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Sobouti F, Moallem Savasari A, Aryana M, Hakimiha N, Dadgar S. Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel. BMC Oral Health 2024; 24:843. [PMID: 39054510 PMCID: PMC11271033 DOI: 10.1186/s12903-024-04364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/10/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND This study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers. METHODS This randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests. RESULTS Pain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all). CONCLUSIONS In conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser. TRIAL REGISTRATION The study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials ( www.irct.ir ) (registration number: IRCT20220630055326N1).
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Affiliation(s)
- Farhad Sobouti
- Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Orthodontic Department, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mehdi Aryana
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Neda Hakimiha
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Dadgar
- Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
- Orthodontic Department, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
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Heimlich FV, de Arruda JAA, Kato CDNADO, Silva LVDO, Souza LN, Ferreira MVL, Pinheiro JDJV, Silva TA, Abreu LG, Mesquita RA. Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies. Braz Oral Res 2024; 38:e025. [PMID: 38597545 DOI: 10.1590/1807-3107bor-2024.vol38.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/20/2023] [Indexed: 04/11/2024] Open
Abstract
Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.
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Affiliation(s)
- Fernanda Vieira Heimlich
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila de Nazaré Alves de Oliveira Kato
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leni Verônica de Oliveira Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leandro Napier Souza
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcus Vinicius Lucas Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Samir ER, Hasnae R, Oumkeltoum E. Diode laser surgery for the treatment of denture-induced fibrous hyperplasia: a case report. Pan Afr Med J 2024; 47:105. [PMID: 38766568 PMCID: PMC11101355 DOI: 10.11604/pamj.2024.47.105.26619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/02/2021] [Indexed: 05/22/2024] Open
Abstract
Denture-induced fibrous hyperplasia (DIFH) is a persistent lesion caused by low-intensity chronic injury of the tissue in contact with an ill-fitting, over-extended denture. This fibrous connective tissue lesion commonly occurs in oral mucosa in patients showing important alveolar ridge atrophy. Surgical excision is the treatment of choice for DIFH. This article describes a successful laser surgery to remove a DIFH on a lower alveolar ridge of a patient wearing an ill-fitting completely removable denture. The use of a diode laser may result in less surgical time, less bleeding during surgery, more vestibular depth, better re-epithelialization of the wound, and no need for suturing.
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Affiliation(s)
- Er-Raji Samir
- Department of Periodontology, Faculty of Dentistry of Rabat, University Mohamed V, Rabat, Morocco
| | - Rokhssi Hasnae
- Department of Periodontology, Faculty of Dentistry of Rabat, University Mohamed V, Rabat, Morocco
| | - Ennibi Oumkeltoum
- Department of Periodontology, Faculty of Dentistry of Rabat, University Mohamed V, Rabat, Morocco
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4
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Mihai LL, Parlatescu I, Calin A, Burcea A. Gingival overgrowth approached using recent mechanical and laser technologies: A case report. Exp Ther Med 2024; 27:84. [PMID: 38274335 PMCID: PMC10809356 DOI: 10.3892/etm.2024.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
Gingival enlargement is a side effect of different drug classes, with calcium channel blockers being among the most often cited examples. Most often accompanied by a disruption in the oral biofilm, this form of gingival overgrowth, with histological signs of hyperplasia and hypertrophy, becomes a chronic inflammatory condition with the oral biofilm a primary cause. This periodontal disease is now classified as 'dental biofilm-induced gingivitis', and its preferred name is drug-influenced gingival expansion. The present study presented the case of a patient with gingival enlargement while being treated with nifedipine for cardiac disease. This patient had factors that contributed to the retention of bacteria, ranging from poor oral hygiene practices to poorly adapted prosthodontics. After reducing these factors, a multimodal treatment was conducted, including bacterial mechanical decontamination through guided biofilm therapy protocol, laser bacterial decontamination, and surgical laser gingivectomy. The patient was referred to their cardiologist for substituting the calcium channel blocker medication. Clinical evaluations followed each treatment step. At 12 months, the patient presented positive, stable results, with an improvement in gingival status (no gingival overgrowth in the area where all risk factors were eliminated and minimal overgrowth in the area where old poorly marginally adapted prosthodontics were kept in place and no/minimal signs of gingival inflammation).
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Affiliation(s)
- Laurenta Lelia Mihai
- Department of Oral Pathology, Faculty of Dental Medicine, Titu Maiorescu University of Bucharest, Bucharest 031593, Romania
| | - Ioanina Parlatescu
- Department of Oral Pathology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest 050037, Romania
| | - Anca Calin
- Department of Materials Science and Engineering, Polytechnic University of Bucharest, Bucharest 060042, Romania
| | - Alexandru Burcea
- Department of Medical and Surgical Emergencies in Dental Medicine, Anesthesia and Sedation, Faculty of Dental Medicine, Titu Maiorescu University of Bucharest, Bucharest 031593, Romania
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Rattan R, Mezghani N, Kaleem A, Melville JC. Lasers and Nonsurgical Modalities. Oral Maxillofac Surg Clin North Am 2024; 36:19-28. [PMID: 37813707 DOI: 10.1016/j.coms.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Head and neck vascular pathology is routinely encountered by the maxillofacial surgeon. Although these anomalies have been traditionally managed by surgical means, adjunctive therapies have been popularized in recent years. The use of laser therapy has gained attention for its ability to better access and to provide more predictable outcomes in the highly intricate and vascular areas of the head and neck. Laser therapy allows for the selective targeting of diseased tissue while maintaining the integrity of surrounding healthy tissue.
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Affiliation(s)
- Rishabh Rattan
- Bernard & Gloria Pepper Katz Department of Oral & Maxillofacial Surgery, University of Texas Health Science Center at Houston
| | - Nadia Mezghani
- Oral and Maxillofacial Surgery, Mount Sinai Health System and Jacobi Medical Center
| | - Arshad Kaleem
- El Paso Head & Neck and Microvascular Surgery, El Paso, TX, USA
| | - James C Melville
- Bernard & Gloria Pepper Katz Department of Oral & Maxillofacial Surgery, Oral, Head & Neck Oncology and Microvascular Reconstructive Surgery, University of Texas Health Science Center at Houston, 7500 Cambridge Street Suite 6510, Houston, TX 77054, USA.
