Effects of laser-assisted cosmetic smile lift gingivectomy on postoperative bleeding and pain in fixed orthodontic patients: a controlled clinical trial

Abstract

Background and objectiveDiode lasers are becoming popular in gingival treatment following orthodontic treatments. Despite their merit and clinical implications, postoperative pain and bleeding after surgery with diode lasers are not assessed except in few controversial studies.MethodThis controlled clinical trial was conducted on 30 healthy orthodontic patients aged 17–29 years, needing esthetic-only gingivectomy in the anterior maxilla. The patients were randomly divided into two groups of 15 each: experimental (laser-assisted surgery) and control (traditional surgery using scalpels). The bleeding rate following the surgery was assessed using the bleeding criteria established by the World Health Organization. The postsurgical pain level was recorded using visual analog scales immediately after the surgery and in patients who consumed analgesics, also 2 h after the analgesic consumption. The data were analyzed using the independent-samples t, Mann-Whitney U, and chi-square tests (α = 0.05).ResultsThe average bleeding rates were 1.15 and 0.36 in the conventional and laser groups, respectively (Mann-Whitney U P < 0.05). Experimental patients had no postsurgical pain (VAS1 and VAS2 = 0). In the control group, the average VAS1 pain was 5.2 out of 10. The difference between VAS1 values in the control/experimental groups was significant (Mann-Whitney U P < 0.001).Conclusion940-nm diode laser seems promising in reducing postoperative bleeding and pain of patients needing cosmetic smile lift surgeries.

Laser Surgery of Soft Tissue in Orthodontics: Review of the Clinical Trials

“…Table 1 shows a summary of clinical trials that were included in this study. Four studies used laser for gingivectomy 10,29,31,32 and 2 studies reported labial frenectomy. 19,32 Lingual frenectomy was investigated by 2 articles.…”

“…However, the types of topical anesthetic drugs are not the same. Junior et al and Aboelsaad and Attia 29 have used benzocaine 20% compared with Seifi et al, To et al 10 and Sobouti et al 31 that have applied tetracaineadrenaline-cocaine also called as TAC 20% (lidocaine 20%, tetracaine 4%, and phenylephrine 2%). Other authors did not mention the type of topical anesthetic that was used.…”

“…17 Some studies claimed that laser decreased postoperative pain. 31 Four studies only used topical anesthesia in laser groups. 10,29,31,32 Aboelsaad and Attia 29 used topical anesthetic gel and applied local anesthesia injection when needed, but the author did not mention how many patients finally got the injection.…”

“…Thirty patients were treated in a study by Sobouti et al with the indication of esthetic-only gingivectomy in anterior maxilla region. 31 Fifteen patients received laser-assisted surgery by diode laser, and conventional surgery by scalpel was conducted for the control group. The experimental group had no postoperative pain and bleeding rate significantly decreased in the laser group.…”

“…32 Six studies used diode laser. 9,10,29,[31][32][33] Junior et al used neodymium-doped yttrium aluminium garnet (Nd:YAG) laser for labial frenectomy in comparison with conventional surgical procedure. 19 Jahanbin et al used Er:YAG laser for fiberotomy.…”