Erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+ in periodontal diseases: Two case reports and review of the literature

Figure 1 Combined erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+ treatment for periodontitis. A: Female patient with severe pocket depth bone loss over 8 mm of teeth 31 and 41, and advanced periodontitis; B and C: Labial and lingual appearance of the periodontium; D: The infected lesion was treated with an erbium-doped yttrium aluminum garnet laser with water spray; E: Intrabony defects were filled with allograft bone mixed with advanced platelet-rich fibrin+.

Figure 2 Treatment of an alveolar bony defects with an erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+. A: Radiographic examination showed an apical lesion and bone loss (black arrow) of tooth 22; B: Infected lesions were treated with erbium-doped yttrium aluminum garnet laser with water spray; C and D: Intrabony defects were filled with allograft bone mixed with advanced platelet-rich fibrin+ (A-PRF+), and the periodontal wound was covered with double layers of A-PRF+ membranes, and then the wound was sutured.

Figure 3 Evaluation of erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+ treatment in periodontitis. A and B: The radiographic and clinical examinations were taken immediately after treatment; C and D: At 6 mo after combined treatment a reduction in probing depths, gained of clinical attachment level, and radiographic evidence of bone defect fill-in was observed; E and F: Periodontal regeneration was noted at 36 mo.

Figure 4 Evaluation of erbium-doped yttrium aluminum garnet laser and advanced platelet-rich fibrin+ treatment in alveolar bony defects. A: Periapical radiograph immediately after surgery; B: At 6 mo after surgery; C: At 36 mo after surgery. At 6 mo there was no evidence of recurrent infection of tooth 22. At 36 mo periodontal regeneration and defect bone fill-in were detected.