Comparative frenectomy with conventional scalpel and dual-waved laser in labial frenulum

Abstract

AimThe purpose of the study is to compare the labial frenectomy between the laser surgery (erbium yttrium aluminum garnet and neodymium-doped yttrium aluminum garnet (Er:YAG and Nd:YAG)) and the scalpel method.MethodsThe trial was a randomized controlled test. Thirty four patients aged from 5 to 10 years requiring the frenectomy were included in this study. Patients were randomly divided into two groups: group A: Er:YAG and Nd:YAG laser group and group B: scalpel group. In addition, this comparison considered the following factors: surgical time and Visual Analog Scale (VAS) pain score, which includes intraoperative pain, postoperative pain and complications, such as speaking and chewing, for 1 day and 7 days following labial frenectomy. After 3 months, we recorded the healing outcome by photos.ResultsThere was a statistically significant difference in mean surgical time between laser surgery (mean=224±59 s) and scalpel surgery (mean=740±168 s). According to VAS scores of the intraoperative period (3 hours after the operation and 1st postoperative day of pain), chewing and speaking were statistically higher in group B than those in group A; but in the 7th postoperative day of pain, there was no significant difference in speaking and chewing. After 1 month, all of the patient results were recorded, including the healing of wound and scar. Except for one patient in group B who had a scar, all patients achieved good results.ConclusionBased on the results of this study, it can be concluded that Nd:YAG laser is an efficient and more comfortable alternative to the scalpel for a frenectomy in upper lip frenulum.

Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review

“…The presence of an abnormal and hypertrophied interdental ULF could cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems of the upper central incisors, as well as aesthetic and functional disorders of the upper lip [8,33]. The surgical approach to solving the problem involves the use of a conventional scalpel [31,36,37], electrosurgery, or the use of different types of high-intensity laser devices [8,[31][32][33][34][35][36][37]. Although electrosurgery is a well-known surgical technique for ULF [14], in this review only studies about traditional surgery and laser surgery have passed the screening phase.…”

“…The patient does not even need to take antibiotic therapy due to the laser irradiation's ability to sterilize and hemostasis the area. On the other hand, the conventional surgical technique may result in longer healing times if the patient does not observe strict oral hygiene leading to plaque accumulation on the sutures, but it has the advantage of having a shorter learning curve for the operator and being less expensive [31,44].…”

Frenectomy with Classical Technique

“…Classical techniques are still widely used (14) . The disadvantages of this technique are the formation of scar tissue, bleeding, pain (17) , and debris sticking to the suture thread (18) .…”

Frenectomy on Maxillary Labial Frenulum Penetrating Papilla Type by Conventional Surgical Techniques: A Case Report

“…Tindakan frenektomi dapat dilakukan dengan teknik konvensional menggunakan skalpel, electrosurgery atau dengan laser. Efektifitas ketiga teknik tersebut tidak ada perbedaan bermakna hasil akhir penyembuhan luka dan hasil operasi 2,24,25. Pada laporan kasus ini menggunakan teknik konvensional karena mempunyai keuntungan skor penyembuhan luka yang lebih tinggi.…”

“…Hal ini sesuai dengan beberapa laporan kasus. Walaupun skor rasa sakit penggunaan laser dalam perawatan frenektomi lebih rendah daripada konvensional dengan skalpel dan dirasakan lebih nyaman, tetapi skor penyembuhan luka frenektomi dengan skalpel lebih tinggi, di mana hal ini menunjukkan penyembuhan luka terjadi lebih dini 24,25. Keuntungan lain teknik ini memerlukan beaya perawatan yang lebih sedikit dan peralatan lebih sederhana sehingga bisa dilakukan oleh banyak operator.…”