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Shakhova M, Elagin V, Plekhanov A, Khilov A, Kurakina D, Kamensky V, Kirillin M. Post-Operational Photodynamic Therapy of the Tumor Bed: Comparative Analysis for Cold Knife and Laser Scalpel Resection. Biomedicines 2024; 12:291. [PMID: 38397893 PMCID: PMC11154242 DOI: 10.3390/biomedicines12020291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
In this paper, we report on a study regarding the efficiency of the post-operational phototherapy of the tumor bed after resection with both a cold knife and a laser scalpel in laboratory mice with CT-26 tumors. Post-operational processing included photodynamic therapy (PDT) with a topically applied chlorin-based photosensitizer (PS), performed at wavelengths of 405 or 660 nm, with a total dose of 150 J/cm2. The selected design of the tumor model yielded zero recurrence in the laser scalpel group and 92% recurrence in the cold knife group without post-processing, confirming the efficiency of the laser scalpel in oncology against the cold knife. The application of PDT after the cold knife resection decreased the recurrence rate to 70% and 42% for the 405 nm and 660 nm procedures, respectively. On the other hand, the application of PDT after the laser scalpel resection induced recurrence rates of 18% and 30%, respectively, for the considered PDT performance wavelengths. The control of the penetration of PS into the tumor bed by fluorescence confocal microscopy indicated the deeper penetration of PS in the case of the cold knife, which presumably provided deeper PDT action, while the low-dose light exposure of deeper tissues without PS, presumably, stimulated tumor recurrence, which was also confirmed by the differences in the recurrence rate in the 405 and 660 nm groups. Irradiation-only light exposures, in all cases, demonstrated higher recurrence rates compared to the corresponding PDT cases. Thus, the PDT processing of the tumor bed after resection could only be recommended for the cold knife treatment and not for the laser scalpel resection, where it could induce tumor recurrence.
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Affiliation(s)
- Maria Shakhova
- Department of Ear, Nose and Throat Diseases, FSBEI HE «Privolzhsky Research Medical University» MOH Russia, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia;
| | - Vadim Elagin
- Institute of Experimental Oncology and Biomedical Technologies, FSBEI HE «Privolzhsky Research Medical University» MOH Russia, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia; (A.P.); (V.K.)
| | - Anton Plekhanov
- Institute of Experimental Oncology and Biomedical Technologies, FSBEI HE «Privolzhsky Research Medical University» MOH Russia, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia; (A.P.); (V.K.)
| | - Aleksandr Khilov
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov St., Nizhny Novgorod 603155, Russia; (A.K.); (D.K.); (M.K.)
| | - Daria Kurakina
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov St., Nizhny Novgorod 603155, Russia; (A.K.); (D.K.); (M.K.)
| | - Vladislav Kamensky
- Institute of Experimental Oncology and Biomedical Technologies, FSBEI HE «Privolzhsky Research Medical University» MOH Russia, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia; (A.P.); (V.K.)
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov St., Nizhny Novgorod 603155, Russia; (A.K.); (D.K.); (M.K.)
| | - Mikhail Kirillin
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov St., Nizhny Novgorod 603155, Russia; (A.K.); (D.K.); (M.K.)
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Hanna R, Benedicenti S. 10,600 nm High Level-Laser Therapy Dosimetry in Management of Unresponsive Persistent Peripheral Giant Cell Granuloma to Standard Surgical Approach: A Case Report with 6-Month Follow-Up. J Pers Med 2023; 14:26. [PMID: 38248727 PMCID: PMC10819981 DOI: 10.3390/jpm14010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Peripheral giant cell granuloma (PGCG) is a non-neoplastic, tumour-like reactive lesion that exclusively involves the gingiva and/or the alveolar crest. The surgical approach with a scalpel has been the golden standard of treatment for PGCG, but the scientific literature reports a high rate of lesion recurrence. Hence, this unique case report aimed to evaluate the efficacy of λ 10,600 nm high-level laser therapy (HLLT) in eradicating persistent, aggressive, and recurrent PGCG that failed to respond to standard surgical treatment. A fit and healthy thirty-four-year-old Caucasian male presented with a two-month history of recurrent episodes of an oral mucosal lesion involving the buccal and lingual interdental papillae between the lower right second premolar (LR5) and lower right first molar (LR6), which was surgically excised with a scalpel three times previously. A λ 10,600 nm-induced HLLT was chosen as a treatment modality at a lower peak power of 1.62 W, measured with a power metre, emitted in gated emission mode (50% duty cycle), whereby the average output power reaching the target tissue was 0.81 W. The spot size was 0.8 mm. Ninety seconds was the total treatment duration, and the total energy density was 7934.78 J/cm2. Patient self-reporting outcomes revealed minimal to no post-operative complications. Initial healing was observed on the 4th day of the post-laser treatment, and a complete healing occurred at two-weeks post-operatively. The histological analysis revealed PGCG. This unique case report study demonstrated the efficacy of λ 10,600 nm-induced HLLT and its superiority to eradicate persistent aggressive PGCG over the standard surgical approach with minimal to no post-operative complications, accelerating wound healing beyond the physiological healing time associated with no evidence of PGCG recurrence at the six-month follow-up timepoint. Based on the significant findings of this unique study and the results of our previous clinical studies, we can confirm the validity and effectiveness of our standardised λ 10,600 nm laser dosimetry-induced HLLT and treatment protocol in achieving optimal outcomes. Randomised controlled clinical trials with large data comparing λ 10,600 nm with our dosimetry protocol to the standard surgical treatment modality at long follow-up timepoints are warranted.
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Affiliation(s)
- Reem Hanna
- Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Medical College, University College London, London WC1E 6DE, UK
- Department of Surgical Sciences and Integrated Diagnostic, University of Genoa, 16132 Genoa, Italy;
- Department of Oral Surgery, King’s College Hospital, London SE5 9RS, UK
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostic, University of Genoa, 16132 Genoa, Italy;
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Lopes-Santos G, Peralta-Mamani M, Oliveira DT. Histological implications of high-power laser use in the oral soft tissue lesions: a systematic review. Lasers Med Sci 2023; 38:263. [PMID: 37952038 DOI: 10.1007/s10103-023-03923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
The objective of this study was to describe the histological artifacts caused by high-power laser use compared to cold scalpel surgery in oral soft tissue lesions. Clinical studies that evaluated and compared histological artifacts resulting from the use of high-power lasers and cold scalpels in oral soft tissue lesions biopsies were retrieved from seven databases and four grey literatures, up to July 2022. The risk of bias was investigated using the ROBINS-I tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Seven studies were eligible for qualitative analysis. Based on the results obtained, those four studies had a low risk of bias, and three studies had an unclear risk of bias. The certainty of the evidence was classified as low. Limited evidence showed that epithelial artifacts such as loss of intraepithelial and subepithelial adhesions, accompanied by pyknotic, fusiform, and/or hyperchromic nuclei, were more common when a high-power laser device was used. Four articles reported that the use of high-power lasers did not interfere with the histopathological diagnosis of oral soft tissue lesions. Due to the heterogeneity of the data, a meta-analysis was not performed. Compared to the use of cold scalpels, histological artifacts, particularly those observed in epithelial tissue, are more common when high-powered lasers are used in oral lesions biopsies. The eligibility criteria and adequate indications of high-power lasers in different oral soft tissue lesion treatments must be respected to avoid tissue artifacts that impair precise histopathological diagnosis.
