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

Abstract Background and objective Diode 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. Method This 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). Results The average bleeding rates were 1.15 and 0.36 in the conventional and laser groups, respectively (Mann-Whitney U P &lt; 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 &lt; 0.001). Conclusion 940-nm diode laser seems promising in reducing postoperative bleeding and pain of patients needing cosmetic smile lift surgeries. </jats:sec

Evaluation of the Diode laser (810nm,980nm) on dentin tubule diameter following internal bleaching

Background: The aim of this study was to evaluate the effect of diode laser irradiation and bleaching materials on the dentinal tubule diameter after laser bleaching. Material and Methods: The dentin discs of 40 extracted third molar were used in this experiment. Each disc surface was divided into two halves by grooving. Half of samples were laser bleached at different wavelengths with two different concentrations of hydrogen peroxide. Other half of each disc with no laser bleaching remained as a negative control. Dentin discs were assigned randomly into four groups (n=10) with following hydrogen peroxide and diode laser wavelength specifications; Group 1 (30% - 810 nm), group 2 (30% - 980 nm), group 3 (46% - 810 nm) and group 4 (46% - 980 nm). All specimens were sent for scanning electron microscopic (SEM) analysis in order to measure tubular diameter in laser treated and control halves. Data were analyzed by ANOVA and Tukey test (p<0.05). Results: A significant reduction in dentin tubule diameter was observed in groups 1, 2 and 4. There was no significant difference between groups 1 and 2 and between groups 3 and 4 after bleaching. Conclusions: The SEM results showed that diode laser was able to reduce dentin tubule diameter and its effect on dentin was dependent on chemical action of bleaching material

One Visit Providing Desirable Smile by Laser Application

Introduction: Providing desirable smile is one of the main concerns in cosmetic dentistry. Hyperpigmentation is one of the esthetic concerns especially in gummy smile patients. Lasers with different wavelength are used for oral surgery including Carbon Dioxide Laser (CO2), Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG), Erbium family and diode laser. In this case, all esthetic procedures including gingival depigmentation, caries detection and removal were done by laser technology in one session.Case study: A 40- year-old male with a chief complaint of black gingiva in upper jaw was referred. The right side of maxillary was anesthetized and depigmentation was done by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er-Cr: YSGG) laser. Due to scores obtained from Diagnodent which indicated caries in dentin, the cavities were prepared by Er-Cr:YSGG laser. The cavities were restored by composite resin. The patient was advised to keep oral hygiene instructions and use mouthwash.Results: The patient reported no pain after surgery and did not use any systemic antibiotic. After 4 weeks, complete healing was observed.Conclusion: Considering acceptable clinical outcome, Er-Cr: YSGG laser can be considered as an effective method for combination of soft and hard tissue treatment

Oral Mucositis Prevention and Management by Therapeutic Laser in Head and Neck Cancers

Introduction: Oral mucositis is considered a severe complication in cancer patients receiving radiotherapy or chemotherapy for head and neck cancer. The aim of this review study was to assess the effect of low level laser therapy for prevention and management of oral mucositis in cancer patients.Methods: The electronic databases searched included Pubmed, ISI Web of Knowledge and Google scholar with keywords as “oral mucositis”, “low level laser therapy” from 2000 to 2013.Results: The results of most studies showed that photobiomodulation (PBM) reduced the severity of mucositis. Also, it can delay the appearance of severe mucositis.Conclusion: Low level laser therapy is a safe approach for management and prevention of oral mucositis

Comparative Study of the Shear Bond Strength of Flowable Composite in Permanent Teeth Treated with Conventional Bur and Contact or Non-Contact Er:YAG Laser

Introduction:The aim of this study was to evaluate and compare the in vitro effect of the Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser with different radiation distances and high-speed rotary treatment on the shear bond strength of flowable composite to enamel of human permanent posterior teeth .Methods : freshly extracted human molar teeth with no caries or other surface defects were used in this study (n=45). The teeth were randomly divided into 3 groups. Group 1: treated with non-contact Er:YAG Laser and etched with Er:YAG laser, Group 2: treated with contact Er:YAG Laser and etched with Er:YAG laser, Group 3 (control): treated with diamond fissure bur and etched with acid phosphoric 37 % . Then the adhesive was applied on the surafces of the teeth and polymerized using a curing light appliance. Resin cylinders were fabricated from flowable composite. Shear bond strength was tested at a crosshead speed of 0.5 mm/min.Results: The amount of Shear Bond Strength (SBS) in the 3 treatment groups was not the same (P&lt;0.05).The group in which enamel surfaces were treated with diamond fissure bur and etched with acid (conrtol group) had the highest mean shear bond strength (19.92±4.76) and the group in which the enamel surfaces were treated with contact Er:YAG laser and etched with Er:YAG laser had the lowest mean shear bond strength (10.89±2.89). Mann-whitney test with adjusted P-value detected significant difference in shear bond strength between the control group and the other 2 groups (P &lt; 0.05).Conclusion: It was concluded that both contact and non-contact Er:YAG laser treatment reduced shear bond strength of flowable resin composite to enamel in comparison with conventional treatment with high speed rotary. Different Er:YAG laser distance irradiations did not influence the shear bond strength of flowable composite to enamel

