Use of carbon dioxide laser in oral soft tissue procedures

Effective Parameters for Orthodontic Tooth Movement Acceleration with Photobiomodulation: An Umbrella Review

Objective: To answer this research question: What are the effective wavelength, power, and energy density parameters for achieving dental movement acceleration? Background Data: Photobiomodulation (PBM) has been clinically studied for its ability to accelerate dental movements in orthodontics. However, its effectiveness is dose dependent. Methods: The search was carried out in PubMed, SCOPUS, and ISI Web of Science. The quality of the included systematic reviews was performed using the AMSTAR 2 tool. The risk of bias was assessed using the ROBIS tool. Results: In total, 29 articles in PubMed, 75 in Scopus, and 61 in ISI Web of Science. Finally, only five systematic reviews were included. Conclusions: The results showed the range from 730 to 830 nm as the most effective range of wavelength to accelerate the orthodontic dental movement. A power range of 0.25-200 mW, with emphasis on the direct correlation between power, wavelength, and energy density. Energy density has not been adequately reported in the most randomized controlled clinical trials.

An Update on the Use of Lasers in Prosthodontics

Lasers are employed in all fields of modern dentistry nowadays, including both surgical and non-surgical dental procedures. Prosthodontics, a branch of dentistry, has also embraced lasers as an invaluable addition to conventional methodologies. This helps improve the standard of care for patients and dentists due to its precise excision, quick healing, and enhanced tissue response after surgeries. In prosthodontics, the most commonly used lasers are carbon dioxide, argon, and yttrium-aluminum-garnet (YAG) lasers. Many reviews have been published in the literature regarding the use of lasers in dentistry; however, reviews on the use of lasers in the field of prosthodontics are limited. This review aims to explain the diverse applications and advancements of lasers in prosthodontics. Furthermore, it will highlight the integration of lasers in diagnostic protocols, treatment modalities, and the fabrication of prosthetic restorations.

Labial Frenectomy using Laser: A Scoping Review

Labial frenectomy is a surgical technique, that aims to remove the frenulum with its attachment to the underlying bone. Frenectomy, is indicated if the frenulum attachment causes midline diastema, gingival recession, hindrance in maintaining oral hygiene, or if it interferes with lip movements and for prosthetic needs. A labial frenectomy can be performed either by the routine scalpel technique, electrocautery, and most recently medical lasers. The aim of this study was to evaluate, whether the laser technique is more effective than the conventional surgical technique, and whether there are differences between the different types of lasers. The scoping review was conducted and prepared on the basis of the indications of the PRISMA guidelines (PRISMA Extension for Scoping Reviews, PRISMA-ScR) of PRISMA checklist, and nine papers were considered admissible to the qualitative analysis for the following outcomes: bleeding during intervention, use of sutures, duration of the intervention, and use of analgesic drugs in the days following the intervention. This review suggests that laser-performed labial frenectomy is faster and offers better intra- and postoperative management; however, due to the limited number of available papers, the final results of the present review are not absolute.

The In Vitro Effect of Laser Irradiation (Er:YAG and CO2) and Chemical Reagents (Hydrogen Peroxide, Sodium Hypochlorite, Chlorhexidine, or Sodium Fluoride) Alone or in Combination on Reducing Root Caries Bacteria

(1) Lasers have been used for the treatment of dentinal hypersensitivity and bacterial reductions in periodontology. The purpose of this in vitro study was to evaluate the effect of Carbon Dioxide (CO₂) and Erbium-doped Yttrium Aluminum Garnet (Er:YAG) lasers with chlorhexidine (CHX), hydrogen peroxide (H₂O₂), sodium hypochlorite (NaOCl), or sodium fluoride (NaF) on the viability of oral bacteria associated with root caries. (2) Streptococcus mutans, Streptococcus sanguinis, and Enterococcus faecalis were grown in Brain Heart Infusion (BHI) broth, diluted to an OD660 of 0.5, and treated with antiseptics with or without simultaneous irradiation with the Er:YAG and CO₂ lasers for 30 s repeated three times. The treatment groups consisted of 1: no treatment, 2: 0.5% H₂O₂ alone, 3: 0.5% NaOCl alone, 4: 0.12% CHX alone, 5: 2% NaF alone, 6: laser alone, 7: laser with 0.5% H₂O₂, 8: laser with 0.5% NaOCl, 9: laser with 0.12% CHX, and 10: laser with 2% NaF for both lasers. The microbial viability was determined through plating and viable colonies were counted, converted into CFU/mL, and transformed into log form. The statistical analysis was performed using a two-tailed paired t-test. (3) The use of CO₂ and Er:YAG lasers alone failed to show statistically significant antibacterial activity against any of the bacteria. The only effective monotreatment was CHX for S. mutans. The combined treatment of 0.5% NaOCl with Er:YAG produced the greatest reduction in overall viability. (4) The combination of the Er:YAG laser with 0.5% NaOCl resulted in the largest reduction in bacterial survival when compared to monotherapies with antimicrobial solutions or lasers.