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Affiliation(s)
- Gabriela Lopes-Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Faculdade do Centro Oeste Paulista - FACOP, Piratininga, São Paulo, Brazil
| | - Denise Tostes Oliveira
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
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Mikhail FF, El Menoufy H, El Kilani NS. Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm. Clin Oral Investig 2023; 27:6939-6950. [PMID: 37878070 PMCID: PMC10630251 DOI: 10.1007/s00784-023-05310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques. MATERIALS AND METHODS Twenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points. RESULTS At 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups. CONCLUSION While diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures. CLINICAL RELEVANCE Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.
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Affiliation(s)
- Faten Fawzy Mikhail
- Surgery & Oral Medicine Department, Oral & Dental Research Institute, National Research Centre, 33 El Buhouth St., Ad Doqi, Dokki, Giza, 12622, Egypt.
| | - Hala El Menoufy
- Laser Research Centre, Faculty of Dentistry, Misr University for Science and Technology (MUST), 6Th of October City, Giza, Egypt
| | - Naglaa Shawki El Kilani
- Laser Research Centre, Faculty of Dentistry, Misr University for Science and Technology (MUST), 6Th of October City, Giza, Egypt
- Oral Medicine, Periodontology, Diagnosis, and Radiology Department, Faculty of Dentistry, Al-Azhar University, Cairo, Egypt
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Maboudi A, Fekrazad R, Shiva A, Salehabadi N, Moosazadeh M, Ehsani H, Yazdani O. Gingivectomy with Diode Laser Versus the Conventional Scalpel Surgery and Nonsurgical Periodontal Therapy in Treatment of Orthodontic Treatment-Induced Gingival Enlargement: A Systematic Review. Photobiomodul Photomed Laser Surg 2023; 41:449-459. [PMID: 37738371 DOI: 10.1089/photob.2023.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Background and objective: Some studies support the superiority of diode laser gingivectomy to scalpel surgery and nonsurgical treatments. However, a systematic review on this topic is lacking. This study aimed to compare gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy (NSPT) in the treatment of orthodontic treatment-induced gingival enlargement (GE). Materials and methods: In this systematic review, an electronic search of the relevant literature was conducted in Web of Science, Medline/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ProQuest with no language restriction. Randomized clinical trials published between 1985 and 2020 on comparative treatment of orthodontic treatment-induced GE by diode laser gingivectomy and scalpel surgery or NSPT regarding intraoperative and postoperative bleeding and/or pain were included. Risk of bias was assessed by the Cochrane 1 tool. Results: Of the initially retrieved 288 articles, 40 were duplicates and excluded; 236 articles were excluded following title and abstract screening, and 5 others were excluded following full-text assessment. Finally, 7 studies underwent systematic review. In the risk-of-bias assessment, 5 studies scored 2, and 2 studies scored 3 out of 6. Intraoperative and postoperative bleeding and pain were found to be significantly lower in the laser group. Conclusions: Within the limitations of this systematic review and with respect to the quality of evidence, the present results revealed lower level of pain and bleeding in diode laser gingivectomy compared with the conventional scalpel surgery and NSPT for treatment of orthodontic treatment-induced GE.
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Affiliation(s)
- Avideh Maboudi
- Department of Periodontology, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Atena Shiva
- Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Oral and Maxillofacial Pathology, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Negareh Salehabadi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hodis Ehsani
- Department of Periodontology, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omid Yazdani
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
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11
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Anwar SK, Edward SN, ELSayed NM. Diode laser versus sclerotherapy: bloodless approaches in the treatment of oral pyogenic granuloma (randomised controlled clinical trial). Odontology 2023; 111:511-521. [PMID: 36307616 PMCID: PMC10020281 DOI: 10.1007/s10266-022-00759-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022]
Abstract
Oral pyogenic granuloma (PG) is traditionally treated by surgical excision which is associated with bleeding, pain and a high rate of recurrence. Our research aimed to clinically assess the effectiveness of diode laser versus sclerotherapy, as bloodless approach, in the treatment of oral PG. We randomly divided 20 patients with oral PG into two groups, with those in the test group being managed via diode laser application and those in the control group via injections of ethanolamine oleate as a sclerosing agent. All patients were evaluated intraoperatively for bleeding severity and postoperatively for pain. The quality of healing was also assessed using Landry healing index after the 1st, 2nd and 4th weeks. Additionally, the patients were recalled after 3, 6 and 9 months from the end of treatment for recurrence evaluation. Our results revealed that intraoperative bleeding did not differ significantly between both groups while postoperative pain decreased significantly in the sclerotherapy group compared to the laser group. For different intervals, the sclerotherapy group had a higher healing quality index than the laser group, although the difference was not statistically significant. However, recurrence occurred in the laser group, there were no cases of recurrence in the sclerotherapy group in all intervals. In conclusion, diode laser treatment of PG is a reliable, less invasive, and sensitive procedure that requires an experienced operator and specialised equipment. However, ethanolamine oleate sclerotherapy is an inexpensive, simple technique besides being less prone to recurrence problems, especially when treatment duration is not a concern.
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Affiliation(s)
- Souzy Kamal Anwar
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt.
| | - Sandra Nabil Edward
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt
| | - Naguiba Mahmoud ELSayed
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt
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Muacevic A, Adler JR. Treatment of Gingival Growth Due to Amlodipine Use With a 445-nm Diode Laser: A Case Report. Cureus 2022; 14:e32592. [PMID: 36660514 PMCID: PMC9845510 DOI: 10.7759/cureus.32592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Amlodipine is a widely used calcium channel blocker associated with gingival enlargement. The effects of amlodipine on gingival enlargement vary depending on the duration of drug use and the dose of the active substance. This report presents a 56-year-old male hypertensive patient who had been using amlodipine (5 mg/day orally, single dose) for the last two years. He presented with diffuse gingival enlargement, complaining of gingival swelling and bleeding. This case report demonstrates the treatment of gingival enlargement with a novel 445-nanometer (nm) blue light diode laser after drug change and oral hygiene, which resulted in permanent and satisfactory clinical results.
