Effects of CO₂ laser treatment on fibroblast attachment to root surfaces: A scanning electron microscopy analysis

Background: The aim of this study was to analyze the CO₂ laser effects on root surfaces affected by periodontal disease in comparison to scaling and root planing for fibroblast attachment. Methods: Thirty single-rooted human teeth extracted because of advanced periodontal disease were included in this study. A total of 60 specimens, obtained from all selected teeth, were randomly assigned to 3 groups: 1) control (untreated); 2) hand scaling and root planing (SRP); or 3) laser (CO₂ defocused pulsed) and ultrasonic scaling. All the specimens were incubated in Petri dishes with fibroblast suspension, and then observed by scanning electron microscopy (SEM). Results: The control group showed the lowest number of attached cells, with no tightly attached fibroblasts. The laser plus scaling group showed the highest number of attached fibroblasts, with the tightly attached fibroblast prevailing. The laser-treated and scaled root specimens did not show any damage or morphologic alteration of the root surfaces. Conclusion: CO₂ laser treatment in defocused, pulsed mode with a low power of 2W combined with mechanical instrumentation constitutes a useful tool to condition the root surface and increase fibroblast attachment to root surfaces.