World Clinical Laser Institute


After practicing conventional periodontics for 20 years, I had made assessments on a daily basis of the core values necessary to achieve periodontal health with the possibility of a minimally invasive approach. As dental laser technology continued to improve, my investigation into this modality heightened. A decade ago, I immersed myself into lasers for periodontal management from periodontitis to enhancing the restorative product by manipulating tissue.

That fascination and immersion in lasers led me to become involved with a WCLI clinical team that developed and standardized the first-ever Er,Cr:YSGG laser-assisted periodontal protocol. The process to determine and validate laser settings, techniques and rationalize it against clinical evidence and results was a daunting task – but one I believe was met with vigor and care by all members of the WCLI research team.

Based on a series of basic steps that leverage the benefits and absorption characteristics of the Er,Cr:YSGG laser wavelength, this new periodontal protocol is straightforward, practical – and the results speak for themselves.

During this process, the team set out to determine the best settings, techniques, accessories to use, and other important criteria for use with the popular Er,Cr:YSGG laser. I am convinced the collective research efforts of the perio protocol team have resulted in a new laser perio protocol that will dramatically advance the use of Er,Cr:YSGG lasers in periodontal therapy.

Dr. Sam Low

Dr. Samuel B. Low, is Professor Emeritus of Periodontology at the University of Florida. He is a past president of the American Academy of Periodontology and the Florida Dental Association. He was most recently appointed as an inaugural member of the Dental Professional Advisory Board at BIOLASE.

Perio Diseases

After years of clinical research in the lab and in the field, a new protocol for treating periodontal disease has emerged for Er,Cr:YSGG laser dentists and periodontists.

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Download your copy of the WaterLase iPlus Perio Protocol in PDF format (500KB)

After years of clinical research in the lab and in the field, a new protocol for treating periodontal disease has emerged for Er,Cr:YSGG laser dentists and periodontists.

Periodontal disease remains one of the most prevalent oral health issues in the world today. According to the American Academy of Periodontology, nearly half of the U.S. population age 30 and older suffers from mild to severe periodontitis.

Research has shown that periodontal disease may be associated with other chronic inflammatory conditions, such as diabetes and cardiovascular disease.

Additional reports link periodontitis to chronic illnesses, such as rheumatoid arthritis, Alzheimer’s disease and even cancer.

Even with the link to various medical conditions, the number of patients affected with mild to severe periodontitis is growing. As a result, it is incumbent on all dental professionals to take a more active role in the treatment and prevention of the disease.

Dentists and researchers affiliated with the WCLI and other professional dental associations have conducted research on various laser wavelengths used in dentistry, including their efficacy in treating periodontitis. In recent years, a proliferation of published research and studies show that the Er,Cr:YSGG laser wavelength is an effective tool for treating periodontitis.

Using specially designed radial firing laser tips that create a corona of laser energy in the periodontal pocket, the Er,Cr:YSGG laser has been shown to be an especially effective instrument for the minimally invasive removal of both subgingival inflamed tissue and calculus deposits. This unique combination, as discussed in the literature, sets the Er,Cr:YSGG laser apart for treating periodontitis with a laser-based approach.

In 2009, the Er,Cr:YSGG laser was cleared by the U.S. Food and Drug Administration (FDA) for promoting “cementum-mediated periodontal ligament new-attachment to the root surface in the absence of long-junctional epithelium.” Later that same year, the U.S. FDA cleared the Er,Cr:YSGG laser for “the removal of subgingival calculus in periodontal pockets with periodontitis by closed or open curettage.”

Throughout the WCLI’s history, the topic of treating periodontal disease using an Er,Cr:YSGG laser has been the focus of hundreds of clinical presentations and research papers presented to WCLI members. The development of a standard protocol for treating periodontal disease using an Er,Cr:YSGG laser has been a painstaking, detailed process led by prominent periodontists, general dentists and laser researchers. After years of lab tests, in vivo and in vitro examinations and field use by protocol developers, a standard Er,Cr:YSGG-based protocol is in place.

The WaterLase® Er,Cr:YSGG protocol for treating periodontitis combines a pre-surgical and surgical phase using an Er,Cr:YSGG laser with several key differences in comparative protocols associated with more limited laser wavelengths such as Nd:YAG, diode or CO2 lasers. The availability of this protocol ensures even greater clinical utility for Er,Cr:YSGG laser owners and provides opportunities for general dentists to reliably treat mild to severe periodontitis with a minimally invasive technique.

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