## 1 Introduction
Additionally, the laser aids in creating a dry and blood-free operating field, minimizing the presence of calculus deposits on the root surface to facilitate extractions [23] and effectively eliminating bacteria within the submucosal biofilm [19]. In addition to the LANAP(r) surgical protocol, Nd:YAG was employed with prolonged pulse duration and reduced levels of maximum pulse power. This application occurred only after the completion of mechanical root cleaning and skeletal modification/detachment, serving to thermally induce (freeze) the fibrin clot at the interface between the tooth and dental flap. Furthermore, it was utilized to achieve hemostasis and stabilize the soft tissue after sutureless treatment [5; 11]. Furthermore, following the conclusion of Nd:YAG treatment, occlusion correction is carried out utilizing the LANAP(r) surgical protocol to eliminate dense, unattached, and concealed teeth, sustain wound stability post-treatment, and facilitate passive tooth eruption [7]. It is important to acknowledge that an elevation in temperature within the periodontal pockets, although limited to a specific area, carries the potential risk of modifying the patient's periodontal tissues. This can result in temporary consequences, such as the occurrence of postoperative pain and swelling, or permanent consequences, such as the loss of periodontal tissue due to thermal damage. To mitigate the occurrence of post-treatment sequelae and minimize complications associated with the implementation of the LANAP technique, which is heavily reliant on the operator's proficiency and susceptible to the dentist's experience, there has been a suggestion to employ clinical protocols of photodynamic therapy. This is primarily aimed at reducing the risk of overheating the periodontal tissues. These processes involve the eradication of germs and microbes using light rather than heat. To effectively combat bacterial infections in the periodontal pocket, it is necessary to employ a photosensizer or chromophore that possesses the ability to bind to the bacterial membrane. This binding interaction enables the subsequent release of singlet oxygen, which is facilitated by the application of energy [12; 13; 14; 15; 24; 25]. Singlet oxygen is an inherently unstable molecular species that can be found in several natural occurrences, including but not limited to the aurora borealis. The half-life of this entity is extremely brief, measuring less than one microsecond. The utilization of a high-power laser with a frequency above 6000 Hz enables its emission within the periodontal pockets. Scientific literature has provided evidence that photodynamic therapy techniques utilizing low-power penetrating lasers, typically emitting continuously without power peaks exceeding 2 W, in conjunction with dyes like toluidine blue, phenothiazazine chloride, or indochina, are ineffective in eliminating the bacteria accountable for periodontal disease [17]. Furthermore, these techniques do not yield superior long-term outcomes compared to conventional nonsurgical periodontal therapy [17]. Despite the administration of these tests, the outcomes failed to meet the anticipated standards [26]. Several studies have been conducted to examine the efficacy of procedures utilizing diode lasers characterized by high peak power and low average powers not exceeding 0.8 W [27]. The objective was to prevent the tissues from experiencing a thermal elevation above 42 degrees Celsius within the range of 27 to 34 degrees. These techniques allow for the introduction of the laser into the periodontal pockets while minimizing any substantial increase in temperature. In contrast, a state of mild vasodilation will be attained, leading to a subsequent occurrence of light bleeding after the therapy. Multiple studies have demonstrated the effectiveness of dye-free photodynamic therapy in managing chronic periodontitis through the implementation of a clinical and microbiological assessment utilizing PCR Real-Time Tests [27; 28].