Lasers hit the dental scene in the 1960s and their use in a range of procedures involving both hard and soft tissues has continued to grow ever since. One type of procedure in which lasers are finding their niche is in frenectomies.
There are different types of lasers, with varying wavelengths, but all comprise an energy source, which is amplified by a gain medium (a solid or a gas) and converted into light that is reflected through an optical resonator, which emits the beam.1Engineering360. Diode Lasers Information.
Lasers designed for use on soft tissues include diode, erbium, CO2 and Nd:YAG lasers. They are defined by the kind of active medium they contain. For example, a diode laser, which is most often used in general practices, operates on semiconductors; erbium lasers feature an erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr: YSGG) crystal medium; CO2 lasers feature a carbon dioxide gas medium; and in Nd:YAG lasers, neodymium-doped yttrium aluminum garnet is the crystal medium.2Linden E. Laser use in periodontics and peri-implantitis. Decisions in Dentistry. 2016;2(6):32–35.
Lasers and Frenectomies
Periodontists, as well as general dentists, use soft-tissue lasers to incise, excise and ablate soft tissues during esthetic and therapeutic treatments. Procedures ranging from gingivectomies to the treatment of periodontal disease and peri-implantitis have traditionally been performed via scalpel or electrosurgery. But while such techniques are still in use, laser surgery continues to gain ground in such applications.
One such place lasers are being applied is the frenectomy. Frenectomies are fairly common procedures in pediatric dentistry in cases of ankyloglossia, also known as tongue-tie, a condition in which the lingual frenum exerts too much restriction on tongue movement. It can compromise eating, speaking and oral hygiene. Frenectomies involve cutting or removing the band in either case to free up the organ.3Hearn GL. Dental laser applications in pediatrics. Decisions in Dentistry. 2018;4(7):28–31.[/mfv]
Labial frenectomies are perhaps less common. These are performed to excise or reposition the labial frenum, which often results in a large gap between the upper front incisors, while pulling on the gingiva enough to cause recession.
With technologies such as soft-tissue lasers, frenectomies can be easily, quickly and safely performed with less chance of scarring than would be possible with scalpels.
Less Pain, Less Discomfort
Lasers also have the advantage of allowing nearly painless surgical procedures. In fact, some patients may only require a topical anesthetic during treatment. An added benefit is that lasers also offer nearly bloodless surgery, as they cauterize and sterilize tissue as they go, minimizing the risk of infection.
Some procedures performed with a laser may not even require suturing. Further, lasers are reported to expedite healing with less discomfort compared with traditional techniques, and to stimulate tissue regeneration.
But with their use come certain risks. Proper training is critical, especially since these devices can emit high temperatures and they generate aerosols during use. Because airborne particles of vaporized tissue may contain viruses, clinicians should exercise appropriate precautions, including wearing eye protection, donning surgical masks and gloves, and using high-speed evacuation.3Linden E. Laser use in periodontics and peri-implantitis. Decisions in Dentistry. 2016;2(6):32–35.
Isolation and evacuation strategies for frenectomies enhance both safety and comfort for patients and clinicians. But systems such as Isolite offer even more. Not only are the throat and airway protected while integrated suction continually evacuates oral fluids, but through LED illumination, the visual field is enhanced, which fosters precision and efficiency. The Isolite mouthpiece can also be used by the patient as a bite block to take the stress off the jaw for added comfort. And in modern-day dentistry, comfort is key.