Lasers have been used in dentistry for approximately two decades and are suitable for multiple procedures, including soft tissue treatment. Lasers for soft tissue treatments are available at varying powers and wavelengths and can be used for procedures that would otherwise be performed using electrosurgery or a scalpel. Laser dentistry generates very little to no heat and is a far gentler form of surgery. When used correctly, dental lasers enable soft tissue to be effectively, precisely, and safely removed.
Uses for soft tissue lasers include: gingivectomies and periodontal treatments, frenectomies, ablating and removing aphthous ulcers, gingival contouring, crown lengthening, troughing, soft tissue incisions, and removing soft tissue lesions.
Laser therapy provides the following advantages:
- Treatment will not harm dental hard tissue
- Laser therapy shouldn’t injure the dental pulp
- The patient will need minimal local anesthetic, and most patients prefer to receive some form of anesthesia
- Diode lasers are safe for use around dental implants
- They are also safe around PFM and full-metal crowns, and gold alloy and amalgam restorations
- Dental lasers provide excellent hemostasis (reduces bleeding)
- Soft tissue removal is very precise and predictable, and the pen-style holder provides good visibility
- Stitches and periodontal packs may not be required, which can be especially advantageous for pediatric or special needs patients
Laser therapy can be appealing for patient’s if they feel at all anxious about treatment. After treatment, most laser therapy patients will experience reduced post-operative pain, gingival swelling, and discomfort. Stitches may not be required due to hemostasis. Soft tissue treatment allows procedures to be performed on young children and infants who would otherwise require a general anesthetic.
All lasers produce heat, and this thermal conductivity can be useful in eliminating gram-negative bacteria.
Gingival Contouring with Soft Tissue Lasers
Gingival contouring using a soft tissue laser can provide a more comfortable treatment for the patient. Using a diode laser allows the clinician to quickly and precisely remove excess tissue with minimal or no bleeding, post-operative pain, or swelling. Laser energy cauterizes and seals capillaries, achieving hemostasis and preventing edema. Tissue damage is minimal, because a continuous sweeping motion is used during treatment. Healing occurs in a matter of days, and patients generally report low levels of discomfort during the healing process.
Benefits of Using Laser Surgery for Frenum Removal
Labial frenal attachments can inhibit lip movements, and sometimes the tissue can prevent the closure of a diastema during orthodontic treatment. Traditional frenectomies require the mechanical excision of the frenum, placement of stitches, and often considerable post-operative discomfort. With soft tissue laser therapy, the frenal attachment can be gently ablated before the laser coagulates and cauterizes the surgery site.
Safety When Using Lasers
Laser soft tissue treatment is extremely safe, provided operatory staff are adequately trained. It is vital for the clinician to understand the characteristics of the chosen wavelength, the limitations, and the thermal implications of the energy produced. For some treatments, it may be better to combine two different wavelengths for an optimal treatment outcome. One of the most critical factors is safeguarding eye health; protective eyeglasses must be worn when laser units are in use. Failure to wear glasses is one of the most commonly reported injuries associated with laser use.
Photobiomodulation (PBM) is a treatment option using laser therapy that focuses light to stimulate molecules within the tissue to promote healing. During PBM, photons enter the tissue and interact with the a mitochondrial component known as cytochrome c complex. This interaction triggers a biological cascade of events that leads to an increase in cellular metabolism, which can decrease pain as well as accelerate the healing process.
Photobiomodulation therapy is defined as a form of light therapy that utilizes non-ionizing light sources, including lasers, light emitting diodes, and/or broadband light, in the visible (400 – 700 nm) and near-infrared (700 – 1100 nm) electromagnetic spectrum. It is a nonthermal process involving endogenous chromophores eliciting photophysical (i.e., linear and nonlinear) and photochemical events at various biological scales. This process results in beneficial therapeutic outcomes including but not limited to the alleviation of pain, immunomodulation, and promotion of wound healing and tissue regeneration.
Lasers not only have the ability to deliver higher power for various conditions, but they also incorporate delivery systems that can efficiently treat tissue in a way that is comfortable to the patient. Simply stated, injured tissue requires threshold levels of light (photons) to be delivered in order to have a therapeutic effect. Hundreds of scientific studies on photobiomodulation therapy have been done in vivo and have characterized the dosages needed to achieve a cellular response to light.