AIM: The aim of the present study is to evaluate the clinical effect of laser assisted new attachment procedure versus excisional new attachment procedure in the treatment of moderate periodontal pockets.

METHOD:

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

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

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

Three sites with pocket depth of 5 mm or above will be selected for the study. The selected sites will be randomized  into three groups. (Group A, B & C). The randomization will be done using a computer generated random table

Group A (control site): SRP

Group B (test site): SRP with ENAP

Group C (test site): SRP with LANAP

TREATMENT PROCEDURE:

ENAP: After scaling and root planning, under adequate local anaesthesia pocket marking will be performed to delineate the depth of the incision. A scalloped, internally-bevelled, partial thick-ness incision will be made from crest of the free gingival margin to the base of pocket in the area being treated. The excised tissue and all of the granulomatous tissue within the area of the pocket will be removed with a curette. The root surfaces are then scaled and planed to a smooth, hard consistency to the base of incision. The gingival tissue is then repositioned against the tooth as closely as possible and if required the wound edges should be secured with sutures and periodontal dressing.

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