Minimally invasive erbium flap (MINIETM flap)—a retrospective surgical treatment for chronic periodontitis

Abstract

This clinical retrospective split-mouth study was designed to evaluate the efficacy of two (FDA approved) erbium laser wavelengths in a minimally invasive flapped approach for the treatment of generalized chronic periodontitis. Twenty-eight (28) patients diagnosed with generalized chronic periodontitis with pocket depths ranging from 4 to 9 mm had 551 posterior teeth surgically treated in a minimally invasive manner and were followed over 6 months. Minimally invasive erbium (MINIE) flaps were performed in all four posterior sextants (distal of cuspid to distal of second molar) in a traditional splitmouth design. Mean baseline probings were 5.4 mm. Patients were randomly assigned to Laser 1 (Er:YAG, Erbium doped yttrium, aluminium, garnet, 2940 nm or Laser 2 (Er, Cr:YSGG, Erbium, chromium doped yttrium, scandium, gallium, garnet, 2780 nm) in the first appointment. The alternate laser wavelength was used in the second appointment. Pre-surgical examination for pocket depth (PD), recession (RC), and clinical attachment levels (CAL) was performed and then repeated 6 months post-surgery. Patients with history of traditional flap surgery (> 5 years ago) completed a visual acuity test (VAT) describing their surgical experience compared to the conventional approach. The results showed statistically significant improvements in PD (1.43 mm) and reduction in CAL (1.41 mm), whereas the change in RC (0.01 mm) was not statistically significant. Clinical improvements of PD and CAL in this study are consistent with the range reported in previous landmark papers implementing a modified Widman flap (MWF) or osseous surgery (OS). The difference compared to traditional procedures was that there was no statistically significant change in RC over 6 months. The patients' experience was much improved compared to traditional flap surgery [1,2].

Efficacy of the Er,Cr:YSGG Laser Application Versus the Conventional Method in Periodontal Flap Surgery: A Split-Mouth Randomized Control Trial

“…They also concluded that in comparison to those traditional techniques, no significant change in terms of recession in patients treated with the minimally invasive erbium flap technique was observed over a six-month period. 46 These researchers had used hand instruments and ultrasonic devices for calculus removal after raising the periodontal flaps and laser only for smear layer removal, However, in the current study we used the laser irradiation for removal of any remaining calculus in hard-to-reach areas with a lower frequency setting of the device and then the setting was adjusted to a higher frequency to achieve a smoother root planing surface and detoxification.…”