Comparative evaluation of Laser-Assisted New Attachment procedure and Excisional New Attachment procedure for the treatment of Periodontal Pockets. A Randomised Split Mouth Clinical Trial

**AIM:**The aim of the present study is toevaluate the clinical effect of laser assisted new attachment procedure versus excisionalnew attachment procedure in the treatment of moderate periodontal pockets.

METHOD:

All the patients will be explained aboutthe aim, nature, and design of the study along with a written informed consentfor their participation before the commencement of the study.

Thestudy is planned as a single centre, longitudinal, triple masked (investigators,subjects and statistician), randomized parallel arm design. The study durationis 6 months in which the clinical parameters will be recorded at baseline, 1month, 3 months, 6 months

The clinical parameters for considerationincludes plaque index (Silness and Loe 1964), gingival bleeding index (Muehlemannand Son 1971), pocket depth and clinical attachment level,  and healing index(landry,Turnbull and Howley),VAS

Threesites with pocket depth of 5 mm or above will be selected for the study. Theselected sites will be randomized  intothree groups. (Group A, B & C). The randomization will be done using acomputer generated random table

Group A (control site): SRP

Group B (test site): SRP with ENAP

Group C (test site): SRP with LANAP

TREATMENTPROCEDURE:

ENAP: After scaling and root planning, underadequate local anaesthesia pocket marking will be performed to delineate thedepth of the incision. A scalloped, internally-bevelled, partial thick-nessincision will be made from crest of the free gingival margin to the base ofpocket in the area being treated. The excised tissue and all of thegranulomatous tissue within the area of the pocket will be removed with acurette. The root surfaces are then scaled and planed to a smooth, hardconsistency to the base of incision. The gingival tissue is then repositionedagainst the tooth as closely as possible and if required the wound edges shouldbe secured with sutures and periodontal dressing.

LANAP:After scaling and root planning, diode laser will be first used on a setting of4.0 W, 100-microseconds pulse duration, and 20 Hz. It is passed from gingivalmargin to the base of the pocket parallel to the root surface and movedlaterally and apically to remove the diseased pocket epithelium anddecontaminate the pocket. A second pass with the laser on to the setting of 4.0W, 650-microseconds pulse duration, and 20 Hz was performed to form a fibrinclot and then the tissue will be compressed against the tooth for closer approximation.