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13
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Kim HR, Son K, Son YT, Kim YG, Lee KB, Lee SC, Suh JY, Lee JM. A Comparative Immunohistochemical Study of Wound Healing after Dental Diode Laser Treatment in the Rat Oral Mucosa. Bioengineering (Basel) 2022; 9:bioengineering9090466. [PMID: 36135012 PMCID: PMC9495772 DOI: 10.3390/bioengineering9090466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/05/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery through histological and immunohistochemical methods. Twenty 12-week-old male rats were assigned to three groups (3, 7, and 14 days). Square-shaped erosion wounds (2 × 2 mm2 diameter) were created on the hard palate of each rat. Two wounds were created using Laser A and a steel scalpel (Bard-Parker No. 15) on the right palate and using Laser B and a steel scalpel on the left side. Rats were sacrificed after 3, 7, and 14 days. Tissues were collected with a margin of 1 mm from the border of the erosional wound of the maxillary hard palate. Histological and immunohistochemical analyses were performed on the tissue samples after 3, 7, and 14 days. The tissue healing pattern and expression of inducible nitric oxide synthase (iNOS) and cluster of differentiation (CD) were observed under a light microscope. Statistical analysis was conducted using the Kruskal−Wallis H test for comparison among the groups (α = 0.05). In comparison to the wounds made with the scalpel, wounds treated with lasers A and B showed delayed healing patterns. There was no significant difference between the two laser treatment groups (p > 0.05). The expression of iNOS and CD68 was not significantly different among the three groups after 3 and 7 days (p > 0.05). On day 14, the groups treated with the dental diode lasers showed higher expression than the group treated with the steel scalpel, but no significant difference was observed (p > 0.05). Laser-induced wounds tended to heal slower than surgical wounds performed using a steel scalpel, but histological and immunohistochemical results showed no significant difference between the dental diode laser and scalpel groups.
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Affiliation(s)
- Hye Rin Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Keunbada Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
| | - Young-Tak Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu 41940, Korea
| | - Yong-Gun Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence: (K.-B.L.); (J.M.L.); Tel.: +82-53-660-7674 (K.-B.L.); +82-053-600-7522 (J.M.L.)
| | - Seung Cheol Lee
- Department of Pathology, Andong General Hospital, Andong-si 36743, Korea
| | - Jo-Young Suh
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Jae Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence: (K.-B.L.); (J.M.L.); Tel.: +82-53-660-7674 (K.-B.L.); +82-053-600-7522 (J.M.L.)
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Mazzoni A, Navarro RS, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT, Silva T, Santos EM, Sobral APT, Júnior AB, Nammour S, Motta LJ, Bussadori SK. Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11133783. [PMID: 35807068 PMCID: PMC9267408 DOI: 10.3390/jcm11133783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023] Open
Abstract
The aim of the study was to evaluate the release of the lingual frenulum through frenectomy in newborns zero to 90 days of age who breastfed and had diagnosis of ankyloglossia with an indication for surgery, comparing two methods: electrocautery and a high-power diode laser. Fifty-seven patients were randomly allocated to two groups (23 submitted to electrocautery and 34 submitted to a high power diode laser). Tongue movements were evaluated based on a clinical assessment and using the Bristol Tongue Assessment Tool (BTAT) before and 15 days after the surgical procedures. The visual analog scale was administered to the mothers on the same occasions for the measurement of pain during breastfeeding. Both groups had an increased BTAT score (favorable outcome) at the post-surgical evaluation, but the anterior third of the tongue was not always free to enable the movements necessary for lingual functions. It is fundamental for surgeons to have skill and in-depth knowledge of the equipment used to avoid accidents and complications in the region of important structures. Both techniques employed in this study were safe and effective, causing little bleeding and few postoperative complications. The group submitted to a high-power diode laser exhibited less post-surgical bleeding compared to the group submitted to electrocautery and no inflammation at the edges of the surgical cut.
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Affiliation(s)
- Adriana Mazzoni
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (A.M.); (K.P.S.F.); (A.C.R.T.H.); (L.J.M.)
| | - Ricardo Scarparo Navarro
- Postgraduate Program in Bioengineering, Scientific and Technological Institute, Brazil University (UB), São Paulo 08230-030, Brazil;
| | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (A.M.); (K.P.S.F.); (A.C.R.T.H.); (L.J.M.)
| | - Raquel Agnelli Mesquita-Ferrari
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (R.A.M.-F.); (T.S.)
| | - Anna Carolina Ratto Tempestini Horliana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (A.M.); (K.P.S.F.); (A.C.R.T.H.); (L.J.M.)
| | - Tamiris Silva
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (R.A.M.-F.); (T.S.)
| | - Elaine Marcílio Santos
- Postgraduate Program in Health and Environment, Metropolitan University of Santos (UNIMES), Santos 11045-002, Brazil; (E.M.S.); (A.P.T.S.)
| | - Ana Paula Taboada Sobral
- Postgraduate Program in Health and Environment, Metropolitan University of Santos (UNIMES), Santos 11045-002, Brazil; (E.M.S.); (A.P.T.S.)
| | - Aldo Brugnera Júnior
- National Institute of Science and Technology, INCT “Basic Optics Applied to Life Sciences”, UFSCar, USP, São Carlos 13565-905, Brazil;
| | - Samir Nammour
- Laser Application in Dental Medicine, Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium;
| | - Lara Jansinski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (A.M.); (K.P.S.F.); (A.C.R.T.H.); (L.J.M.)
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (A.M.); (K.P.S.F.); (A.C.R.T.H.); (L.J.M.)
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil; (R.A.M.-F.); (T.S.)
