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Use both Nd:YAG and CO2 lasers
... In the last few years, the CO 2 laser has been successfully used in oral soft tissue surgery procedures, such as gingival resections, gingivoplasties, soft tissue biopsy samples, frenectomies, treatment of lymphangiomas, and crown lengthenings (7)(8)(9). Because of their special characteristics, the CO 2 , the Er:YAG and the Er,Cr:YSGG lasers have been the systems most widely used to perform frenectomies. ...
To compare upper lip frenulum reinsertion, bleeding, surgical time and surgical wound healing in frenectomies performed with the CO2 laser versus the Er, Cr:YSGG laser.
A prospective study was carried out on 50 randomized pediatric patients who underwent rhomboidal resection of the upper lip frenulum with either the CO2 laser or the Er,Cr:YSGG laser. Twenty-five patients were assigned to each laser system. All patients were examined at 7, 14, 21 days and 4 months after the operation in order to assess the surgical wound healing.
Insertion of the frenulum, which was preoperatively located between the upper central incisors, migrated to the mucogingival junction as a result of using both laser systems in all patients. Only two patients required a single dose of 650 mg of paracetamol, one of either study group. CO2 laser registered improved intraoperative bleeding control results and shorter surgical times. On the other hand, the Er,Cr:YSGG laser achieved faster healing.
Upper lip laser frenectomy is a simple technique that results in minimum or no postoperative swelling or pain, and which involves upper lip frenulum reinsertion at the mucogingival junction. The CO2 laser offers a bloodless field and shorter surgical times compared with the Er,Cr:YSGG laser. On the other hand, the Er,Cr:YSGG laser achieved faster wound healing.
Labial frenum is the fold of mucosa that attaches specific area of inner surface of upper lip to the
specific area of alveolar mucosa. The adverse effects of a low-attaching frenum are: midline
diastema, poor aesthetics and gingival recession. It can be treated either by conventional surgery
(by scalpel, scissors and other surgical instruments) or, recently, by use of laser technology.
11 years old Egyptian child complained of a midline diastema due to low attachment of upper labial
frenum. Diode laser (980 nm) was used for frenectomy, pain during and postoperatively, bleeding
and swelling were assessed. The actual procedure takes 4-6 minutes, no pain during and after
operation, also no bleeding. The child felt soreness at the operation site for 3 days and uneventful
healing with new tissues is evident within 12 days.
There is little support in the dental literature to justify the use of lasers for periodontal root therapy. To the contrary, there are several in vitro studies suggesting potentially adverse effects when lasers are applied to root surfaces. The purpose of this study was to evaluate, in vivo, soft tissue attachment to root surfaces following CO2 laser irradiation. Using a four-quadrant design with one quadrant serving as an untreated control, the remaining quadrants in each of two dogs were treated by (1) scaling and root planing, (2) laser only, and (3) laser followed by scaling and root planing. Prior to the assigned treatments, the roots of three teeth in each quadrant (including the control) were exposed by flap reflection and ostectomy. After root therapy the flaps were repositioned and allowed to heal for 28 days. Clinical attachment levels were determined prior to surgery, at 28 days, and by histologic measurement. Results indicate that specimens treated with laser only lost attachment compared to controls and other treatment groups. Furthermore, there was no histologic evidence of soft tissue attachment to a laser-treated surface that featured a residual char layer.
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