Vestibuloplasty Using 980nm Diode Laser

Shallow vestibules might obstruct oral hygiene maintenance and induce gingival recession owing to muscle traction. Food buildup during mastication is reported to be increased by insufficient vestibular depth combined with insufficient connected gingiva. As a result, a shallow vestibule that interferes with oral hygiene and adequate plaque management maintenance must be corrected. Vestibuloplasty, which can be done with a scalpel, electrocautery, or lasers, gives the requisite vestibular depth.

In certain instances, an anatomical variation such as higher insertion of the muscle attachments of vestibular mentalis and other associated muscles leads to a decrease in the vestibular depth and to make matters worse, an insufficient keratinized gingiva which is a critical component for the maintenance of periodontal health.

Considering the mucogingival problem posed by an inadequate vestibular depth, an array of treatment procedures such as gingival augmentation with the use of grafts and vestibuloplasty through a secondary epithelization have been planned to enhance the vestibular depth.

Vestibuloplasty is a mucogingival procedure that aims at the surgical modification of the gingiva-mucous membrane relationships including deepening of the vestibular trough, altering the position of the frenulum or muscle attachments, and widening of the zone of attached gingiva. A variety of vestibuloplasty techniques have been advocated in literature such as Edlanplasty, Kazanjian vestibuloplasty, etc. Most of these techniques have been used as pre prosthetic procedures to enhance the vestibular depth related to edentulous denture bearing areas

Clark’s vestibuloplasty became popular for improving vestibular depth and was also highly helpful in resolving the mucogingival issue linked with teeth. The intense pain and discomfort, as well as the delayed healing and high odds of relapse, were major downsides of these traditional vestibuloplasty treatments, making them less desirable.

Periodontal operations in the new century have evolved from very aggressive to less invasive. Lasers have provided the essential push for such a transition by delivering painless and acceptable methods. Lasers have several benefits over traditional scalpels, including the ability to provide a clean, sterile area with great hemostasis for the physician and reduced discomfort and edema for the patient afterwards.

Lasers are becoming increasingly popular in the field of dentistry providing alternative to conventional scalpel procedures. In recent years, lasers such as Nd:Yag, Er, diode, and diode in conjunction with Er:Yag have been used for frenectomy. The diode laser was introduced in the mid-90s. The diode laser contains a solid active medium and is composed of semiconductor crystals of aluminum or iridium, gallium, and arsenic. Wavelengths of diode laser range from 810 to 1064 nm. They are used in soft tissue surgeries as their wavelength approximates the absorption coeficient of pigmented tissue containing hemoglobin, collagen, melanin, and chromophores. The diode laser has been an effective choice for most clinicians worldwide owing to its compact size and affordability. They are used either in continuous or pulsating modes with fiber- optic surgical tips 

Herein we cover the following diode laser vestibuloplasty protocol as an exemple:
Initial therapy is completed for the patients and necessary oral hygiene instructions are given. Necessary laser protective equipment comprising of the laser safety glasses are worn by the clinician and the patient and proper precautions are taken. After application of topical anaesthetic gel and adequate anaesthesia is attained with a local infiltration anaesthesia, a 808 nm wave length diode laser with 400 μm surgical tip is used with the following settings; 1 to 1.5W in a continuous mode using an initiated tip. Ablation with the laser tip is initiated at the mucogingival junction with a horizontal stoke directing the laser parallel to the bone slowly relieving the muscle fibers till the desired depth. Tension is placed by retracting the patient’s lip to enable the laser assisted excision of the muscle fibers. After a sufficient vestibular depth was established, the lip is once again pulled to assess for any residual muscle fibers and if any fibers are noticed, they are excised with the laser tip.

Rapid advances in laser technology and a better knowledge of the bio-interactions of various laser systems have broadened the use of laser in dentistry. They are an ideal alternative to traditional knife surgery because to patient comfort, bloodless field, and reduced discomfort and recovery time. The diode laser has become an attractive alternative for frenectomy because to its compact size, low cost, fiber optic delivery, and convenience of use for minor surgery of oral soft tissue.

We strongly recommend the Portable(Blue three) model Surgery Laser System LASER-1.2B to fulfill the laser operational criteria for these types of procedures. This device is equipped with a Red Diode Laser pilot beam of 635nm, varying max power (10W+3W+200mW), CW, Single Or Repeat Pulse mode, and Fibers of 400um And 600um transmission system, making it a highly practical laser surgical option for Vestibuloplasty. Because of its peak absorption in hemoglobin and water permeability, the CO2 + KTP”-like laser unit of LASER-1.2B at a wavelength of 980nm is useful for coagulation, vaporisation, and bloodless surgery. It ensures a smooth and accurate procedure with little bleeding and post-operative pain and/or discomfort, as well as the avoidance of sutures.

This procedure is performed by a qualified Periodontist*

Reference: Diode laser frenectomy: A case report with review of literature
Evaluation of Patient Perceptions After Vestibuloplasty Procedure: A Comparison of Diode Laser and Scalpel Techniques

Disclaimer: Although the information we provide is used by different doctors and medical staff to perform their procedures and clinical applications, the information contained in this article is for consideration only. SIFLASER is not responsible neither for the misuse of the device nor for the wrong or random generalizability of the device in all clinical applications or procedures mentioned in our articles. Users must have the proper training and skills to perform the procedure with each Laser System.

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