Learn about the causes of gingival enlargement and some of the benefits of LightScalpel CO2 laser gingivectomies. Laser gingivectomy for treatment of gingival hyperplasia. A, Presurgical view. B, Ten days after the laser procedure. The cause of the hyperplasia was lack of. One of these is gingivectomy and it is the main topic discussed in this article. It is a dental procedure that is done with a hard tissue laser or old gold standard.
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Group 1 show no significant differences in plaque and gingival means between the visits, the bacteriological examination showed no growth of bacteria and histological examination revealed less inflammatory cells than Group 2.
Laser gingivectomy – Wikipedia
Group 2 show significant differences in plaque and gingivvectomy indices between the visits. Though gungivectomy remains the gold standard choice in gingivectomy but Diode laser may have some advantages over it. Diode Laser Versus Scalpel Gingivectomy.
Biomed Pharmacol J ;10 4. Gingivectomy is a surgical procedure of excising the unsupported gingival tissue to a level where it is attached and create a new gingival margin that is apical to the old position.
Different methods can be used to perform gingivectomy; of the most common are scalpel and laser.
For many years, scalpel were been used in performing gingivectomy in which small surgical blades and other periodontal surgical instruments were used to cut the tissue and place the gingival margin in a more ideal position 4.
Scalpel has advantages of easy to be used, precise incision with well-defined margins, the healing is fast, and there is no lateral tissue damage.
While the disadvantages of alser are need of giving anesthesia, bleeding that result in inadequate visibility and the incision cut is gingivechomy sterilized.
LASER is an acronym for light amplification by stimulated emission of radiation. YAG and the Erbium: In our research we used the Diode laser, Diode laser is highly lsaer by hemoglobin and melanin that allows easy manipulation of soft-tissue during gingival recontouring, and improved epithelization and healing of the wound.
The better control of laser, less post-operative inflammation and pain and gingivectomh improved healing in the surgical site all are the benefits of using laser in surgery. This study was done to examine the differences between using Diode laser and scalpel in performing gingivectomy, and to evaluate the differences in bacterial count in the surgical area and patient perception regarding the need of taking pain killer following the surgery and the presence of discomfort during eating and speech.
Fifty subjects with an age range from years old had participated in this study, they were all systemically healthy, nonsmoker, and they were diagnosed as having plaque-induced gingivitis and gingival enlargement.
They were divided into two groups: Group 1 includes 25 subjects in which gingivectomy was done using the Diode Laser.
Group 2 with 25 subjects in which scalpel had been used to perform conventional gingivectomy. The surgeries were performed at the periodontic department in the college of dentistry- university of Baghdad.
All surgeries were done after explaining to the patient the aim of our study and informed consent was taken. Scaling and polishing were done to all the participants prior to the surgery.
In Group 2, periodontal gingivectoomy was placed after the surgery and was lazer after one week. Microbiological samples gingivdctomy been collected with the use of sterile paper points from the surgical area immediately after performing gingivectomy and then sent to the microbiological lab to measure the presence or absence of bacterial growth after 24 hours and 72 hours of incubations.
The tissue removed during the surgery had been sent for histopathological examination. A second biopsy was taken at the 3 rd visit and also been sent to histopathological examination. Regarding the post-operative pain, at the follow up visit the patients had been asked if they needed to use any pain killer. Also they were asked about any discomfort and difficulty during speech and eating.
Bacterial growth in group 1. Click here to View figure. The subjects in Group 2 all experienced some discomfort in speech and eating after the surgery and before the removal of the periodontal pack, while in Group 1 none of the patient experienced any discomfort. The mean of the plaque index in Group 1 was 1. For the gingival index, the mean in Group 1 was 1.
Using the t-test, there was a high significant difference between the means of the plaque index and a significant difference in the means of the gingival index at the 2nd and the 3rd visits in Group 2, while there were no significant differences between the means of the plaque index as well as the gingival index in Group 1.
The biopsy taken immediately during the conventional gingivectomy shown dense fibrous connective tissue stroma and stratified squamous epithelium while the ginivectomy biopsy showed necrotic epithelium and burning like appearance with no clear demarcation between layers.
Seven days later, lasee biopsies were taken, in conventional gingivectomy moderate fibrous connective tissue with dense inflammatory infiltrated cells. In Laser the biopsies revealed densely fibrous connective tissue with fewer lasser cells and clearly re-epithelization suggestive of good histological healing. Deciding whether to do a conventional gingivectomy by scalpel or to use laser depends on many factors, in our study we compared between the two methods.
First of all the surgery was easier and quicker in Laser than conventional gingivectomy. Bleeding was observed in the conventional gingivectomy while relatively blood-less gingivvectomy laser. Less anesthesia is needed in laser gingivectomy. A significant increase in the plaque index and the gingival index had been seen in patients with conventional gingivectomy when comparing the means at the day of the surgery and after week at the removal of the periodontal pack, this could be explained by the presence of periodontal pack which act as retentive factor for plaque leading to gingival gingivsctomy.
Histologically, in the biopsy taken after 7 days less infiltration of inflammatory cells had been seen in laser with a good improved epithelization, which result in reducing the scars and the contraction of the wound and llaser improve the healing. This work is licensed under a Creative Commons Attribution 4. October 16, Manuscript accepted on: November 03, Published online on: Copy the following to cite this article: Copy the following to cite this URL: Bacterial growth in group 1 Click here to View figure.
Bacterial growth in Group2 Click here to View figure. Discomfort Click here to View figure.