- Correspondence: ; Tel.: +55-113385-9241
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Flórez PRB, Guzmán JA, Orozco Páez J. Laser-Assisted Lip Repositioning Surgery: A Modification to The Conventional Technique. J Lasers Med Sci 2022; 13:e22. [PMID: 35996488 PMCID: PMC9392887 DOI: 10.34172/jlms.2022.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/08/2022] [Indexed: 09/22/2023]
Abstract
Introduction: The lip repositioning surgical technique arose with the objective of correcting and harmonizing the act of smiling. Since the conventional technique was published, some modifications of the technique have been proposed in order to counteract postoperative recurrence and to achieve the best esthetic appearance of the smile. The objective of this paper was to describe the laser-assisted lip repositioning technique (laser-assisted LRS) with a 940nm diode laser and 2780nm Er,Cr: YSGG, as a modification to the conventional lip repositioning technique, for the treatment of a gummy smile. Case Report: The proposed technique consists in achieving the descent of the upper lip by removing the intraoral mucosal band through the laser peeling of oral mucosa, preserving the connective tissue intact for healing by secondary intention. The technique was implemented in two patients with a diagnosis of a gummy smile caused by a short and hyperactive upper lip; the healing process was satisfactory, and there was no bleeding or postoperative edema. Postoperative controls were performed at 3 and 10 months, and no recurrence was found. Conclusion: the 940nm Diode laser or 2780nm Er,Cr: YSGG laser-assisted lip repositioning technique described here is less invasive than that performed with a conventional scalpel, offers aesthetic results, lower risk of infection and recurrence of the gummy smile in the long term.
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A Novel Concept of Combined High-Level-Laser Treatment and Transcutaneous Photobiomodulation Therapy Utilisation in Orthodontic Periodontal Interface Management. SENSORS 2022; 22:s22062263. [PMID: 35336433 PMCID: PMC8951072 DOI: 10.3390/s22062263] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
This case report is aimed to demonstrate the synergetic effects of λ940 nm laser photobiomodulation (PBM) therapy in augmenting the advantages of high-level-laser treatment (HLLT)-mediated reaction orthodontic periodontal interface management. Materials and Methods: A 32-year-old female who presented with a persistent gummy smile of upper incisors and low upper midline frenum attachment post-orthodontic treatment, was seeking a better smile appearance. She had a history of delayed wound healing without underlying medical conditions; otherwise, she was fit and healthy. She underwent laser ablation of the upper midline frenum and gingivoplasty of the upper incisors region with λ940 nm and λ2780, respectively, as well as transcutaneous PBM therapy (λ940 nm) to accelerate wound healing. The laser protocols were as follows: λ2780 nm: power output—2 W, pulse width—60 μs, free running pulse (FRP), spot area—0.0016 cm2, pulse repetition rate—25 pulses per second (s), 80 mJ/pulse, 90 s, λ940 nm: 1.2 W, continuous wave (CW) emission mode, 300 μm, 60 s; whereas the adjunctive λ940 nm induced-PBM parameters were as follows: power output—1.4 W, CW—120 s, single application, spot area—2.8 cm2. An acceleration of the wound healing was observed on the 4th day of treatment with no immediate or post-operative complications. The results showed no functional or aesthetic relapses at a long-term follow-up of 6 months. The authors concluded that λ940 nm laser-PBM can provide a synergetic effect to HLLT in accelerating wound healing and offering a precision smile with minimal to none post-operative complications. It is safe and justifiable to utilise dual therapy over the conventional methods, which serves our patients’ needs in our daily practice and in various clinical indications. The concept and laser protocols of this clinical case report can pave the roadmap for future extensive studies.
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17
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Amaral Vargas EO, de Melo Magalhães K, Pereira Ferreira DMT, Marañón-Vásquez G, Sant'anna EF, Maia LC, Pithon MM. Clinical parameters in soft tissue adjunctive periodontal procedures for orthodontic patients: surgical laser vs scalpel. Angle Orthod 2022; 92:265-274. [PMID: 34875012 PMCID: PMC8887394 DOI: 10.2319/022621-159.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To systematically review existing literature regarding clinical parameters comparing surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients. METHODS AND MATERIALS MEDLINE, Scopus, Web of Science, The Cochrane Library, LILACS, Bibliografia Brasileira de Odontologia (Brazilian Dental Literature - BBO), Embase, Open Grey, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination for the Improvement of Higher Education Personnel - CAPES), and Google Scholar were searched up to December 2020 without language restriction. Clinical trials comparing clinical parameters from surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients were selected. Risk of bias (RoB) assessments were performed using the Cochrane RoB2 tool. Narrative syntheses were performed, and the certainty of evidence was determined using the GRADE tool. RESULTS Five randomized clinical trials were included. One study was rated as low RoB, whereas others presented some concerns or high RoB. The studies were highly heterogeneous in relation to the procedure performed, laser protocol, outcomes evaluated, and follow-up periods. In general, regardless of the procedure and laser protocol used, the studies did not show significant differences between laser and scalpel for the outcomes of probing pocket depth, clinical crown length, gingival index, and relapse rate. Pain and bleeding were significantly lower with the use of laser compared with the scalpel. The certainty of evidence ranged from moderate to very low. CONCLUSIONS The existing literature on the subject is scarce and very heterogeneous and has methodological limitations. Based on the available evidence, it is not possible to draw definitive conclusions about the beneficial effect of laser use in orthodontic patients.
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The use of diode laser in esthetic crown lengthening: a randomized controlled clinical trial. Lasers Med Sci 2022; 37:2449-2455. [PMID: 35083533 DOI: 10.1007/s10103-022-03508-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
This clinical trial assessed patient comfort, satisfaction, and the achievement and maintenance of ideal gingival margin levels using laser compared to conventional surgery in sculpting the soft tissues during esthetic crown lengthening. Eighteen patients with altered passive eruption were treated in a randomized split-mouth design by laser or scalpel crown-lengthening surgery. Patients were evaluated for intra- and postoperative pain and bleeding at 3 and 7 days. Clinical parameters including clinical crown length, probing depth, plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, 3 and 6 months postoperatively. A gradual reduction in postoperative pain was recorded for both sides with no statistically significant difference at 3 (scalpel: 4.4 ± 1.33, laser: 4.8 ± 1.34; p = 0.088) and 7 days (scalpel: 1.8 ± 0.94, laser: 1.8 ± 1.10; p = 0.655). A statistically significant gain of coronal tooth structure was observed at 1, 3, and 6 months. Stability in the post-crown-lengthening level of the gingival margin was achieved one month following the procedure with no significant changes in the following months. All patients reflected acceptable results based on clinical evaluation and patient-reported outcomes. The diode laser can be used effectively as an alternative to the scalpel for the management of altered gingival contour. CLINICAL SIGNIFICANCE : This study demonstrated that a diode laser is an effective tool for the management of cases with altered passive eruption. In addition, it gives insight to practitioners regarding the timing of esthetic restorative procedures and emphasizes the preservation of the gingival complex dimensions.
