Therapeutic effect of laser on pediatric oral soft tissue problems: a systematic literature review

The Effectiveness of Lasers in Treatment of Oral Mucocele in Pediatric Patients: A Systematic Review

The mucocele is the most common minor salivary gland associated disease of the oral cavity. It is also considered one of the most common biopsied oral lesions in pediatric patients. In recent years, extensive evidence has been published about the usage of lasers in treating mucoceles in pediatric patients. The aim of the present study was to assess the effectiveness of laser irradiation in the treatment of pediatric mucocele. An electronic search of databases (PubMed, Scopus, Web of Science and Google Scholar) was carried out in order to identify all relevant articles using a combination of the following keywords: "Pediatric", "Oral", "Mucocele", "Dental", "Oral Medicine", "Soft Dental Lasers", "Hard Dental Lasers", and "Lasers," for all case reports, case series, case-control and cohort studies published from 2007 to 2021. After limiting the search results, removing duplicate titles, and eligibility evaluation, 17 papers were enrolled in the study. Out of the total studies included, 10 articles were related to the diode (635 nm, 808 nm, 810 nm, and 980 nm), 5 to CO₂ (10,600 nm), 3 to Er, Cr: YSGG (2780 nm), and 1 involving KTP lasers (532 nm). All studies indicated successful clinical results on mucocele excision with better intra- and post-operative indicators. The general characteristics and outcomes were summarized, and the quality of the studies was assessed using CARE guidelines in this systematic review. The reduction or absence of pain and bleeding, hemostasis, reduced operating time, minimal analgesic consumption, and an antibacterial effect were among the advantages of laser irradiation in the included studies. The laser has proven itself to play an effective role in the treatment of oral mucocele in paediatric patients.

Clinical Comparison of Diode Laser Assisted “v-Shape Frenectomy” and Conventional Surgical Method as Treatment of Ankyloglossia

(1) Background: Ankyloglossia, or tongue-tie is a condition, in which the tip of tongue cannot protrude beyond the lower incisor teeth because of short frenulum linguae, often containing scar tissue. Limitations of movement are the most important clinical symptoms of this condition, together with feeding, speech, and mechanical problems. (2) Methods: the present study included two groups of patients (group A and group B) including, respectively, 29 and 32 patients (61 patients total), aged from 8 to 12 and presenting ankyloglossia classified according to the Kotlow’s classification. The patients in group A underwent a common surgical procedure. For the patients of group B, a diode laser device (K2 mobile laser, Dentium, Korea) with a micro-pulsed wavelength of 980 ± 10 nm and power of 1.2 watts was used. The post-surgical discomfort of the patients (recording the pain perceived immediately after the end of the anesthesia and during the following week, using the Numeric Rating Scale (NRS) system) and healing characteristics (recorded using the Early Wound Healing Score or EHS) were evaluated. (3) Results: The results shows that the pain in the patients who underwent laser-assisted frenectomy is significantly reduced (p < 0.001) when compared to those who underwent conventional surgical frenectomy, both immediately after surgery (with a reduction in the average NRS of 80.6%) and after the first week (with a reduction in the average NRS of 86.58%). Additionally, in the same patients, an augmentation in the average value of the EHS of 45% was recorded, highlighting significantly (p < 0.001) better quality in the healing of the wound within the 24 h after surgery. Moreover, other advantages observed in the use of laser assisted-frenectomy are the absence of bleeding and, consequently, a clear operative field; no need to use sutures; no need to take painkillers or antibiotics after surgery; and having a faster recovery and less time needed to perform the operation. (4) Conclusions: within the limits of the present study, it seems possible to assert that the laser frenectomy performed using the v-shape technique presents a series of advantages if compared to the conventional surgical method.

Perioperative outcomes of frenectomy using laser versus conventional surgery: a systematic review

Introduction: Frenectomy is an oral surgical procedure usually performed with a scalpel. Several authors recently reported the interest of laser, as a minimally invasive and efficient alternative tool to perform frenectomy. This study aimed to compare the perioperative management of patients requiring a frenectomy using scalpel versus laser. Materials and methods: A systematic review of the literature has been carried out from Pubmed and Scopus databases following PRISMA guidelines. PICO method was used to select the relevant articles. Clinical studies comparing the perioperative outcomes of patients requiring frenectomies using scalpel versus laser were included. Results: Ten articles involving 375 patients were included. Pre-operative parameter (anxiety before surgery) and per-operative data such as anesthesia, surgery duration, bleeding, suture and difficulty were assessed. The post-operative outcomes investigated were pain, analgesics use, functional discomfort, edema, healing and satisfaction of patients. Laser achieved satisfactory peri-operative outcomes such as shorter operative time, without suturing requirement, as well as less post-operative pain and functional discomfort. Discussion: The low number of eligible studies, the different type of lasers used and heterogeneity across the methodology of the selected studies were the limits of the study. Conclusion: Laser-assisted surgery became an attractive tool to perform oral soft tissue surgery.