Introduction: Frenectomy is one of the most common soft-tissue surgical procedures among children. Short superior labial frenulum is a condition that may lead to a number of disorders in the permanent dentition arrangement and subsequent disturbing aesthetic results. The widespread laser application in pediatric frenectomies is attributed to the fact that lasers claim to provide minimally invasive, short, blood-free manipulation, significantly better patient’s perception, and possibility of treatment under local anesthesia.
Aim: The present paper aims to examine and compare the intraoperative parameters and the healing process for the surgical treatment of short labial frenulum using Er:Cr:YSGG and diode lasers.
Materials and Methods: The study included 52 patients aged 6 to 18 years; 28 of them underwent frenectomy with an Er,Cr:YSGG laser (WaterLase, Biolase),while the remaining 24 patients were treated with a diode laser (Elexxion).The object of the study involved signs such as bleeding ,duration of the procedure,need of sutures, postoperative pain, discomfort during eating/speaking, wound healing, etc.
Results: Our results showed that diode lasers provide better bleeding control during surgery, while Er,Cr:YSGG lasers showed accelerated soft-tissue healing and reduced levels of pain in the early postoperative period. Operative time, discomfort during eating or speaking, and the risk of recurrence showed no statistically significant differrence between the two lasers.
Conclusion: Laser-assisted frenectomy has many benefits for the patient as well as the oral surgeon. Both diode and Er,Cr:YSGG lasers provide reduction of intraoperative bleeding, shortened surgical time, uneventful postoperative period with low levels of pain, fewer eating/speech disorders, and adequate wound healing.
Grzech-Leśniak K, Matys J, Jurczyszyn K, Ziółkowski P, Dominiak M, Brugnera Junior A Jr, et al. Histological and thermometric examination of soft tissue de-epithelialization using digitally controlled Er:YAG laser handpiece: an ex vivo study. Photomed Laser Surg. 2018 Jun;36(6):313-9. doi: 10.1089/pho.2017.4413.
Aras MH, Göregen M, Güngörmüş M, Akgül HM. Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia. Photomed Laser Surg. 2010;28(2):173-7. doi:10.1089/pho.2009.2498.
Pié-Sánchez J, España-Tost AJ, Arnabat-Domínguez J, Gay-Escoda C. Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr:YSGG laser. Med Oral Patol Oral Cir Bucal. 2012;17(2):e228-32. doi:10.4317/medoral.17373.
Kazakova RT, Tomov GT, Kissov CK, Vlahova AP, Zlatev SC, Bachurska SY. Histological gingival assessment after conventional and laser gingivectomy. Folia Med (Plovdiv). 2018;60(4):610-6. doi:10.2478/folmed-2018-0028.
Suter VGA, Altermatt HJ, Bornstein MM. A randomized controlled clinical and histopathological trial comparing excisional biopsies of oral fibrous hyperplasias using CO2 and Er:YAG laser. Lasers Med Sci. 2017;32(3):573-81. doi:10.1007/s10103-017-2151-8.
Protásio ACR, Galvão EL, Falci SGM. laser techniques or scalpel incision for labial frenectomy: a meta-analysis. J Maxillofac Oral Surg. 2019;18(4):490-9. doi:10.1007/s12663-019-01196-y.
Medeiros Júnior R, Gueiros LA, Silva IH, de Albuquerque Carvalho A, Leão JC. Labial frenectomy with Nd:YAG laser and conventional surgery: a comparative study. Lasers Med Sci. 2015;30(2):851-6. doi:10.1007/s10103-013-1461-8.
Delli K, Livas C, Sculean A, Katsaros C, Bornstein MM. Facts and myths regarding the maxillary midline frenum and its treatment: a systematic review of the literature. Quintessence Int. 2013;44(2):177-87. doi:10.3290/j.qi.a28925.
Amaral MB, de Ávila JM, Abreu MH, Mesquita RA. Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial. Int J Oral Maxillofac Surg. 2015;44(11):1383-9. doi:10.1016/j.ijom.2015.05.015.
Kaur M, Sharma YPD, Singh P, Sharma S, Wahi A. Comparative evaluation of efficacy and soft tissue wound healing using diode laser (810 nm) versus conventional scalpel technique for second-stage implant surgery. J Indian Soc Periodontol. 2018;22(3):228-34. doi:10.4103/jisp.jisp_46_17
Eroglu CN, Tunç SK, Elasan S. Removal of epulis fissuratum by Er,Cr:YSGG laser in comparison with the conventional method. Photomed Laser Surg. 2015;33(11):533-9. doi:10.1089/pho.2014.3856.
