Downloaded from jada.ada.org on June 30, 2011 796 JADA 142(7) http://jada.ada.org July 2011
I appreciate the efforts of Dr. Mark Thomas and Dr. Kathy Shafer in their February JADA article, “Insufficient Evidence That Pulsed Nd:YAG Laser Treatment Is Superior to Conventional Nonsurgical Therapy in the Treatment of Periodontal Disease” (JADA 2011;142: 194-195). The manufacturer of a Nd:YAG pulsed laser used in a Food and Drug Administration–cleared protocol1 says that the laser assisted new attached procedure has more than 400 periodontist clients (R. Gregg, president and owner, Millennium Dental Technologies, written communication, April 1, 2011). I have been utilizing this protocol as a surgical modality in our full-time practice of periodontics for several years now, and lecture extensively on the clinical results we have been achieving by using scrupulous clinical, radiographic and digital photography. We are currently preparing for publication.
However, I think that the summary article has inaccurate and misleading conclusions. I am quite surprised that JADA even published a review article that the authors themselves labeled “evidence quality poor.” It is important to state that this review article is addressing the nonsurgical use of the Nd:YAG laser. The original systemic review on which this article is based appeared in Journal of Periodontology in July 2009.2 It is significant to reveal the following inconsistencies about this review article:
There is no question, even among those of us using the Nd:YAG laser in periodontal therapies, that more good quality research is needed. But using the existing research inappropriately in this manner clarifies nothing, but simply adds to the confusion.
It is significant to note that the authors did not discuss the standardized FDA-cleared protocol nor the landmark human histology study by Yukna and colleagues,5 which showed connective attachment in the absence of a long junctional epithelium in all specimens in the human study.
The article that Dr. Thomas and Dr. Shafer wrote really doesn’t have scientific validity for any conclusion other than a biased review of the articles the authors thought should be included.
The studies that were picked were not standardized, did not follow the FDA clearance and had very inconsistent variables from a statistical point of view.
In fact, multicenter studies are currently in progress to compare the different modalities of periodontal treatment to the Nd:YAG FDA-cleared laser protocol. Ironically, I am a graduate of the University of Kentucky, Division of Periodontics, where this review article originated and where I recently lectured at the School of Dentistry about the use and benefits of the Nd:YAG laser, showing numerous successful clinical cases using this laser as a surgical modality.
I hope that readers of JADA will understand and appreciate the benefits of laser periodontal therapy in the years ahead by evaluating sound clinical and research studies.
Eric Linden, DMD, MSD
Practice Specializing in Laser Periodontal Therapy, Periodontics, and Dental Implants
Offices in Manhattan & Woodcliff Lake, N.J.