Discussion
infection, periodontitis, tooth
PROLIFERATION, INFECTION, PERIODONTITIS, APICAL PERIODONTITIS
Alveolar ridge preservation is a successful method to maintain the alveolar process after tooth extraction and is also recommended in extraction sites with infection [Most studies involving ARP in infected areas have been based on results at later time points after extraction [In recent years, the photobiomodulation of the Er:YAG laser has also gained attention; Lin T et al. have shown that Er:YAG laser irradiation promotes gingival soft tissue wound healing and periodontal stem cell proliferation [For the dimension changes, a statistically significant reduction in labial bone height resorption was observed when the Er:YAG laser was used. It was reported that the thickness of the bone plate plays an important role in bone dimensional changes. Buccal bones thinner than 1.5 mm lose more horizontally compared to thicker ones. In this study, the difference in buccal plate width was not statistically significant at baseline. The benefit of Er:YAG irradiation on buccal bone preservation might be partly attributed to less mechanical stimuli during degranulation with the Er:YAG laser [Although successful results were achieved by using an Er:YAG laser for alveolar preservation, the best parameters are controversial. There is no consensus in the literature on the optimal dose, frequency, and intensity parameters. The recommended power settings for the Er:YAG laser are 1–3 W for soft tissue and 1.5-3 W for bone [There are some limitations in this study. First, the bone graft was implanted into the socket. Therefore, the effect of the Er:YAG laser might be influenced by the immunoregulatory response induced by the graft materials. Second, the infected teeth involved in this study were not grouped by aetiology. There is a difference in infection modality between periodontitis and apical periodontitis. Third, the sample size was small. RCTs with larger sample sizes that consider the aetiology of infection and perform ARP without bone grafts are needed to further illustrate the effect of the Er:YAG laser on healing in extraction sockets with infection.