Calisir M, Ege B. Evaluation of patient perceptions after frenectomy operations: A comparison of neodymium-doped yttrium aluminum garnet laser and conventional techniques in the same patients. Niger J Clin Pract. 2018;21(8):1059-64. doi:10.4103/njcp.njcp_2_18.
Hanna R, Parker S. The advantages of carbon dioxide laser applications in paediatric oral surgery. A prospective cohort study. Lasers Med Sci. 2016;31(8):1527-36. doi:10.1007/s10103-016-1978-8.
Ugurlu F, Cavus O, Kaya A, Sener CB. Evaluation of dental anxiety in patients undergoing dentoalveolar surgery with laser treatment. Photomed Laser Surg. 2013;31(4):169-73. doi: 10.1089/pho.2012.3364.
Viet DH, Ngoc VTN, Anh LQ, Son LH, Chu DT, Ha PTT, et al. Reduced need of infiltration anesthesia accompanied with other positive outcomes in diode laser application for frenectomy in children. J Lasers Med Sci. 2019;10(2):92-96. doi: 10.15171/jlms.2019.15.
Yadav RK, Verma UP, Sajjanhar I, Tiwari R. Frenectomy with conventional scalpel and Nd:YAG laser technique: A comparative evaluation. J Indian Soc Periodontol. 2019;23(1):48-52. doi: 10.4103/jisp.jisp_352_18.
Akpınar A, Toker H, Lektemur Alpan A, Çalışır M. Postoperative discomfort after Nd:YAG laser and conventional frenectomy: comparison of both genders. Aust Dent J. 2016;61(1):71-5. doi: 10.1111/adj.12333.
Ize-Iyamu IN, Saheeb BD, Edetanlen BE. Comparing the 810nm diode laser with conventional surgery in orthodontic soft tissue procedures. Ghana Med J. 2013;47(3):107-11.
Sezgin G, Öztürk Özener H, Meseli SE, Kuru L. Evaluation of patient's perceptions, healing, and reattachment after conventional and diode laser frenectomy: a three-arm randomized clinical trial. Photobiomodul Photomed Laser Surg. 2020;38(9):552-9. doi: 10.1089/photob.2019.4783.
Olivi G, Caprioglio C, Olivi M, Genovese MD. Paediatric laser dentistry. Part 4: Soft tissue laser applications. Eur J Paediatr Dent. 2017;18(4):332-4. doi: 10.23804/ejpd.2017.18.04.12.
Soliman MM, Al Thomali Y, Al Shammrani A, El Gazaerly H. The use of soft tissue diode laser in the treatment of oral hyper pigmentation. Int J Health Sci (Qassim). 2014;8(2):133-40. doi:10.12816/0006079
Merigo E, Clini F, Fornaini C, Oppici A, Paties C, Zangrandi A, et al. Laser-assisted surgery with different wavelengths: a preliminary ex vivo study on thermal increase and histological evaluation. Lasers Med Sci. 2013;28(2):497-504. doi:10.1007/s10103-012-1081-8
Sindel A, Dereci Ö, Hatipoğlu M, Özalp Ö, Dereci ON, Kocabalkan B, et al. Evaluation of temperature rise following the application of diode and ErCr:Ysgg lasers: an ex vivo study. Eur Oral Res. 2018;52(3):131-6. doi:10.26650/eor.2018.479
Onur SG. Evaluation of pain perception and wound healing after laser-assisted frenectomy in pediatric patients: a retrospective comparative study. Photobiomodul Photomed Laser Surg. 2021;39(3):204-10. doi: 10.1089/photob.2020.4886.
Olivi G, Chaumanet G, Genovese MD, Beneduce C, Andreana S. Er,Cr:YSGG laser labial frenectomy: a clinical retrospective evaluation of 156 consecutive cases. Gen Dent. 2010;58(3):e126-e133.
Öztürk Özener H, Meseli SE, Sezgin G, Kuru L. Clinical efficacy of conventional and diode laser-assisted frenectomy in patients with different abnormal frenulum insertions: a retrospective study. Photobiomodul Photomed Laser Surg. 2020;38(9):565-70. doi: 10.1089/photob.2020.4841.
Olivi M, Genovese MD, Olivi G. Laser labial frenectomy: a simplified and predictable technique. Retrospective clinical study. Eur J Paediatr Dent. 2018;19(1):56-60. doi: 10.23804/ejpd.2018.19.01.10.
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