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CASE REPORT
Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 68-70

Laser frenectomy: Recommended in elderly patients


Department of Periodontology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India

Date of Web Publication21-Nov-2014

Correspondence Address:
Dattaprasad P Dadhe
Sinhgad Dental College and Hospital, S. No. 44/1, Vadgaon (Bk), Off Sinhgad Road, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-2868.145144

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  Abstract 

Buccal frenectomy is a common preprosthetic surgical procedure. It is a procedure usually done to aid denture stability. Although it is conventionally being performed using a scalpel, the diode lasers possess certain advantages such as rapid healing and less recurrence. Three cases of preprosthetic laser frenectomy are presented here with a satisfactory outcome.

Keywords: Diode laser, frenectomy, pre-prosthetic surgery


How to cite this article:
Lele SV, Garde JB, Dadhe DP, Karadkar VM. Laser frenectomy: Recommended in elderly patients. J Dent Lasers 2014;8:68-70

How to cite this URL:
Lele SV, Garde JB, Dadhe DP, Karadkar VM. Laser frenectomy: Recommended in elderly patients. J Dent Lasers [serial online] 2014 [cited 2020 Apr 4];8:68-70. Available from: http://www.jdentlasers.org/text.asp?2014/8/2/68/145144


  Introduction Top


The role of laser in dentistry is well-established in conservative management of oral problems. [1],[2] Diode laser has shown satisfactory results as an alternative to the conventional methods in the management of periodontal diseases and endodontics. [3],[4],[5]

Preparation of the oral tissue for the better retention, stability and support of the complete denture prosthesis is an essential step undertaken. The alveolar ridges must be round, smooth without any extra tissue bands like high frenum attachments. These tissue bands may jeopardize the denture support causing failure of the prosthesis. Therefore, removal of such high frenum becomes the important and unavoidable step to achieving successful prosthesis. It may be performed using conventional scalpel; however, diode laser is found to be more efficient in terms of healing and better tissue response. Thus, we undertook Diode laser as the choice of tool for three selected cases of high buccal frenum attachment and aspiring for complete denture at our center.


  Case Report Top


Three adult male patients underwent total dental extraction as a consequence of advanced generalized periodontitis. All patients were suffering from hypertension and under the medications for the same. No allergies reported. The average weight of the patients was 72.4 kg.

The clinical examination revealed the presence of a high frenum attachment extending from the alveolar ridge to the buccal vestibule in the region of mandibular molar. This could have led to the dislodgement of the denture [Figure 1].
Figure 1: Pre-operative picture showing high buccal frenal attachment

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It was decided to perform laser frenectomy under infiltrated local anesthesia [Figure 2]. The optical fiber used was 300 μm diameter allowing a very fine soft tissue cut. 2% lignocaine infiltrated in and around the frenum. The laser fiber was applied vertically and laterally to the frenum initially causing disruption of the mucosal continuity. This easily allowed performing a deeper cut of the frenum in a horizontal dimension. The whole procedure was performed in about 5 min, without pain. No sutures were required. Hemostasis was satisfactory immediately after the procedure [Figure 3]. All three patients were comfortable. Nine days later the healing was found to be normal [Figure 4].
Figure 2: Frenectomy being carried out by Diode laser

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Figure 3: Frenectomy completed

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Figure 4: Clinical picture after 9 days showing good healing

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  Discussion Top


Frenectomy is a frequent surgical procedure before the complete denture prosthesis. The benefit of diode laser lies in higher precision when compared to the scalpel, which results in less pain, bleeding, swelling and scarring. The procedure is quick, easy to perform, does not require nerve block and no sutures are required, which reduces the risk of post-operative infection and trismus. [6]

We have chosen laser as a treatment option avoiding the conventional blade for the above-reported cases considering these advantages.

Laser is known to transmit energy to the cells causing warming, welding, coagulation, protein denaturization, drying, vaporization and carbonization. [7] These processes are known to decrease the inflammatory tissue response and augment the healing. [8] Due to the debilitation, hypoproteinemia, and compromised immune system, elderly edentulous patients are prone to post-surgical infections subsequently leading to the delayed healing. It also prolongs the replacement of missing teeth further jeopardizing the nutrition.

Another advantage is lesser time required to perform the procedure. The conventional method generally requires more than 15 min that necessarily includes hemostasis and suturing. Whereas, the Laser indigenously possesses the property of cauterization that heals well by secondary intention. It also avoids the food lodgment across the sutures and omits the overall inconvenience to the patient.

Therefore, in our opinion, the laser may be considered as the preferred choice for the pre-prosthetic surgical procedures in elderly individuals.

 
  References Top

1.
Ishikawa I, Aoki A, Takasaki AA. Clinical application of erbium: YAG laser in periodontology. J Int Acad Periodontol 2008;10:22-30.  Back to cited text no. 1
    
2.
Kafas P, Kalfas S. Carbonization of a radicular cyst using fiber-optic diode laser: A case report. Cases J 2008;1:113.  Back to cited text no. 2
    
3.
Capodiferro S, Maiorano E, Scarpelli F, Favia G. Fibrolipoma of the lip treated by diode laser surgery: A case report. J Med Case Rep 2008;2:301.  Back to cited text no. 3
    
4.
de Souza EB, Cai S, Simionato MR, Lage-Marques JL. High-power diode laser in the disinfection in depth of the root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e68-72.  Back to cited text no. 4
    
5.
Kafas P, Dabarakis N, Theodoridis M. Performing gingivoplasty without injected anaesthesia: A case report. Surg J 2008;3:27-29.  Back to cited text no. 5
    
6.
Kafas P, Angouridakis N, Dabarakis N, Jerjes W. Diode laser lingual frenectomy may be performed without local anaesthesia. Int J Orofac Sci 2008;1:1.  Back to cited text no. 6
    
7.
Sarver DM, Yanosky M. Principles of cosmetic dentistry in orthodontics: Part 2. Soft tissue laser technology and cosmetic gingival contouring. Am J Orthod Dentofacial Orthop 2005;127:85-90.  Back to cited text no. 7
    
8.
Sharma S, Saimbi CS, Koirala B. Erosive oral lichen planus and its management: A case series. JNMA J Nepal Med Assoc 2008;47:86-90.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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Discussion
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