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Kato RB, Jácome-Santos H, Couto APGR, Abreu LG, Mesquita RA, Kato CNADO. Management of Mucocele of the Glands of Blandin-Nuhn With a High-Intensity Laser: A Case Report. J Lasers Med Sci 2021; 12:e27. [PMID: 34733750 DOI: 10.34172/jlms.2021.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/21/2021] [Indexed: 11/09/2022]
Abstract
Introduction: The glands of Blandin-Nuhn are mucous and serous salivary glands situated on both sides of the midline of the ventral surface of the tongue. In this area, a mucocele generally results from trauma. The diagnosis of mucoceles is based on clinical and histopathological examinations and the recommended treatment is surgical excision. Case Report: This report describes a case of mucocele of the glands of Blandin-Nuhn (MGBN) affecting a 20-year-old male. Oval-shaped swelling with a smooth and bright surface of soft consistency was observed on the ventral surface of the individual's tongue. The diagnostic hypothesis was mucocele. Surgical excision was performed in a single session with a diode laser. A histopathological examination revealed mucus extravasating into connective tissue, with foamy macrophages and granulation tissue. Conclusion: The high-intensity laser was a safe and effective tool for treating MGBN. No need for a suture, minimal or no intraoperative bleeding, and a minimal report of pain and edema by the patient were observed. A diode laser may be a helpful tool because it is less invasive and it is safe and effective.
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Affiliation(s)
- Rayla Bentes Kato
- School of Dentistry, Centro Universitário do Pará - CESUPA, Belém, Pará, Brazil
| | - Humberto Jácome-Santos
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Palaia G, D'Alessandro L, Pergolini D, Carletti R, Di Gioia CRT, Romeo U. In vivo clinical and histological thermal effect of a 445 nm diode laser on oral soft tissues during a biopsy. J Oral Sci 2021; 63:280-282. [PMID: 33980770 DOI: 10.2334/josnusd.20-0665] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Blue diode laser emits a 445 nm wavelength light, which is extremely effective with hemoglobin, and has an optimal hemostatic effect. This work analyzes its thermal effects and clinical efficacy, when used to perform excisional biopsies. Forty-two excisional biopsies were performed with the laser; then, the extent of perincisional thermal effects was evaluated and patients were followed up. Average alteration on epithelial tissue was 507.07 µm, and on connective tissue was 320.39 µm. In all the cases, it was possible to obtain a histological diagnosis. Diode lasers can be safely used to perform biopsies; various intra- and postoperative advantages were confirmed.
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Affiliation(s)
- Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome
| | | | - Daniele Pergolini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome
| | - Raffaella Carletti
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome
| | - Cira R T Di Gioia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome
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21
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Hanke A, Fimmers R, Frentzen M, Meister J. Quantitative determination of cut efficiency during soft tissue surgery using diode lasers in the wavelength range between 400 and 1500 nm. Lasers Med Sci 2021; 36:1633-1647. [PMID: 33496905 PMCID: PMC8433103 DOI: 10.1007/s10103-020-03243-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/29/2020] [Indexed: 01/19/2023]
Abstract
Within the scope of this ex vivo study, the cut efficiency was investigated with eight diode laser wavelengths in the range from 400 to 1500 nm. Incisions on porcine gingiva samples were generated in CW-mode at a power range of 0.5–4 W using a bare fiber (∅ = 320 μm) in contact and non-contact mode at a cut speed of 2 mm/s. Cut depths, cut widths, and thermal damages were recorded based on histological sections and were evaluated via measurement masks. Moreover, with respect to the controllability of a therapeutic measure, an efficiency factor was defined. At powers above 2 W, for 445 nm, the maximum cut depth was 820 μm and 344 μm for 810 nm, respectively. At all wavelength and power ranges, the cut width averaged 125 μm. At minimum output power (0.5 W), the spatial expansion of the thermal damage in the tissue surface layer corresponds in the blue/green wavelength range from the very beginning of the laser impact to the fiber core diameter. It could be shown that increases in the diode laser power output do not correlate to the same extent with the incision depth nor with thermal damage to tissue.
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Affiliation(s)
- Amelie Hanke
- Department of Operative and Preventive Dentistry, Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Rolf Fimmers
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Bonn University, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Matthias Frentzen
- Department of Operative and Preventive Dentistry, Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany
- Center of Dento-Maxillo-Facial Medicine, Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Jörg Meister
- Center of Dento-Maxillo-Facial Medicine, Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany.
- Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany.
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Velenjak Street, 19857-17443, Tehran, Iran.
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22
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Katara A, Waghmare M, Kadakia N, Samson S, Minhas R. A case series of treatment of oral mucosal lesions using diode lasers. SCIENTIFIC DENTAL JOURNAL 2021. [DOI: 10.4103/sdj.sdj_28_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Recurrent Oral Mucocele Management with Diode Laser. Case Rep Dent 2020; 2020:8855759. [PMID: 33083064 PMCID: PMC7556084 DOI: 10.1155/2020/8855759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/31/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Mucocele is the most common minor salivary glands disease. Its management may present a challenge for dental professionals. The aim of the present clinical case was to describe mucocele treatment with diode laser and its benefits. Case Report. A case of lower lip mucocele in a 10-year-old female patient is reported. A conventional excision surgery was performed. Two months later, the patient reported discomfort and swelling at the same operative site. The lesion had recurred. Thus, mucocele was removed using a diode laser with wavelength of 980 nm, an initiated fiberoptic tip of 300 μm, in continuous mode, and a power setting of 2 Watts. The procedure was rapidly completed with no bleeding. The patient was followed-up after 2 weeks and 6 months. The wound healed without complications: no postoperative discomfort or pain and no infection. There was no recurrence. Conclusion Diode laser is an effective, easy, bloodless, and well-accepted procedure to treat mucocele in pediatric patients.
