Patient perceptions of laser-assisted esthetic crown lengthening: open-flap vs. flapless techniques

Abstract

Objectives: Patient perception of and satisfaction with dentistry are important because they influence treatment adherence and overall outcomes. This study investigated patients’ perceptions of laser-assisted esthetic crown lengthening (ECL) for treating “gummy smiles” using either an open-flap or flapless technique. Materials and Methods: This study included 36 healthy patients with altered passive eruption who underwent esthetic crown-lengthening surgery and were randomly divided into two equal groups: open-flap and flapless. Gingivectomy and ostectomy were performed using an Er,Cr:YSGG laser in both groups. Patients’ perceptions of postsurgical morbidity were assessed using a 5-point self-administered Likert scale. The participants provided ratings on their levels of anxiety immediately after surgery, as well as their experiences with pain, swelling, bleeding, discomfort, tooth sensitivity, and use of pain medication after 7 days. Nine months after surgery, another survey was conducted to assess the overall satisfaction. Results: Patients reported higher anxiety after open-flap surgery than after the flapless procedure. Flapless surgery was also associated with less postoperative pain, swelling, bleeding, discomfort, sensitivity, and need for pain medication. Both groups reported high satisfaction with the final cosmetic outcome after 9 months, although patients who underwent flapless surgery tended to report even greater satisfaction. The flapless procedure was also significantly faster, taking approximately 15 min less than open-flap surgery. Conclusions: Flapless laser-assisted ECL offers several advantages over the open-flap method, including reduced patient anxiety, pain, discomfort, and shorter treatment time. Clinical Relevance: This study suggests that laser-assisted flapless ECL may be a more patient-friendly and efficient procedure compared to traditional open-flap surgery with similar esthetic results. This could be important for dentists looking to offer their patients a less invasive and potentially more comfortable option.