Assessment of healing following low-level laser irradiation after gingivectomy operations using a novel soft tissue healing index: A randomized, double-blind, split-mouth clinical pilot study.

BACKGROUND: Lasers have become a part of modern dentistry since the past three decades. A wide-ranging assortment of lasers is being used in periodontology for both soft and hard tissue surgical procedures. Regardless of the frequent practice of using these well-known surgical lasers, there is another lesser familiar class of lasers called the low-level lasers. The main doctrine behind using low-level laser therapy (LLLT) is centered on the biostimulation, or the biomodulation effect, which relies on the dexterity of low-intensity laser energy when irradiated at a specific wavelength, is able to modify cellular activities (increase in cell metabolism and fibroblast and keratinocyte proliferation). AIM: The aim of the present study was to investigate the adjunctive use of LLLT on gingival healing after gingivectomy procedures. MATERIALS AND METHODS: Ten systemically healthy patients requiring gingivectomy or gingivoplasty procedures bilaterally in either the maxillary or mandibular teeth were included in the study. After surgical intervention, a diode laser (810 nm) was randomly activated to one side of the operated area while other side did not receive any treatment and served as the control. The healing index given by Landry et al. was used to evaluate the soft tissue healing immediately postsurgery and at the 3rd day, 1 week, and 2 weeks postoperatively. After the follow-up period, results were analyzed using appropriate statistical tests. RESULTS: There was no statistically significant difference observed in the surface epithelialization between both groups on the 3rd and 7th-postoperative days, but highly significant differences were observed on the 14th day. CONCLUSION: Within the confines of this pilot study, the outcomes have indicated that gingival wound healing may be improved using LLLT after gingivectomy and gingivoplasty operations.

Histological Gingival Assessment after Conventional and Laser Gingivectomy.

BACKGROUND: Gingivectomy is a procedure often performed in everyday clinical practice using numerous instruments. AIM: To evaluate and compare the gingival cut surface after gingivectomy with 6 different surgical instruments - a surgical scalpel, an Er:YAG laser, a CO2 laser, a ceramic bur, an electrocautery device, and a diode laser. MATERIALS AND METHODS: Gingivectomy using the above listed instruments was performed in 18 patients. The histological samples excised with a surgical scalpel were assigned as a control group and the other five types - as test groups. The following histological parameters were measured: coagulation layer thickness (in µm); presence or absence of a microscopic rupture and presence or absence of hemostasis in-depth. RESULTS: The best instrument of the above listed ones which demonstrated excellent results is the CO2 laser. The Er:YAG laser has a thin coagulation layer and lack of hemostasis in-depth. The diode laser has the widest coagulation layer which is an advantage from a clinical point of view. Electrocautery proved to be as effective as the diode laser, but it should not be used around metal restorations. The ceramic bur has less pronounced hemostasis in-depth. CONCLUSIONS: Modern dentistry uses a wide variety of methods that are designed to be applied in everyday practice. Good knowledge of the ways to use them, their advantages and disadvantages is essential to obtaining the optimal result depending on the clinical case.