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de Jesus AO, Matias MDP, de Arruda JAA, Aires AV, Gomes IP, Souza LN, Abreu LG, Mesquita RA. Diode laser surgery versus electrocautery in the treatment of inflammatory fibrous hyperplasia: a randomized double-blind clinical trial. Clin Oral Investig 2020; 24:4325-4334. [PMID: 32356212 DOI: 10.1007/s00784-020-03296-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 04/17/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare the efficacy and safety of diode laser and electrocautery techniques for inflammatory fibrous hyperplasia (IFH) removal. MATERIALS AND METHODS In this randomized double-blind clinical trial, 40 individuals were randomly allocated to two groups: group 1 (G1) consisted of 20 individuals assigned to treatment with diode laser and group 2 (G2) consisted of 20 individuals assigned to treatment with electrocautery. The following transoperative parameters were evaluated: bleeding, temperature, and surgical technique parameters (energy deposited on tissue, flow rate, and time of incision). The postoperative parameters evaluated were as follows: pain, functional alterations (chewing, speaking), analgesic medication intake, swelling, healing of the wound area, and patient satisfaction. RESULTS Among the 40 individuals included in the study, four (two in G1 and two in G2) did not complete the entire follow-up. Therefore, 36 individuals (18 in G1 and 18 in G2) participated. Participants in G1 and in G2 had similar demographic characteristics. No difference regarding the trans- or postoperative parameters evaluated was observed between G1 and G2 (p > 0.05). Also, no difference regarding the time for healing was observed between groups. CONCLUSIONS Diode laser seems to be as effective and safe as electrocautery when applied under similar conditions for IFH removal. CLINICAL RELEVANCE IFH corresponds to 65% of the lesions observed in denture wearers. This study shows that under similar conditions diode laser is as effective and safe as electrocautery for removal of IFH.
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Affiliation(s)
- Alessandro Oliveira de Jesus
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Michelle Danielle Porto Matias
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Amanda Vieira Aires
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isadora Pereira Gomes
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leandro Napier Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, room 3322, Pampulha, Belo Horizonte, MG, 31270-901, Brazil.
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Lione R, Pavoni C, Noviello A, Clementini M, Danesi C, Cozza P. Conventional versus laser gingivectomy in the management of gingival enlargement during orthodontic treatment: a randomized controlled trial. Eur J Orthod 2020; 42:78-85. [PMID: 31111882 DOI: 10.1093/ejo/cjz032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To compare the use of diode laser with conventional surgery evaluating the effectiveness of gingivectomy as an adjunct to non-surgical periodontal treatment in the management of gingival enlargement (GE) during orthodontic treatment. TRIAL DESIGN Prospective three-arm parallel group randomized clinical trial with 1:1:1 allocation ratio. METHODS Sixty subjects (33 males and 27 females), with a mean age of 14.4 ± 1.9 years, were selected according to inclusion criteria: overgrown gingivae on the labial side of the anterior teeth secondary to fixed appliance therapy, six maxillary anterior teeth present, and healthy non-smokers patients. Patients were enrolled in the study and randomly assigned to three groups by a computer-generated randomization list and by a block size of 4. The allocation information was concealed in opaque and sealed envelopes by the statistician. In the first group, all subjects underwent a conventional scalpel gingivectomy of the maxillary anterior sextant. In the second group, all subjects were treated using laser-assisted gingivectomy; while subjects assigned to the third group underwent only non-surgical periodontal treatment and served as control group (CG). The observer who performed all the measurements was blinded to the group assignment. Blinding was obtained by eliminating from the elaboration file every reference to patient group assignment. Intergroup comparisons of changes in the periodontal parameters were conducted at 1, 3, and 6 months using ANOVA with repeated measures and Tukey's post hoc tests. The significance level was set at P <0.05. RESULTS After 1 month, the TGs showed a significant improvement of all periodontal parameters when compared with the CG. No statistically significant differences were observed between the two TGs. At the 3-month observation, a relapse occurred in the TGs, while the CG showed the greater improvement of soft tissue health. In the 6-month versus 3-month evaluation, no significant differences between the three groups were found for any periodontal measurements. In the long-term evaluation (6 months versus baseline), a significant greater reduction of pockets were found in the TGs when compared with the CG. CONCLUSIONS The adjunct use of both scalpel gingivectomy and laser gingivectomy was more effective in controlling gingival inflammation than non-surgical periodontal treatment alone at 1, 3 and 6 months. In the control group, greater improvement in the periodontal parameters were observed within 3 months, depending on a self-care approach for the management of GE. LIMITATIONS This study was a short-term study (6-month follow-up). TRIAL REGISTRATION ClinicalTrials.gov (registration number: NCT03514316).
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Affiliation(s)
- Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Chiara Pavoni
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Andrea Noviello
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Italy
| | - Marco Clementini
- Department of Periodontology, Vita Salute San Raffaele University, Milan, Italy
| | - Carlotta Danesi
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Italy
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Italy.,Department of Dentistry, UNSBC, Tirana, Albania
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de Araújo JGL, Araújo EMDS, Rodrigues FCN, Paschoal MAB, Lago ADN. High Power Laser and Photobiomodulation in Oral Surgery: Case Report. J Lasers Med Sci 2019; 10:75-78. [PMID: 31360373 DOI: 10.15171/jlms.2019.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The labial frenum is a fold of mucous membrane that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. In some cases, its presence can cause a midline diastema, periodontal diseases related to food impaction, or retention of biofilm, among others. In such cases, lip frenectomy is indicated as treatment, which can be performed with a scalpel (conventional method), an electric scalpel, or a surgical laser. Objective: To show a clinical case performed at Laser Extension Project in Dentistry, Federal University of Maranhão grounded in a literature review. Case Presentation: A laser frenectomy was performed on a female patient, aged 20, who had a diastema between the upper central incisors and an indication for frenum removal. The high-power diode laser is excellent for procedures in soft tissue because its wavelength is well absorbed by hemoglobin and other pigments; its use also allows a reduction in the amount of anesthetic and medicines used. The parameters used were 2 W, in a continuous mode, 808 nm infrared emission; with delivery of the beam through optical fiber 300 μM; energy of 120 J; 20 pps. Conclusion: the high power diode laser allowed a satisfactory result, the procedure was safe, the technique was a simple one and of reduced clinical time, as mentioned in the literature. It is worth noting that the technique is dependent on the skill of the professional performing it.
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Affiliation(s)
- Júlia Gomes Lúcio de Araújo
- Department of Dentistry I, Federal University of Maranhão, Av. Dos Portugueses, 1966, Bacanga, 65080-805, São Luis, MA, Brazil
| | | | | | | | - Andréa Dias Neves Lago
- Department of Dentistry I, Federal University of Maranhão, Av. Dos Portugueses, 1966, Bacanga, 65080-805, São Luis, MA, Brazil
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Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial. Lasers Med Sci 2019; 35:395-402. [PMID: 31273569 DOI: 10.1007/s10103-019-02832-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.