The Esthetic Crown Lengthening by Er;Cr:YSGG laser: A Case Series

Introduction: Laser technology as a new modality in dentistry has gained special attention. Among different types of lasers, erbium lasers have gained special attention for management of oral soft and hard tissue simultaneously. This study presents series of cases of crown lengthening (CL) and restorations accomplished by erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG).Case Reports: Seven patients were selected for this study. After complete oral examination and diagnosis, the treatment plan of each patient was designed. All cases needed esthetic CL. In some cases, frenum revision and class V cavity preparation was done by Er;Cr:YSGG laser. All patients treated with Er;Cr:YSGG laser producing a wavelength of 2780 nm (Biolase, Irvine, California, USA); Tip T4, 400 μm Diameter for soft tissue management and Tip G6, 6 mm long, 600 μm diameter for hard tissue management.Results: All patients reflected acceptable results based on clinical evaluation and patients’ declaration of post-surgical status.Conclusion: Using Er;Cr:YSGG laser in class v cavity preparation and flapless CL seemed to be effective and beneficial

Morphological Changes of Human Dentin after Erbium- Doped Yttrium Aluminum Garnet (Er:YAG) and Carbon Dioxide (CO2) Laser Irradiation and Acid-etch Technique: An Scanning Electron Microscopic (SEM) Evaluation

INTRODUCTION: The aim of this study was to investigate the morphological changes of human dentin after Erbium-Doped Yttrium Aluminum Garnet (Er:YAG), Carbon Dioxide (CO2) laser-irradiation and acid-etching by means of scanning electron microscopic (SEM)METHODS: 9 extracted human third molars were used in this study. The teeth were divided in three groups: first group, CO2 laser with power of 1.5 w and frequency of 80 Hz; second group, Er:YAG laser with output power of 1.5 W frequency of 10 Hz, very short pulse withwater and air spray was applied; and third group, samples were prepared by acid-etching 37% for 15 sec and rinsed with air-water spray for 20 sec. Then, the samples were prepared for SEM examination.RESULTS: Melting and cracks can be observed in CO2 laser but in Er:YAG laser cleaned ablated surfaces and exposed dentinal tubules, without smear layer was seen.CONCLUSION: It can be concluded that Er:YAG laser can be an alternative technique for surface treatment and can be considered as safe as the conventional methods. But CO2 laser has some thermal side effects which make this device unsuitable for this purpose.

Defocused Irradiation Mode of Diode Laser for Conservative Treatment of Oral Hemangioma

Vascular lesions rise from abnormalities in blood vessels or endothelial proliferation. Capillary hemangiomas are formed by small capillaries surrounded by a layer of endothelial cells in a connective tissue stroma. Various treatments are used for these conditions like excisional surgery, sclerotherapy, and recently laser irradiation. In this case study, we report successful treatment of intraoral capillary hemangioma by gallium/aluminum/arsenide (GaAlAs) laser. A 29 year old woman with a red lesion on the upper side of the right maxillary premolar was referred to private dental office. The Diode laser with wavelength of 810 nm was selected for treatment of the lesion in defocused mode by output power of 4 W in continuous mode. No bleeding was observed during surgery which provided better vision for surgeon and resulted in a minimally invasive procedure. According to results, Diode laser can be considered as a conservative modality in treatment of oral capillary hemangioma, especially in the esthetic zone

Effect of Different Powers of Er,Cr:YSGG Laser Treatment on Surface Morphology of Microhybride Composite Resin: Scanning Electron Microscope (SEM) Evaluation

Introduction: The aim of this study was to evaluate and compare microhybride composite treated by bur and different power of Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser by Scanning Electron Microscope (SEM).Methods: 21 microhybride composite blocks (DiaFil TM, DiaDent, Korea) with 2 × 4 × 4 mm dimensions were made. The bonding surface of these blocks were polished, The samples were put into 6 groups for laser irradiation as follows: Group 1 (power: 1W, Energy: 50 mJ); Group 2(power: 2 W, Energy: 100mJ); Group 3 (power: 3W, Energy: 150mJ); Group 4 (power: 4W, Energy: 200mJ); Group 5 (power: 5W, Energy: 250mJ) and Group 6(power:6 W, Energy :300mJ). One group prepared by bur- treated. All samples were prepared by repetition rate of 20 Hz. Then, the samples were prepared for SEM examination.Result: Some irregularities were seen in Er,Cr:YSGG laser samples in comparison to Bur group that produced favorable surface for adhesion of repair composite.Conclusion: Among different lasers, Er;Cr:YSGG laser can be chosen as a suitable technique for surface treatment of unsatisfactory composites.Key words: SEM evalution; laser; composite resi

The Versatility of 980 nm Diode Laser in Dentistry: A Case Series

Introduction: Laser surgery has been considered a popular alternative over conventional modalities in dentistry during the last few years. Among different types of lasers, diode lasers have gained special attention in oral soft tissue surgery.Case Reports: Five patients were referred to a private office. After careful evaluation of medical history and oral examination, oral diagnosis and treatment plan of each patient was established as follows: (1) A 21-year-old female with ankyloglossia (tongue-tie); (2) A 65-year-old female with a poor denture fit needing vestibuloplasty and frenectomy; (3) A 10-year-old male patient with pigmented gingiva in mandible and maxilla; (4) A 14-year-old female needing exposure of maxillary right canine for bracket bonding; and (5) A 25-year-old female patient who has a gingival maxillary frenum with a nodule. The treatment plan for all the patients was laser surgery with diode laser at 980 nm, in continuous mode.Results: All the patients experienced normal healing process with no postoperative complications. Favorable outcomes of laser surgery were observed on follow-up sessions.Conclusion: Considering the versatility of the 980 nm diode laser in oral soft tissue surgeries and the advantages of laser surgery, this study suggests the use of 980 nm diode laser in this regard