A study by Lopes, et al compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm2) with or without conventional scaling and root planing (SRP) versus SRP alone for the treatment of periodontal pockets. The split-mouth design study involved 19 patients with periodontal pockets ranging from 5 to 9 mm. Each site was assigned to a treatment group, as follows: Group 1: SRPL = SRP and laser; Group 2: L = laser; Group 3: SRP = SRP only; and Group 4: C = control, no treatment. The study evaluated clinical para meters of probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) at baseline and one, 3, 6, and 12 months post-treatment. Visible plaque index, gingival bleeding in dex (GI), bleeding on probing (BOP) and subgingival plaque samples were also measured 12 days postoperatively and at one, 3, 6, and 12 months post-treatment. Inter- and intragroup statistical analyses were performed (P < .05). The study found that GI decreased for SRPL and in creased for groups L, SRP, and C (P < .05) 12 days postoperatively, and decreased for SRPL and SRP (P < .05) 3, 6, and 12 months after baseline; BOP and PD decreased for all treated groups (P < .01) 3, 6, and 12 months post-treatment. CAL gain was significant for SRPL, L, and SRP (P < .05) 3, 6, and 12 months post-treatment. SRPL and L presented a significant reduction in the percentage of sites with bacteria, 6 and 12 months post-treatment (P < .05). The study concluded that nonsurgical periodontal therapy with Er:YAG laser may be an alternative treatment for reduction and control of the proliferation of microorganisms in persistent periodontitis.