include enhanced bacterial reduction, targeted debridement of diseased tissue, minimized collateral damage to healthyperiodontium, reduced post-operative pain and discomfort, faster healing, and potentially less gingival recession. These benefits stem from the ability to confine thermal effects to microscopic volumes, leaving intervening healthy tissue intact to facilitate repair and regeneration. Potential applications range from adjunctive therapy for non-surgical periodontitis treatment and gingival depigmentation to the challenging management of periimplantitis and potentially stimulating periodontal regeneration.

Recent clinical evidence from well-designed randomized controlled trials supports the efficacy of adjunctive laser-assisted periodontal therapy, demonstrating significant improvements in clinical parameters, patient comfort, and healing outcomes compared to mechanical therapy alone. The successful application of LPMC in oral tissue regeneration and gingival depigmentation provides encouraging proof-of-concept for periodontal applications.

However, the application of LPMC in periodontology is still in its early stages. Significant research is required to develop periodontology-specific LPMC systems, determine optimal treatment parameters for various clinical indications, and generate robust clinical evidence through well-designed trials. Challenges related to the cost of equipment, the need for specialized training, and the technical complexities of intraoral delivery must also be addressed.

Despite these challenges, the fundamental principle of precise, patterned micro-coagulation aligns well with the goals of modern periodontal therapy: to effectively manage disease with minimal invasiveness and maximal preservation and regeneration of periodontal tissues. As research progresses and technology evolves, LPMC has the potential to become a valuable tool in the periodontist's armamentarium, contributing to improved treatment outcomes and enhanced patient care. The future of LPMC in periodontology holds exciting possibilities for more targeted, less traumatic, and potentially regenerative approaches to managing these prevalent and impactful diseases.

Ethical approval:

Institutional Review Board approval is not required.

Declaration of patient consent:

Patient's consent not required as there are no patients in this study.

Conflicts of interest:

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation:

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship: Nil

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