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Laser Assisted Periodontal Procedures   « Back to Newsletters
Dental lasers have recently gained a lot of popularity due for various reasons. Our medical colleagues have been using lasers extensively for the past 30 years to perform procedures like uvuloplasty, cyst and aphthous ulcer removal, and more recently cosmetic laser skin resurfacing. The advantages of using the laser versus conventional surgery are:
American Dental Technologies (ADT) pioneered laser use in dentistry and obtained FDA clearance in 1990 for laser-assisted soft tissue procedures. There are different types of lasers based on their operating wavelength. Diode laser is becoming one of the most popular types due to its portability, light weight and versatility. The DioLase ST dental laser system is a portable instrument intended for ablating, incising and coagulating soft tissue using a contact fiber optic delivery system. "Addition of DioLase ST unit to my practice allowed me to perform a variety of cosmetic periodontal procedures in less time and with a more predictable post-operative result", - said Dr. Carrie Berkovich, whose focus is on achieving maximum esthetic outcome in dental and periodontal treatment. "Procedures like gingivectomy/gingivoplasty, tissue contouring prior to porcelain veneers and/or crown placement, esthetic crown lengthening, frenectomy, reduction of excessive gingival display or gingival overgrowth, and biopsies constitute a large proportion of contemporary periodontics, and lasers have definitely enhanced the results and simplified the course of treatment", - further adds Dr. Berkovich. Here is the example of how laser assisted procedure was used to correct gingival color and contour. Brown or dark pigmentation and discoloration of gingival tissue, whether physiological or pathological, can be caused by a variety of local and/or systemic factors. Frequently, the gingival hyperpigmentation is caused by excessive melanin deposition. Melanin hyperpigmented gingiva is an esthetic problem to many individuals, especially those with gummy smiles. People become more conscious of the black or dark patches of pigmentation and request their removal, particularly if the hyperpigmentation is visible during smile and speech. Clinicians have tried to remove melanin hyperpigmentation of the gingiva by various methods. Chemical agents such as phenol and alcohol have been used in combination; however, these chemical agents are quite harmful to oral soft tissues. Free gingival graft surgery has also been used to eliminate the hyperpigmented area; but this requires an additional surgical site and color matching. Abrasion technique, using a large, round diamond bur in a high-speed handpiece with copious irrigation, has also been used, but it is difficult to control the depth of de-epithelialization and to obtain adequate access. Gingivectomy (gum removal) has also been used; however, this is associated with loss of alveolar bone, prolonged healing by secondary intention and excessive pain. Gingevectomy results in non-permanent depigmentation when performed solely for cosmetic reasons. In this case, diode laser was used in eliminating the melanin hyperpigmented gingiva, producing great esthetic result.
This is another example of using laser to treat drug-induced gingival overgrowth. It has been shown that certain medications, such as calcium-channel blockers (Nifedipine, Procardia, etc.) that are used to treat hypertension, immuno-suppressants (Cyclosporine) and anti-epileptic agents (Phenytoin) largely contribute to gingival overgrowth, which can affect both function and appearance of some people. Maintaining good oral hygiene is the key to minimize this adversary drug effect. However, when the condition has already developed, the only way to treat it is via periodontal surgical procedure, aimed at removal and contouring of soft tissues to produce an adequate functional and esthetic result.
If you have any questions or would like to discuss your case, please do not
hesitate to contact Dr. Berkovich. We look forward to helping you achieve great
health and a beautiful smile!
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