## 1 Introduction  
Periodontitis and peri-implantitis are pathological conditions resulting from the colonization of pathogenic bacteria within the periodontal pockets and peri-implant spaces [1]. These illnesses are characterized by the progressive degradation of the underlying bone structure, leading to the loss of support for either the natural tooth or the dental implant. The revised classification of periodontal diseases, resulting from the collaborative consensus conference held by the European Federation of Periodontology (EFP) and the American Academy of Periodontology (AAP) in 2017, emphasizes the significance of bacterial colonization in periodontal and peri-implant tissues, as well as the unique susceptibility of each patient to periodontitis [1]. Following the conventional nonsurgical and surgical treatments for periodontal and peri-implant conditions, there are documented instances of therapeutic failures in the existing literature [2; 3; 4]. The incomplete decontamination of the root or implant surface and adjacent soft tissues is responsible for their presence, which is attributed to the aggressive bacterial biofilm. These bacterial species, including _Porphyromonas gingivalis_, _Troponema denticola_, _Bacteroides forythus_, _Fusobacterium nucleatum_, and _Peptostreptococcus micros_, belong to [PERSON]'s red and orange complexes [5]. Multiple studies [6; 7; 8; 9; 10; 11; 12; 13; 14; 15; 16] have demonstrated that the persistence of these bacteria remains evident even after a year of treatment, regardless of whether the patient undergoes periodontal maintenance therapy every 4-6 months. This recolonization of the periodontal pockets is observed in both nonsurgical interventions and regenerative surgery [2; 3]. It can be inferred that the management of advanced periodontitis necessitates the utilization of antibiotic combinations, despite the World Health Organization's recommendations to reduce their usage to prevent the proliferation of antibiotic resistance. To mitigate these circumstances, numerous scholarly investigations have been suggested to implement laser-based protocols for the management of periodontitis, either independently or in conjunction with other substances. Various classifications of lasers exist. Penetrating lasers within the wavelength range of 600 nm to 1100 nm appear to be well-suited for use in periodonontology, provided that the necessary parameters are utilized. Numerous investigations have been conducted since the 1980s to examine the application of laser therapy in the field of periodonontology. The literature available during that time period indicated that laser radiation could potentially achieve decontamination of periodontal pockets [17; 18]. The Laser-Assisted New Attachment Procedure (LANAP) protocol was developed based on this idea, and numerous investigations in the academic literature have provided evidence of its efficacy [7; 8; 9; 10; 11]. The inclusion of a solid-crystal, digitally pulsed, yttrium aluminum garnet dental laser with neodymium doping (Nd:YAG) is an essential element of the LANAP(r) surgical technique [19]. The Nd:YAG laser can selectively vaporize granulation tissue by interacting with endogenous chromophores, namely melanin and hemoglobin. This process also leads to a reduction in bleeding, as the laser exhibits a hemostatic effect [7; 8]. During the initial phase of the therapy, the Nd:YAG laser is introduced into the periodontal pocket prior to employing alternative treatment modalities, utilizing a brief pulse duration and a substantial pulse width. The maximum pulse power setting is operationally defined as the peak level of light energy attained during a laser pulse [20]. The objective of utilizing the Nd: YAG laser in this particular stage is to selectively induce photodepolarization of the inflamed follicular epithelium, a process commonly referred to as \"de-epithelialization\" [21; 22]. This serves to initiate the formation of a surgical access flap in the gingiva, resembling the one generated in neoadjuvant ablative surgery [19].