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28
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Çayan T, Hasanoğlu Erbaşar GN, Akca G, Kahraman S. Comparative Evaluation of Diode Laser and Scalpel Surgery in the Treatment of Inflammatory Fibrous Hyperplasia: A Split-Mouth Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:91-98. [PMID: 31050932 DOI: 10.1089/photob.2018.4522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: This study aimed to compare the efficacy of diode laser surgery and the scalpel surgery in the removal of inflammatory fibrous hyperplasia (IFH). Background data: Diode laser systems are proposed as an alternative to scalpel surgery on surgeries involving oral soft tissues. Some of the advantages of the laser systems are ease of application, adequate coagulation, reduced postoperative pain, and decreased scarring. In addition, there are increasing data on the antibacterial effects of the diode lasers in dentistry; however, the direct bactericidal role of the diode laser in oral soft tissue procedures has not yet been investigated. Materials and methods: A total of 22 patients were enrolled in this study. One side of IFH was randomly assigned for excision with scalpel blade or with diode laser. Perioperative bleeding, postoperative pain, wound healing, and bacterial counts were evaluated for both methods. Results: The bleeding on the side treated by diode laser was found significantly lower (p < 0.05). A notable reduction in total bacterial counts was observed in the laser group after the first postoperative day. However, this trend did not reach statistical significance. No significant differences were recorded regarding subjective postoperative pain between the groups (p = 0.065). The healing of the postoperative wounds was significantly faster in the conventional group at each time point. Conclusions: Diode laser has offered some advantages over conventional method in the management of IFH. However, large-cohort comparative studies are required to provide additional data regarding the wound healing capacity of the diode laser.
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Affiliation(s)
- Timuçin Çayan
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Güzin Neda Hasanoğlu Erbaşar
- 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gülçin Akca
- 3 Department of Medical Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sevil Kahraman
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
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29
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Antunes JLF, Domaneschi C, Lemos CA. Noninferiority trials in oral medicine. Oral Dis 2018; 25:357-362. [PMID: 29766614 DOI: 10.1111/odi.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
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30
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Jaeger F, Chiavaioli GM, de Toledo GL, Freire-Maia B, Amaral MBF, Mesquita RA. High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study. Lasers Med Sci 2017; 33:51-56. [PMID: 28951983 DOI: 10.1007/s10103-017-2333-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/19/2017] [Indexed: 12/17/2022]
Abstract
The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.
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Affiliation(s)
- Filipe Jaeger
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
- Department of Dentistry, Centro Universitário Newton Paiva, Belo Horizonte, Brazil.
- Oral and Maxillofacial Sugery Service, Baleia Hospital - CENTRARE, Belo Horizonte, Brazil.
| | | | | | - Belini Freire-Maia
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Oral and Maxillofacial Sugery Service, Baleia Hospital - CENTRARE, Belo Horizonte, Brazil
| | - Marcio Bruno Figueiredo Amaral
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Oral and Maxillofacial Sugery Service, Baleia Hospital - CENTRARE, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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31
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Efficiency of soft tissue incision with a novel 445-nm semiconductor laser. Lasers Med Sci 2017; 33:27-33. [DOI: 10.1007/s10103-017-2320-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
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32
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A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival. Lasers Med Sci 2017; 33:19-25. [PMID: 28861729 DOI: 10.1007/s10103-017-2315-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 08/24/2017] [Indexed: 10/19/2022]
Abstract
The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 μs; pulse length 100 μs, 400-μm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values < 0.05). One patient in the control group experienced ecchymosis. All implants were successful in function. Application of laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.
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33
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Seifi M, Matini NS. Laser Surgery of Soft Tissue in Orthodontics: Review of the Clinical Trials. J Lasers Med Sci 2017; 8:S1-S6. [PMID: 29263776 DOI: 10.15171/jlms.2017.s1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction: Recently, a wide variety of procedures have been done by laser application in orthodontics. Apart from the mentioned range of various treatments, laser has become a tool for many soft tissue surgeries as an alternative to conventional scalpel-based technique during orthodontic treatments in the management of soft tissue. Due to scarce information in the latter subject, this study was designed in order to include clinical trials that included soft tissue ablation by laser in orthodontics. Methods: Literature was searched based on PubMed and Google Scholar databases in 5 years (2010-2015) with English language restriction and clinical trial design. Studies that performed soft tissue application of laser during orthodontic treatment were extracted by the authors. Results: Only eight studies met the inclusion criteria. No significant difference was found between laser ablation and conventional scalpel technique in the matter of treatment outcome. However, few issues remained to clarify the differences in the mentioned procedures. Conclusion: Laser performance can be recommended in case of preceding less bleeding and discomfort during surgical procedure. There are still quandaries among clinical application of scalpel-based surgery in aesthetic region with bracket-bonded teeth. Precaution and knowledge regarding the characteristics of laser beam such as wavelength, frequency, power and timing is extremely needed.
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Affiliation(s)
- Massoud Seifi
- Tayebi Research Center, Marquette University, Wisconsin, USA.,Dentofacial Deformities Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin-Sadat Matini
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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34
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Ortega-Concepción D, Cano-Durán JA, Peña-Cardelles JF, Paredes-Rodríguez VM, González-Serrano J, López-Quiles J. The application of diode laser in the treatment of oral soft tissues lesions. A literature review. J Clin Exp Dent 2017; 9:e925-e928. [PMID: 28828162 PMCID: PMC5549593 DOI: 10.4317/jced.53795] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 06/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background Since its appearance in the dental area, the laser has become a treatment of choice in the removal of lesions in the oral soft tissues, due to the numerous advantages they offer, being one of the most used currently the diode laser. The aim of this review was to determine the efficacy and predictability of diode laser as a treatment of soft tissue injuries compared to other surgical methods. Material and Methods A literature review of articles published in PubMed/MEDLINE, Scopus and the Cochrane Library databases between 2007 and 2017 was performed. “Diode laser”, “soft tissue”, “oral cavity” and “oral surgery” were employed for the search strategy. Only articles published English or Spanish were selected. Results The diode laser is a minimally invasive technology that offers great advantages, superior to those of the conventional scalpel, such as reduction of bleeding, inflammation and the lower probability of scars. Its effectiveness is comparable to that of other types of lasers, in addition to being an option of lower cost and greater ease of use. Its application in the soft tissues has been evaluated, being a safe and effective method for the excision of lesions like fibromas, epulis fissuratum and the accomplishment of frenectomies. Conclusions The diode laser can be used with very good results for the removal of lesions in soft tissues, being used in small exophytic lesions due to their easy application, adequate coagulation, no need to suture and the slightest inflammation and pain. Key words:Diode laser, soft tissues, oral cavity, oral surgery.
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Affiliation(s)
- Daniel Ortega-Concepción
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Jorge A Cano-Durán
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | | | | | - José González-Serrano
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Juan López-Quiles
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
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