Evaluation of the efficacy of Er,Cr: YSGG laser in the treatment of alveolar osteitis

Objective: This study aimed to compare the effects of the Photon Induced Photoacoustic Streaming (PIPS) technique, applied with an Er,Cr:YSGG laser, on pain control and soft tissue healing in the management of alveolar osteitis (AO) with those of conventional saline irrigation. Method: A total of 78 systemically healthy patients (ASA I–II, aged 18–65 years) who presented to the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, with a diagnosis of AO were included. Participants were randomly assigned to two groups: Laser Group (n = 39) and Control Group (n = 39). In the Laser Group, extraction sockets were irrigated with 10 mL saline and subjected to 30 seconds of contact-free PIPS activation (Er,Cr:YSGG, 2780 nm, 1.0 W, soft tissue mode), followed by 30 seconds of saline irrigation and another 30 seconds of activation. The Control Group received standard irrigation with 20 mL saline on the same days. The protocols were repeated on postoperative days 1 and 3. Pain was assessed using the Visual Analogue Scale (VAS), while healing was evaluated using the Soft Tissue Healing Index (Landry, Turnbull and Howley Index) and Granulation Tissue Formation (GTF) scores on days 1, 3, 7, and 14. Results: VAS scores were significantly lower in the Laser Group on days 3, 7, and 14 compared with the Control Group (all p < 0.001), and the group × time interaction for healing indices favored the laser (p < 0.001). GTF was higher in the Control Group on day 1 but significantly greater in the Laser Group by day 7 (p = 0.024). Conclusion: The PIPS technique with Er,Cr:YSGG laser provides faster and more pronounced pain reduction and promotes earlier and more consistent soft tissue healing compared with conventional irrigation in AO management. Keywords: Alveolar osteitis, Er,Cr:YSGG, Pain, PIPS.