Diode laser chairside frenectomy in orthodontics: A case series (DIODE LASER FRENECTOMY: CASE SERIES)

Offering the whole orthodontic and surgical treatment to the patient as a single package in a one office can save them considerable time and the trouble. Diode laser enables orthodontists to do so while enjoying its benefits over the scalpel.

Laser Techniques or Scalpel Incision for Labial Frenectomy: A Meta-analysis

Introduction

Labial frenectomy is a common procedure in the oral surgery specialty. Nowadays, laser surgery seems to provide better post-operative results than scalpel surgery. Thus, the aim of this study was to analyze whether trans-surgical and postoperative variables of labial frenectomy are better when performed with laser than with conventional scalpel.

Materials and Methods

A systematic review has been performed based on PRISMA criteria. The search included three databases, with no limitations of time or language. After screening, seven papers were included in qualitative analysis and six in meta-analysis. Bias analysis was performed according to Cochrane Handbook. Pain during the first (MD - 3.18, 95% CI - 4.03 to - 2.32) and seventh post-surgical days (MD - 1.04, 95% CI - 1.45 to - 0.64); discomfort during speech on the first (MD - 2.15, 95% CI - 3.94 to - 0.37) and the seventh post-surgical days (MD - 1.60, 95% CI - 1.96 to - 1.24); discomfort during chewing on the first (MD - 2.90, 95% CI - 3.35 to - 2.45) and the seventh days (MD - 1.56, 95% CI - 2.21 to - 0.91); and average surgery time (MD - 1.84, 95% CI - 3.22 to - 0.46) were lower in the laser group than in the scalpel group.

Conclusion

The results of this systematic review have shown better results to laser group in the following variables: pain, discomfort during speech and chewing. However, the evidence is limited due the high risk of bias.

Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients

Aim

To suggest regarding the timing of oral surgery and laser treatment for frenulum abnormalities in the pediatric population.

Materials and methods

We investigated the sex, age, frenulum site, reason for consultation, treatment method, and prognosis of 35 patients aged 15 years or younger and who were examined at our hospital for the chief complaint of frenulum abnormality.

Results

A total of 21 (mean age, 6.0 years) of the 35 patients underwent frenectomy using a carbon dioxide (CO₂) laser. Of these, 7 patients (mean age, 2.8 years) underwent the procedure with general anesthesia and 14 patients (mean age, 7.6 years) underwent the procedure with local anesthesia. The surgical site was the lingual frenulum in 15 patients and the maxillary labial frenulum in 6 patients. No adverse events were intraoperatively reported in any of the patients, and the procedure was quickly and safely performed. The mean postoperative follow-up period was 4.6 months, and readhesion was noted in one patient (4.8%). The most common reason cited for not undergoing frenectomy in the 14 patients (mean age, 3.4 years) was the young age of the child.

Conclusion

Retrospective study of pediatric patients with frenulum abnormalities demonstrated the usefulness of the CO₂ laser in performing frenectomy and offered suggestions regarding the timing of this procedure.

Clinical significance

Frenectomy performed using a CO₂ laser for pediatric patients is a useful, simple, and safe treatment method.

How to cite this article

Komori S, Matsumoto K, Matsuo K, Suzuki H, Komori T. Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients. Int J Clin Pediatr Dent 2017;10(3):272-277.